Dementia - home care

A loved one with dementia will need support in the home as the disease gets worse. You can help by trying to understand how the person with dementia perceives their world. Give the person a chance to talk about any challenges and take part in their own daily care.

Start by talking with your loved one's health care provider. Ask how you can:

• Help the person stay calm and oriented
• Make dressing and grooming easier
• Talk to the person
• Help with memory loss
• Manage behavior and sleep problems
• Encourage activities that are both stimulating and enjoyable

Tips for reducing confusion in people with dementia include:

• Have familiar objects and people around. Family photo albums can be useful.
• Try to maintain a regular sleep and eating schedule.
• Keep lights on at night.
• Use reminders, notes, lists of routine tasks, or directions for daily activities.
• Stick to a simple activity schedule.
• Talk about current events.

Taking regular walks with a caregiver can help improve communication skills and prevent wandering.

Calming music may reduce wandering and restlessness, ease anxiety, and improve sleep and behavior.

People with dementia should have their eyes and ears checked. If problems are found, hearing aids, glasses, or cataract surgery may be needed.

People with dementia should also have regular driving tests. At some point, it won't be safe for them to continue to drive. This may not be an easy decision. Seek help from their provider and other family members. State laws vary on the ability of a person with dementia to continue to drive.

Supervised meals can help with feeding. People with dementia often forget to eat and drink, and can become dehydrated as a result. Talk to the provider about the need for extra calories due to increased physical activity from restlessness and wandering.

Also talk to the provider about:

• Watching for risk of choking and what to do if choking occurs
• How to increase safety in the home
• How to prevent falls
• Ways to improve bathroom safety

The Alzheimer's Association's Safe Return Program requires people with dementia to wear an identification bracelet. If they wander, their caregiver can contact the police and the national Safe Return office, where information about them is stored and shared nationwide.

Eventually, people with dementia may need 24-hour monitoring and assistance to provide a safe environment, control aggressive or agitated behavior, and meet their needs.

LONG-TERM CARE

A person with dementia may need monitoring and help at home or in an institution. Possible options include:

• Adult day care
• Boarding homes
• Nursing homes
• In-home care

Many organizations are available to help you care for a person with dementia. They include:

• Adult protective services
• Community resources
• Local or state government departments of aging
• Visiting nurses or aides
• Volunteer services

In some communities, dementia-related support groups may be available. Family counseling can help family members cope with home care.

Advance directives, power of attorney, and other legal actions may make it easier to decide on care for the person with dementia. Seek legal advice early, before the person is unable to make these decisions.

There are support groups that can provide information and resources for people with Alzheimer disease and their caregivers.

Caring for someone with dementia; Home care - dementia

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Budson AE, Solomon PR. Life adjustments for memory loss, Alzheimer's disease, and dementia. In: Budson AE, Solomon PR, eds. Memory Loss, Alzheimer's Disease, and Dementia. 3rd ed. Philadelphia, PA: Elsevier; 2022:chap 28.

Budson AE, Solomon PR. Why diagnose and treat memory loss, Alzheimer's disease, and dementia? In: Budson AE, Solomon PR, eds. Memory Loss, Alzheimer's Disease, and Dementia. 3rd ed. Philadelphia, PA: Elsevier; 2022:chap 1.

Peterson RC, Graff-Radford J. Alzheimer disease and other dementias. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 95.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.