Alzheimer’s disease is a common form of dementia. This and other types of dementia are progressive brain disorders that make it difficult for a person to remember things and think clearly. Dementia patients can also experience mood swings, personality changes, unpredictable behaviors, and the inability to care for themselves as the dementia progresses. 

If you are a family member providing Alzheimer’s and dementia care to a loved one, these symptoms can be challenging for both you and the affected person. Seeing a loved one’s independence and cognitive function decline can be devastating and lead to frustration, confusion, and sadness. 

But there are certain things you can do to make the caregiving journey less stressful when caring for a dementia patient. Please keep reading for some tips on dementia caregiving. These tips can help you if your loved one has Alzheimer’s or related dementia like vascular dementia or traumatic brain injury. They are applicable for the early stages of the disease, especially the middle stages and later stages, when challenging behaviors become more common.

What are the 4 R's of dementia care provided by family members?

The 4 R’s of dementia care are listed below. They can help Alzheimer’s and dementia care providers and other family members deal with troubling behavior that people with dementia may demonstrate. 

Reassurance

A person with dementia is easily overwhelmed because of memory difficulties. For instance, familiar places can seem unfamiliar to people with dementia. They may not recognize friends. They can lose track of time and start to worry even if you’re only gone for a few minutes. Anxiety and fear are common in such individuals. An important part of caregiving is reassuring the person and managing stress by saying things like, “You’re safe,” or “Everything is fine,” or “I’m here for you.”

Reconsideration

When dealing with a loved one’s dementia, it’s important to reconsider difficult situations and behavior changes from their point of view. For example, if a member of the caregiving team seems to make your loved one angry or agitated for no reason, keep in mind that they may not remember the person and may be perceiving them as a stranger. Reconsidering the situation from their perspective will help you stay calm, empathize with them, and help you help them better.

Redirection

Yelling or speaking in a harsh tone with a person engaging in challenging behaviors is rarely helpful. Instead, many caregivers find that redirecting someone with dementia works. This can include taking them into a different room, starting a conversation about something interesting, or giving them a comforting or loved object to redirect their mind from a difficult situation.

Relaxation

People with dementia often rely on their caregivers’ emotions and pick up nonverbal cues about how to react to the world around them. This is especially true in the later stages of dementia. If you, the caregiver, are upset or anxious, a person with dementia may feed off your emotions. Try to speak in a reassuring tone and keep your body language relaxed, especially when dealing with troubling behavior.

What are 5 things dementia caregivers should not say to someone with dementia or Alzheimer’s disease?

The Alzheimer’s Association and Family Caregiver Alliance recommend that you avoid saying the following to someone with dementia: 

“I just told you that!”

Many dementia caregivers get frustrated when a loved one repeatedly asks the same questions. However, getting frustrated will not help the person retain the information any better. Try to repeat the answer calmly. Take a break from the conversation if you need to.

“Remember when…”

People with dementia often have trouble recalling past events, and this question can make them feel embarrassed or frustrated. Instead, try saying, “I remember when…” which may help jog old memories without putting them under pressure or embarrassing them.

“Your sister died last year.”

Many dementia patients do not remember a bereavement. Reminding them of the death of a loved one can bring on a fresh wave of grief, like they are hearing the news for the first time. If you must remind them of a loved one’s passing, show sensitivity to minimize distress.

“Let’s get you bathed, then we’ll go for a walk, and later we’re having lunch with Ron.”

No doubt older adults with dementia need help with personal care and need to eat nutritious foods and stay active (both physically active and socially active). However, an overload of too much information about the activities of daily life from family members or other caregivers can cause confusion because of cognitive impairment and declining communication skills. Instead, use short, simple sentences, make eye contact, speak slowly, and give instructions one step at a time.

“Don’t you recognize me?”

It can be distressing for a caregiver when a loved one with dementia does not recognize them. It is also difficult for someone with dementia not to recognize the people around them. Do not be offended if this happens, as it only makes the person feel anxious or guilty.

What do family caregivers need most?

People with dementia require high levels of care. The caregiving role is often filled by informal caregivers such as family members. Family caregivers are at an increased risk of stress, depression, and other health complications. Seeing a mental health professional can help caregivers maximize their own well-being. You can help a family member or primary caregiver for someone with Alzheimer’s and dementia by:

• Offering caregiver support (sharing the burden of care).
• Taking a person with dementia to health care appointments.
• Providing occasional respite care (relief from caregiving demands).
• Helping with household chores, paying bills, or financial planning.
• Installing safety features around the home to address any safety concerns a care partner identifies.
• Getting involved in personal activities such as self-care or social events.
• Contacting support groups and other local resources, such as a family caregivers support group, for access to resources.
• Researching other forms of community resources that can make the caregiving experience easier.
• Identifying other resources that can help with the decision-making process about further care.

References:

1. https://www.bu.edu/articles/2021/andrew-budson-and-maureen-oconnor-six-steps-to-managing-alzheimers-disease-and-dementia/
2. https://www.alzheimers.org.uk/blog/language-dementia-what-not-to-say
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181916/