Caring for an individual with dementia can present a number of challenges to the caregiver. Dementia may cause the individual to exhibit behaviors that seem strange and irrational. Dementia also creates difficulty with memory, thinking ability, communication, and control of bodily functions. Understanding the issues can help you as a caregiver to develop strategies to better care for dementia patients.
Wandering
Individuals who suffer from dementia seem to wander aimlessly at times. They may be restless or trying to find someone or something. They may start off with a purpose, and then forget where they are going and get back. You can minimize the risk of a person with dementia wandering outside by installing "child-safe" plastic covers over doorknobs or putting a home security system in place. It is also wise to have a person prone to wandering wear identification jewelry or a tag with his name and address affixed to his clothing.
Incontinence
As dementia progresses, loss of bowel or bladder control is common. Accidents may occur when the individual doesn't remember where the bathroom is or cannot make it in time. When accidents happen, it is important to be understanding and reassuring to maintain the person's dignity and reduce embarrassment. It may help to establish a routine to use the bathroom on a set schedule. Easy-to-remove clothing will also help the individual to avoid accidents. If necessary, incontinence pads can be used.
Agitation/Paranoia
Agitation and paranoia in dementia patients can result in a range of behaviors from irritability to verbal or physical aggression. Sometimes agitation is triggered by fatigue, fear or changes in the environment. To minimize agitation, maintain routines and keep furnishings and objects in the same locations. Avoid excess noise, clutter and large groups of people. When agitation occurs, try to redirect the person to a pleasant activity such as a favorite T.V. show or a snack. The person may make false accusations and accuse someone of stealing an object that is missing. Avoid arguing and handle the situation by empathizing with her feelings then helping to find the missing object.
Repetitive Speech or Actions
Sometimes a person with dementia will repeat a word, phrase or activity over and over. While this behavior can be stressful and annoying to caregivers, it is usually harmless to the person with dementia. This behavior may be caused by anxiety, fear or boredom. When it happens, try to distract the individual with a different activity. Avoid discussing an upcoming event until immediately prior to avoid causing him worry and anxiety.
Sundowning
Sundowning involves behaviors including restlessness, disorientation and agitation that often escalate at the end of the day and continue through the night. Factors such as exhaustion and biological clock changes are believed to cause this behavior in dementia patients. Sundowning can be minimized by restricting sugary foods and caffeine to the morning hours and encouraging physical activity during the day. Keep the evening hours calm and utilize adequate lighting to avoid shadows, which can be disorienting.
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