Article on how to behave with a person with dementia?

Manifestation of dementia and underlying diagnoses

The most common disease in patients with dementia is Alzheimer's. Statistics do not provide positive forecasts; the number of patients is growing every year, and in a couple of decades it will double. Atherosclerosis of cerebral vessels takes second place, but it begins much earlier than Alzheimer's. The first signs are detected already at 45 years of age.

Not everyone pays attention to the symptoms at the very beginning of the development of diseases, which is why they progress so quickly. After the diagnosis is made, a difficult period begins in the life of the patient and loved ones - rejection and rejection of the situation. The condition deteriorates quickly: today the patient is adequate, but tomorrow he may show aggression and completely run away from home. The person does not understand what is happening to him; it is as if pages of his life are being torn out of his memory.

The mental world of the weak-minded

Current medicine, unfortunately, has not invented a medicine that helps with diseases associated with dementia. Doctors treat the body, but they cannot restore brain activity.

An elderly person suffering from dementia begins to lose memory from the most recent memories, so he does not have short-term sensations. The events of past days, then months, years disappear from memory, and now a person may no longer recognize his grandchildren and children. His own reflection is frightening, the image of a young man is preserved in his memory, but in the mirror he appears unfamiliar, the patient considers what is happening around him to be a mockery. In the last stage, the person returns to the newborn stage and experiences instincts: hence frequent incontinence, dehydration and possible hunger or overeating.

What to do with the environment of a person with dementia

Decide who will care for the patient. It is better to find several people, because it is extremely difficult to continuously be in the company of a person with dementia. If such an opportunity is absent, then it is worth reconsidering your attitude to the situation and understanding that it is not easier for the patient himself, but perhaps several times more difficult, because the world is collapsing, and he does not even understand how this is happening.

Symptoms of dementia

Dementia develops gradually. At first, the signs of pathology are completely invisible, although minor changes occur in the structure of the brain. Subsequently, dementia begins to appear, progressing gradually, worsening the quality of normal life.

Many people stop coping with work and household chores. We have to provide assistance, show care, and monitor patients. In the most severe cases, relatives resort to the services of a nurse or send the patient to a specialized boarding house.

Signs of dementia depend on the degree and form of the disease. At the initial stage, patients experience mild forgetfulness, which gradually reduces social activity and affects professional qualities. Interest in current events and hobbies fades away.

Changes in behavior become apparent:

impulsiveness and increased irritability appear;
mood changes frequently;
cruelty is felt towards loved ones

At this stage, relatives sometimes do not notice the onset of pathology. Caring for patients with dementia that is beginning to manifest itself is not yet required. Old people live separately and cope with their responsibilities.

With moderate dementia, symptoms that become apparent include:

loss of ability to control familiar objects;
the emergence of difficulties when performing household chores;
partial loss of self-care skills.

In severe dementia, profound degradation occurs. The elderly person becomes helpless. He cannot go to the toilet in a timely manner, make a purchase in a store, take prescribed medications, perform hygiene procedures, eat or prepare food. Personality disintegration is observed when short-term memory is practically absent.

Communication and emotions

It is important for relatives and people caring for someone with dementia to understand and accept the situation. There is no cure for dementia, but a positive emotional environment has a positive effect on the patient, remission will occur and the disease will not progress.

Remember, old age awaits everyone, so be calm.

It is difficult to constantly be in the company of a person who, as if out of spite, constantly asks again, does not believe statements and always sees a catch. For people with dementia, this behavior is considered the norm, because every minute they forget who you are to them. Forgets daily care and the lengths you have to go to to provide him with proper care. Do not aggravate the situation with your own aggression and do not provoke the patient if you no longer have the strength. Just leave the room, be alone with yourself. Treat the patient like a child, just don’t try to educate him, forgive and love him more.

Also adhere to the following rules for communicating with your sick relative:

your speech should be quiet and calm;
ask questions that have a one-word answer: yes/no;
speak in short and clear sentences;
during a conversation, remove sources of excess noise so that the patient can concentrate - this is very difficult for him;
point to the objects you are talking about;
speak clearly about your emotions.

Dementia at home: provide a safe environment

Memory loss and poor coordination of movements in the patient increase the risk of injury. Try to make your home as safe as possible.

· Remove piercing and cutting objects, household poisons and medicines.

·Hide dangerous electrical devices away.

· Shut off the gas supply when the patient is alone.

