As the summer season begins and many of us celebrate the 4th of July, I'm reminded of how the term independence translates to those with Alzheimer's disease and related forms of memory loss. It's only natural that well-intentioned caregivers want to do all that they can to reduce the anxieties and frustrations of their loved one with memory loss. However, sometimes we can go overboard, resulting in doing almost everything for them, which takes away their independence and freedom of choice. We all know about the "use it or lose it" theory and that the more we do for the person with memory loss the less they will be able to do for themselves. Every person deserves to feel successful and valued and to enjoy meaningful activities every day.
Consider the following tips to help your loved one with memory loss maintain their dignity and feel as successful, independent and in control of their daily lives as they can be:
1. Simplify Dressing
While getting dressed might seem like a very routine and almost rote activity for the caregiver, it can be a very challenging task for someone whose brain can no longer process the steps involved. First, it is important to give them a choice in selecting their outfit. To reduce your loved one's frustration, it's a good idea to offer two selections rather than expecting them to select from a closet full of clothing. If the person has a tendency to layer his or her clothing over existing clothes, try sequencing the activity by laying out each item of clothing and verbally cueing him or her through the process. Even though it may take longer to button their shirt, or put a belt, socks and shoes on, it is far better to give them the time needed rather than doing it for them, so they may maintain their skills.
2. Accommodate Dining
Breakfast, lunch, dinner and snack times not only ensure good nutrition, but also provide opportunities for maintaining social skills while promoting a sense of predictability and security. Depending on the person's level of cognition, they can still be involved in many aspects of their dining experience, such as certain aspects of meal preparation or helping to set the table. At Sunrise Senior Living, our Life Enrichment Managers engage residents in activities such as helping to set tables, thereby maintaining their life skills and engagement, and also supporting a homelike environment. For your loved ones who require assistance with feeding, a suggestion would be to try placing your hand under their hand and guiding them or adapting their meal into a finger food, rather than beginning to feed them at the first indication that they are having difficulty manipulating their utensils. Through verbal promptings, visual cueing, adapting the food, and meaningfully engaging them in the process, you are promoting their independence.
3. Personalize Personal Care and Bathing
Imagine how you would feel if every day someone told you to brush your teeth, wash your face, comb your hair or take a bath. Consider how that approach can be upsetting to your loved one with memory loss who is already feeling vulnerable in these types of situations. Instead of making a statement such as "it's time for you to wash your face," try saying "you usually like to get freshened up at this time of day," which makes for a more pleasant suggestion that offers a choice. If they decline your suggestion, don't try to control or force the point; instead just walk away, give them some time and approach them later. Even though they may have memory loss, they are still an adult and deserve our utmost respect to ensure their dignity. Remember to consider ways that they like their care to be personalized -- e.g., their favorite soap, lotions, hair care products, mirror, music playing in the background or singing their favorite song with them. Bathing can be a very disruptive and unpleasant experience for people with memory loss, as there are a number of factors that can lead to discomfort, including water temperature or your loved one not remembering the purpose of bathing. Be prepared with these tips to help your loved one feel in control during the process.
4. Maintain Dignity in the Bathroom
Always remain mindful of ensuring your loved one's privacy and sense of control when using the bathroom. This is especially important for persons who experience incontinence, which can be both embarrassing and distressing. A calm, caring, respectful approach will cause less embarrassment and discomfort. Before setting up a bathroom schedule to maintain their continence, remember to first observe and follow the person's regular routine and bowel and bladder habits. Other things to keep in mind to create a safe and pleasant experience for both you and your loved one include ensuring that they are wearing manageable clothing, calmly talking them through each step and making sure that the bathroom is easily accessible.
5. Adapt Activities
Regardless of a person's level of memory loss, they can still participate in meaningful activities or life-enriching moments. The goal should always be to make your loved one feel successful, valued and engaged with a sense of purpose. In many cases, your loved one may still enjoy, but is no longer able to participate in a way that they once did. Caregivers can help to keep seniors stimulated and increase their loved one's sense of well-being by adapting their favorite activities. For example, if your loved one previously enjoyed watching fireworks but now becomes anxious or frustrated by large crowds or loud noises, you can plan to watch them on TV or find a vantage point in the distance where you can take them in together. If they previously enjoyed tennis or golf but no longer have the stamina, shorten the timeframe, adapt it to a game of balloon badminton or set up crochet or a putting green in the backyard. Also, try to make it an intergenerational activity by inviting children. Adapting these activities and giving them the opportunity to give tips or guidance to the children will not only boost their self-esteem but also promote their independence.
With any of these daily activities, it's important to remember to put yourself in your loved one's shoes and try to imagine how you would feel in each of these situations. Think about the sense of independence, freedom of choice and dignity that you would want to maintain. It may not always be easy to be patient while your loved one with memory loss manages these routine activities, but remember to take a deep breath, keep calm and help them to be successful each day.
For more by Rita Altman, R.N., click here.
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