Dementia (cont.)
What Kind of Care Does a Person with Dementia Need?
People with moderate and advanced dementia typically need round-the-clock
care and supervision to prevent them from harming themselves or others. They
also may need assistance with daily activities such as eating, bathing, and
dressing. Meeting these needs takes patience, understanding, and careful thought
by the person's caregivers.
A typical home environment can present many dangers and obstacles to a person
with dementia, but simple changes can overcome many of these problems. For
example, sharp knives, dangerous chemicals, tools, and other hazards should be
removed or locked away. Other safety measures include installing bed and
bathroom safety rails, removing locks from bedroom and bathroom doors, and
lowering the hot water temperature to 120°F (48. 9°C) or less to reduce the risk
of accidental scalding. People with dementia also should wear some form of
identification at all times in case they wander away or become lost. Caregivers
can help prevent unsupervised wandering by adding locks or alarms to outside
doors.
People with dementia often develop behavior problems because of frustration
with specific situations. Understanding and modifying or preventing the
situations that trigger these behaviors may help to make life more pleasant for
the person with dementia as well as his or her caregivers. For instance, the
person may be confused or frustrated by the level of activity or noise in the
surrounding environment. Reducing unnecessary activity and noise (such as
limiting the number of visitors and turning off the television when it's not in
use) may make it easier for the person to understand requests and perform simple
tasks. Confusion also may be reduced by simplifying home decorations, removing
clutter, keeping familiar objects nearby, and following a predictable routine
throughout the day. Calendars and clocks also may help patients orient
themselves.
People with dementia should be encouraged to continue their normal leisure
activities as long as they are safe and do not cause frustration. Activities
such as crafts, games, and music can provide important mental stimulation and
improve mood. Some studies have suggested that participating in exercise and
intellectually stimulating activities may slow the decline of cognitive function
in some people.
Many studies have found that driving is unsafe for people with dementia. They
often get lost and they may have problems remembering or following rules of the
road. They also may have difficulty processing information quickly and dealing
with unexpected circumstances. Even a second of confusion while driving can lead
to an accident. Driving with impaired cognitive functions can also endanger
others. Some experts have suggested that regular screening for changes in
cognition might help to reduce the number of driving accidents among elderly
people, and some states now require that doctors report people with AD to their
state motor vehicle department. However, in many cases, it is up to the person's
family and friends to ensure that the person does not drive.
The emotional and physical burden of caring for someone with dementia can be
overwhelming. Support groups can often help caregivers deal with these demands
and they can also offer helpful information about the disease and its treatment.
It is important that caregivers occasionally have time off from round-the-clock
nursing demands. Some communities provide respite facilities or adult day care
centers that will care for dementia patients for a period of time, giving the
primary caregivers a break. Eventually, many patients with dementia require the
services of a full-time nursing home.
A list of caregiver organizations and support groups is included at the end
article.
Next: What Research Is Being Done? »
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