·Install patient safety devices (for example, a microwave oven for cooking).

·Check the operation of door locks, install locks on windows.

·Use locks that cannot be opened by a sick person.

· Monitor smokers closely.

·Do not change the patient’s usual arrangement of furniture.

·Provide adequate general lighting, staircase lights, and nightlights in the bedroom and closet.

·Control the temperature in the room, avoid drafts, hypothermia or overheating, help select and put on clothing appropriate to the temperature conditions.

·Monitor the quality of products, do not allow consumption of poor quality or spoiled products.

·Install grab bars in the bathtub and toilet, the bathtub bottom and floors should not be slippery, and door locks should also be able to be opened from the outside.

·The covering material underfoot in all rooms must be non-slip.

·Furniture should be stable, chairs and bed should be high enough.

Keep in touch

As the disease progresses, communication between caregivers and the patient may become increasingly difficult. The patient's vision and hearing should be checked, if necessary, order stronger glasses, and replace the hearing aid. When communicating, it is recommended:

Respectfully address the patient by name (patronymic);

· speak clearly, slowly, face to face with the patient, while keeping your head at eye level;

· show love and warmth by hugging the patient, if this does not bother him;

listen carefully to the patient;

· pay attention to non-verbal means of communication;

· try to establish what gestures and combinations of words, cue words are necessary to effectively maintain communication with the patient;

·avoid negative criticism, disputes, conflicts;

Before speaking, check whether the patient is listening to you.

Bathing and personal hygiene

The patient may forget to wash, not see the need to wash, or not remember how to do it. When offering your help to the patient, try to preserve his personal dignity.

·When washing, try to adhere to the patient’s previous habits.

· Try to make washing as pleasant as possible and help the patient relax.

·Showering may be easier than taking a bath, but if a person is not used to showering, it may bother them.

·If the patient refuses to bathe or shower, wait a while - the mood may change.

· Let the patient do everything possible himself.

·If the patient is embarrassed when bathing or showering, you can leave certain areas of the body covered.

· Don't forget about safety, this is provided by securely fastened objects, handles or railings that you can grab onto, a rug that you can't slip on, and an additional stable chair.

·If, while helping a sick person wash, you encounter problems every time, ask someone to help you.

Dressing

A person with dementia may forget the dressing procedure and may not see the need to change clothes. Sometimes patients appear inappropriately dressed in the presence of people.

·Place the patient's clothes in the order in which they need to be worn.

·Avoid clothing with complex fasteners; use clothing with elastic bands, Velcro, zippers, etc.

· Do not rush the patient when dressing, encourage him to act independently.

· Shoes should be comfortable, non-slip, with rubber soles, loose, but not falling off the foot.

Toileting and incontinence

Patients may forget where the toilet is and what to do in it, and they stop feeling when to go to the toilet.

·Encourage the patient to go to the toilet.

·Set a specific visiting routine.

·Mark the door to the restroom in large, colored letters.

·Leave the toilet door open to make it easier to find.

·Make sure the patient's clothing is easy to remove.

·Limit fluid intake before bedtime within reason.

·You can place a chamber pot next to the bed.

·Use diapers if necessary.

Nutrition and cooking

People with dementia often forget to eat and may not remember how to use a fork or spoon. In the later stages of the disease, the patient needs to be fed. Physical problems may also appear—the inability to chew and swallow food normally.

· Remind the patient about the need to eat.

·Give him food that he can eat with his hands.

·Cut food into small pieces to prevent the patient from choking.

·In the later stages of the disease, prepare pureed and liquid foods.

·Remind people to eat slowly.

· Do not forget that the patient may lose the sensation of cold and hot and get burned, so the food should be warm.

·Do not give the patient more than one serving at once.

·If you have problems swallowing, seek advice from your doctor, he will introduce you to techniques that stimulate swallowing.

·Make sure that the patient receives enough nutrients.

In the later stages of the disease, the patient may lose the ability to prepare food. This can be a serious problem if a person lives alone. Poor motor coordination leads to an increased risk of injury, such as burns and cuts when preparing food. Try to provide the patient with ready-made food.

If the patient does not sleep well

The patient may stay awake at night and disturb the entire family's sleep. For caregivers, this can be the most debilitating problem. What can be done?

·Try not to let the patient sleep during the day.

·Taking a long walk every day may help. Give more physical activity during the daytime.

