Care Tips for Patients with Alzheimer’s
June 05 2018
Providing Good Care for Patients with Cognitive Impairment
Alzheimer’s is a terrible disease that slowly destroys memory and thinking skills. Eventually the patient’s ability to carry out simple tasks becomes difficult or even non-existent. It is particularly hard on the patient’s family, as they watch their loved one deteriorate and eventually, perhaps not be able to recognize their own family and friends. It is as if their loved one becomes someone they don’t recognize.
Each day is different when dealing with Alzheimer’s patients. There are some good days where they have more lucid moments and there are some bad days where they fall into restlessness, become agitated or even hallucinate or experience paranoia.
There are several ways in which an Alzheimer’s patient and their family will need help or care. These include helping with changes in behavior and communication, everyday care, safety, relationships and caregiver health.
Changes in Communication
- Gain the patient’s attention, sit in front of and at the same level as the patient and maintain eye contact.
- Help to orient the patient by explaining or re-explaining who you are and what you will be doing.
- If the patient has difficulty finding a word, gently provide assistance.
- Make it clear the encounter is not a “test” but a search for information to help the patient.
- Use simple and direct wording, presenting one question, instruction or statement at a time. If the patient doesn’t understand, rephrase your statement. Use yes-or-no and multiple choice questions.
- Hearing and vision problems in the patient can add to their confusion.
Changes in Behavior
- Note that causes of these behavioral changes include pain; depression; stress; lack of sleep; constipation; soiled underwear; sudden change in place, routine or person; feelings of loss; too much noise or stimulus; feeling lonely; being pushed to do something they don’t want to do or an interaction of medicines.
- Speak calmly and reassure the patient. Listen to their concerns and frustrations and show your understanding.
- Allow the patient to keep as much control in his or her life as possible.
- Keep a routine. Daily tasks should be done at the same time each day.
- Build quite times into the day, along with activities. Try soothing music, reading or walks.
- Reduce noise, clutter and the number of people in the room.
- Try to distract the patient with a favorite snack, object or activity.
- To prevent wandering, keep shoes, keys, coats and other signs of departure out of sight. If a patient has a history of wandering, it is best they are not left unattended.
- If a family caregiver lives with them and is present 24/7, the family can install a security system that announces when a door is opened to help them keep track of their loved one without worrying about having them in sight every moment of the day.
- Gather up all your supplies before starting the bathing process.
- Keep the patient calm. Be gentle and respectful, telling the person what you are going to do step-by-step. Let them keep as much of their dignity as possible, giving them a towel to put over them to help them feel less exposed.
- If the patient tends to be aggressive, give them a washcloth to hold, making it less likely he or she will try to hit you.
- Never leave a confused or frail patient alone in the tub or shower.
- After bathing, pat their skin dry to prevent infections or rashes.
- When the patient has trouble getting in and out of the tub or shower, do a sponge bath instead.
- Allow the patient to dress on his or her own as long as possible, providing gentle help or instructions when needed
- Place some clothes in another room to reduce the number of choices for the patient. If the patient likes to wear the same clothes every day, have the family purchase several sets.
- Choose loose fitting clothes, cotton socks and underwear and pants with elastic waistbands.
- When you like how you look, you feel better! Remember to let the patient do as much as possible by himself or herself, providing instructions when needed or showing them how to do something.
- It is important to have good mouth help so encourage the patient to brush their teeth or clean their dentures.
- If a patient wants to wear makeup, help them put on powder and lipstick; avoid eye makeup.
- Encourage the patient to shave, helping as needed; use an electric razor for safety.
- Keep the patient’s nails clean and trimmed.
A patient with cognitive impairment and confusion may need some changes throughout the home to help keep them safe.
- Hide a spare house key outside in case the patient locks you out of the house.
- Telephones ringers should be set to low and the least number of rings possible. An answering machine should also be used. The ringing can cause agitation or the patient could become the victim of telephone scam.
- Each room should have adequate lighting. Use nightlights, especially in bathrooms and bedrooms.
- Cover or mark dangerous things such as unused electrical outlets and hot surfaces like radiators.
- All general safety steps should be in place, such as working smoke and carbon monoxide detectors, keeping flammable materials away from sources of heat.
- Use mobility and medical aides when needed. Hand rails, safety bars and grip strips should be used where needed. Outside, mark uneven surfaces or steps with reflective or colored tape. Lock doors or cabinets in the kitchen if the patient has a tendency to “play” with things that are considered unsafe for them.
- Keep all areas where people walk free of furniture. Tack cords along the walls to prevent tripping. Remove rugs that could cause a tripping hazard.
- Medications, including over-the-counter should be kept locked up to prevent the patient from accidently overmedicating or overdosing.
- Keep plastic bags out of reach to prevent suffocation. Remove flammable sources such as lighters or fuel tanks on grills. The patient should be monitored when using items such as these. Remove or secure any other item that may present a danger to the patient, such as “junk drawers,” artificial fruits and vegetables or anything that appears to be edible but isn’t, such as cleaning supplies.
- Family members should remove all guns and other weapons from the home or lock them up. They should install safety locks on guns or remove ammunition and firing pins. They should also lock all power tools and machinery in the garage, workroom or basement.
- Live-in caregivers may want to use a monitoring device, like those used for infants, at night in the patient’s bedroom and/or bathroom to alert them to sounds indicating fall or the need for help.
- Remove the locks from bathroom doors to prevent the patient from getting locked inside. Do not leave a severely impaired patient alone in the bathroom.
Family and friends might have a hard time communicating or dealing with their loved one. You can help them to cope and communicate better.
- Provide information for families with teenage or young children to help parents communicate what Alzheimer’s to help younger family members understand the effects of the disease.
- Share tips for better communication, such as the tips you use to communicate with the patient (see above).
- Remind them to be patient with their loved one and to avoid correcting them when they make mistakes or forgets things.
- Help the family understand how to schedule visitors so that the patient doesn’t become over-stimulated and agitated, keeping the number of people in a room to a minimum and scheduling them to visit during the time of day when the patient is at their best.
- Remind them to respect their loved one’s personal space and to not take it personally if their loved one doesn’t recognize them or is unkind or angry.
- Being out in public, their loved one may do or say odd things. The family may want to consider carrying a card that reads, “My family member has Alzheimer’s disease. He/She might say or do things that are unexpected. Thank you for your understanding.” This will allow them to let others know without having to say it out loud or explain it over and over again.