Learn how to stay connected as dementia progresses
Forgot the way home? Check. Forgot to pay for items at the supermarket? Check. Cannot remember what they did last week? Check.
If you are ticking off these questions after observing a family member, you may want to bring them for a medical check-up as they may be suffering from dementia. It is a progressive brain disease and is not part of normal ageing.
People with dementia will gradually lose the ability to communicate. They may not be able to understand what is said to them or understand what others are saying. But they enjoy being with people they know and engaging in familiar activities: having a meal together or preparing familiar food.
To engage meaningfully with people with dementia, we need to respond appropriately to their feelings while respecting and valuing them.
"Learn to understand their underlying needs, ensure the person's safety and provide them with as much dignity and independence as possible," said the Dementia Singapore.
Here are some tips the association shared.
1. Do not test their memory by asking them what they did recently.
Because of the disease, they are not able to remember many things and you will frustrate them by asking, "Don't you remember?" Use memory aids like diaries, clocks, or calendars to help them know what they have done and will be doing later.
2. Simplify activities and communication.
Break an activity down into simple, step by step tasks. The person with dementia will be able to focus on one step at a time and complete the activity. Keep your sentences short and simple.
3. Offer reassurance and praise.
This will increase the person's self-esteem and reinforce positive behaviour.
4. Do not argue with the person with dementia.
What they see, hear or recall may not be the same as what you saw, heard, or know.
5. Identify and remove triggers to negative behaviour.
For example, if the person wants to go out of the house each time he sees shoes by the door, keep the shoes out of sight.
6. Identify underlying reasons for challenging behaviours.
Try to establish if they have any underlying needs that they could not express. For example, they could be too hot or too tired, or they could need a drink or use the toilet. If they seem uncomfortable, it could be a medical problem.
7. Keep up with social activities.
Most persons with dementia would benefit from physical or social activities regardless of the severity of their condition. Social activities ensure that they remain in contact with other people, and it offers a sense of well-being. Those at the mild to moderate stage of dementia would enjoy being with family and friends in small gatherings as they are still able to converse.
Recreational activities such as card games or hobbies will be enjoyable to them too. But persons at the severe stage of dementia will more likely prefer a one to one interaction as they need more visual and verbal cues.
8. Enjoy safe, outdoor activities.
Care needs to be taken to prevent falls when the person with dementia is walking in public spaces — steps, stairs, roads, and crowded shopping malls — especially if they have osteoarthritis, heart problems or had a stroke previously.
Public spaces where there are even footpaths and seats available for rest would be ideal. Some of them are neighbourhood parks, community gardens or tai chi/qigong with a community group, Memories Café or the Family of Wisdom programme organised by the Dementia Singapore.
There is no cure for dementia presently, but treatment is available to manage the symptoms and slow down the progression of the disease. The disease will gradually take away a person's ability to communicate with the family. When that happens, their loved ones will need to consider the person's feelings and respond appropriately while giving them as much dignity and independence as possible.
For more tips or advice, please call the Dementia Singapore helpline at 6377 0700 (weekdays, 9am to 6pm).
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References:
This article was last reviewed on 15 Nov 2022
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