· Make sure that the patient can feel comfortable and comfortable when going to bed.

A person with dementia often loses things and accuses you of stealing

The patient may often forget where he put this or that object. Often he accuses you or other people of stealing lost items.

· Find out if the patient has a secluded place where he hides things.

·Keep replacements of important items, such as a spare set of keys or glasses.

·Check trash cans and baskets before emptying them.

· Answer the patient’s accusations calmly, do not get irritated.

·Agree that the item is lost and help find it.

Vagrancy

Sometimes patients show a tendency to wander, which causes a lot of anxiety and worry to relatives and caring staff. The patient may leave home and wander around the surrounding area, go to an unknown direction and get lost, or even end up in another city. If the patient leaves home alone, care must be taken to ensure his safety.

Make sure that he always has some form of identification document with him,

·Make sure that the person with dementia has a note in their pocket indicating the address and telephone number where the person's next of kin or caregivers can be contacted.

· Make sure that all exits from the house are well locked, that the patient is safe in the house/apartment and will not be able to leave the house without your knowledge.

· If the patient gets lost, control your emotions, speak calmly, do not scold the patient, try to express your support to him when he is found.

· It is useful to have a recent photograph of the patient in case he gets lost and you need help from others in finding him.

· To combat vagrancy, you can attach unbreakable mirrors to all doors: your own reflection in the mirror distracts the patient from the intention of opening the door.

Delusions and hallucinations

Patients may experience delusions and hallucinations. Delusional ideas are characterized by the appearance of false beliefs in the patient. For example, the patient feels that they are pursuing him, want to poison him, cause harm, etc. Delusional ideas are perceived by him as a reality that causes fear. The patient may have visual and auditory hallucinations; he may see or hear things that do not actually exist, for example, figures or voices of people talking in the room.

· Do not argue with the patient about the reality of what he saw or heard, since if he feels that he must defend his own views, this may lead to increased delusion.

·If the patient is frightened, try to calm him down: take him gently by the hand, speak in a soft, calm voice.

·Distract the patient's attention from the hallucination by drawing his attention to a real object in the room.

·Seek advice from a doctor: the patient’s condition may be due to the use of medications.

Aggressive behavior

A serious problem for caregivers can be the manifestation of aggressiveness and violence on the part of the patient. In such cases, the following tips may be helpful:

·Try to remain calm and do not show your own fear or anxiety.

· Retaliatory aggressiveness should be avoided by all possible means; An accusing, threatening or judgmental tone of voice can increase the patient's aggression.

·You should not be too close to the patient, he may perceive this as a threat.

· Try to switch the patient’s attention to a calmer activity.

· Try to determine what caused the patient’s reaction and make sure that these conditions are not repeated.

·If the patient’s aggressive behavior is repeated frequently, it is necessary to seek help from a specialist.

How to cope with the stress of caring for a patient

Alzheimer's disease affects not only the patient, but also the entire family. The heaviest burden is borne by those who directly care for the sick. Constantly exposed to stress, these people need to know how to help themselves.

Family.

For some people caring for a sick person, the family is the best helper, for others it brings only grief. Do not reject the help of other family members if they have enough time, and do not try to shoulder the entire burden of caring for the patient. Contact special services for help.

Don't keep your problems to yourself

You need to share your experiences caring for the patient with others. Keeping them with you makes your job more difficult. Feeling that your emotions are a natural reaction in your situation, it will be easier for you to cope with your problems. Do not reject the help and support of others, even if it seems to you that you are burdening them with it.

Leave time for yourself

You need to have time for yourself too. This way you can see others, do what you love, and most importantly, enjoy life. If you need to be away for a while, try to find someone who can replace you so that you can take a break.

Consider your limits

How much can you endure before the work becomes too much for you? Most people are able to set their own limits before caring becomes overwhelming. If you feel that you are overworked and that work is beyond your strength, seek help to prevent a crisis.

Don't blame yourself

Don't blame yourself or the patient for the difficulties you have to face. Remember, it is only their illness that is to blame. If you feel like you are losing touch with family and friends, don’t blame them or yourself. Try to determine what exactly is disconnecting you and discuss this problem with them. Don't forget that your relationships with other people can be an irreplaceable source of support for you, which is beneficial for both you and the patient.

Follow the advice of others and don't be afraid to seek advice

It can be very useful for you to seek advice from a specialist about the changes occurring with the patient.