Caring for someone with dementia
As a carer of someone with dementia, you’ll soon find the level of support that’s needed for their day-to-day living while maintaining their independence.
As the condition progresses, they will come to rely on you more and more for everyday tasks. You’ll also play an important role in providing reassurance as they lose their self-confidence with the worsening of symptoms.
People with dementia tend to feel less anxious if they are in a regular daily routine and a calm household. It’s important for them to feel useful despite their condition, so try to involve them in household tasks where possible, such as helping to prepare a meal. Try to support them in keeping up their favourite activities, such as doing the gardening, looking after their pet, or seeing friends and family.
For tips on memory triggers to help the person with dementia in the home, see our section on how to adapt your day-to-day living in living well with dementia.
Staying fit and eating healthily are particularly important for people with dementia. Being ill can make the symptoms of dementia worse, and the better they feel, the more they – and you – can enjoy life.
Meal-times can take a long time and need a lot of patience: the person with dementia may have forgotten what various foods are, and what foods they like. Depending on the stage of dementia, they may need to be reminded frequently to take the next mouthful. Or they may find it difficult to use a knife and fork and you may need to guide the cutlery to their mouth.
Be prepared for the person’s eating and drinking habits to change over time, perhaps resulting in refusal to eat or wanting strange combinations of food. Sometimes it can be difficult to work out why they aren’t eating, or spitting the food out – it may be worth having their teeth checked by dentist in case this is contributing to the problem.
Try to choose meal-times when the person is wide awake – they may not swallow properly if they’re falling asleep or being drowsy.
If you think the person is not eating enough or isn’t having a balanced diet, ask his or her GP for advice. You may also get some helpful tips from other carers – contact your local carers’ group, please see myhealthlondon’s dementia super map and search for ‘carers and families’ near you.
Washing can become a challenge for people with dementia – they may be confused and disorientated in the shower, for example – and it’s likely that the person you’re looking after will need help from you.
Personal hygiene tends to be a very private activity so it may be hard to get used to, both for you and the person with dementia. If so, try to find ways to help the person to wash without losing their dignity. For example, it may help to uncover part of the body at a time and wash there while keeping the rest covered.
Try to stick to their usual routine for washing, and keep the process as relaxed as possible to avoid stress and confusion.
Incontinence is common among the general population, not just people with dementia. However, dementia can cause people to forget to go to the toilet, forget how to recognise when they need to go, or forget where the loo is. Urinary tract infections can also cause incontinence, as can constipation, prostate problems in men, and certain medications – so it’s worth checking with the GP to see if any of these apply.
Of course, some people with dementia find it deeply embarrassing to suffer from incontinence, and it’s naturally hard for a carer to know how best to react to it. Bear in mind it’s part of their dementia and try to take it in your stride without making a big deal of it. There are a number of practical steps you can take to make it easier:
Help reduce ‘accidents’ by making sure the person you’re looking after can find the toilet - stick a notice or picture of the loo on the door.
Make sure the person can undo their clothing easily – some people with dementia find it hard to manage zips and buttons. Elasticated waist-bands may be easier for some people.
Look out for signs that they need to go to the loo – for example, if they’re fidgeting or standing up and sitting down again
To reduce night-time accidents, encourage the person to drink plenty of fluids during the day but not for two to three hours before bed
Incontinence pads, available from some pharmacies, can save embarrassment, help keep the skin dry, and can easily be changed after an accident
Changing and washing clothes straight away will help avoid any unpleasant or embarrassing odour
Waterproof sheets or mats are available to protect beds and reduce the amount of laundry you have to do.
The continence nurse in your area can offer practical advice and support – ask your GP to put you in touch.
Caring for the carer
Caring for someone with dementia can be demanding even for the most patient and loving of carers. It’s important that you make sure you pay attention to your own health and well-being as this will help you cope better. Make sure you take regular breaks and try to keep up your own social life and interests. Don’t be afraid of asking friends, family, and neighbours to help out so you can take some time off. You can also arrange to have respite care – in which a carer comes to your home – through homecare agencies or your local authority.
Money, benefits and legal advice
For easy to understand finance, benefits, tax credits and legal advice for carers, see the section on Money and Legal at NHS Choices.