Caregiver's Guide to Understanding Dementia Behaviors

Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here are more interesting dementia brain boosting activities

Family Caregiver Alliance

Caring for a loved one with dementia poses many challenges for families and caregivers. People with dementia from conditions such as Alzheimer’s and related diseases have a progressive brain disorder that makes it more and more difficult for them to remember things, think clearly, communicate with others, or take care of themselves. In addition, dementia can cause mood swings and even change a person’s personality and behavior. This Fact Sheet provides some practical strategies for dealing with the troubling behavior problems and communication difficulties often encountered when caring for a person with dementia.

Ten Tips for Communicating with a Person with Dementia
We aren’t born knowing how to communicate with a person with dementia—but we can learn. Improving your communication skills will help make caregiv-ing less stressful and will likely improve the quality of your relationship with your loved one. Good communication skills will also enhance your ability to handle the difficult behavior you may encounter as you care for a person with a dementing illness.

1. Set a positive mood for interaction. Your attitude and body language communicate your feelings and thoughts stronger than your words. Set a positive mood by speaking to your loved one in a pleasant and respectful manner. Use facial expressions, tone of voice and physical touch to help convey your message and show your feelings of affection.

2. Get the person’s attention. Limit distractions and noise—turn off the radio or TV, close the curtains or shut the door, or move to quieter sur-roundings. Before speaking, make sure you have her attention; address her by name, identify yourself by name and relation, and use nonver-bal cues and touch to help keep her focused. If she is seated, get down to her level and maintain eye contact.

3. State your message clearly. Use simple words and sentences. Speak slowly, distinctly and in a reassuring tone. Refrain from raising your voice higher or louder; instead, pitch your voice lower. If she doesn’t understand the first time, use the same wording to repeat your message or ques-tion. If she still doesn’t understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns or abbreviations.

4. Ask simple, answerable questions. Ask one question at a time; those with yes or no answers work best. Refrain from asking open-ended ques-tions or giving too many choices. For example, ask, “Would you like to wear your white shirt or your blue shirt?” Better still, show her the choices—visual prompts and cues also help clar-ify your question and can guide her response.

5. Listen with your ears, eyes and heart. Be patient in waiting for your loved one’s reply. If she is struggling for an answer, it’s okay to suggest words. Watch for nonverbal cues and body language, and respond appropriately. Always strive to listen for the meaning and feelings that underlie the words.

6. Break down activities into a series of steps. This makes many tasks much more manageable. You can encourage your loved one to do what he can, gently remind him of steps he tends to forget, and assist with steps he’s no longer able to accomplish on his own. Using visual cues, such as showing him with your hand where to place the dinner plate, can be very helpful.

7. When the going gets tough, distract and redirect. When your loved one becomes upset, try changing the subject or the environment. For example, ask him for help or suggest going for a walk. It is important to connect with the person on a feeling level, before you redirect. You might say, “I see you’re feeling sad—I’m sorry you’re upset. Let’s go get something to eat.”

8. Respond with affection and reassurance. People with dementia often feel confused, anxious and unsure of themselves. Further, they often get reality confused and may recall things that never really occurred. Avoid trying to convince them they are wrong. Stay focused on the feelings they are demonstrating (which are real) and respond with verbal and physical expressions of comfort, support and reassurance. Sometimes holding hands, touching, hugging and praise will get the person to respond when all else fails.

9. Remember the good old days. Remembering the past is often a soothing and affirming activity. Many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years earlier. Therefore, avoid asking questions that rely on short-term memory, such as asking the person what they had for lunch. Instead, try asking general questions about the person’s distant past—this information is more likely to be retained.

10. Maintain your sense of humor. Use humor whenever possible, though not at the person's expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with you.

Club eases the pain of dementia

Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here are more interesting dementia brain boosting activities

BBC News

The families of people with dementia often do not get the support they need until a crisis occurs.

That is the conclusion of the Nuffield Council on Bioethics, an ethics think-tank.

I went to meet a group of carers at a community centre in east London.

The Monday Club are, on the face of it, a jolly group.

Card games are being played - and Harry Brown has brought along some apples from his garden.

The weekly group is run by the Alzheimer's Society and supported by the local council in Redbridge.

It provides solace, companionship and fun for dementia sufferers and their carers.

Difficult circumstances

These are strong people, often coping with very difficult daily circumstances.

Gerald Hale, who was a fireman for 35 years, is joining in the sing-song. He attends the group along with his wife of 62 years, Pat.

He is now 84, smartly dressed and was diagnosed with dementia about a year ago.

Mr Hale told me: "The main thing is not knowing or remembering anything. Your life is very limited.

"I dread to think about the future."

The illness is further along for the family of Gunvor Lasocki.

They are familiar with the ethical dilemmas mentioned in the new report - such as, when is it acceptable not to tell the truth?

Daughter Gillian has spent the past three years looking after her 86-year-old mother, whose parents died some time ago.

She said: "My mother gets inconsolable if anyone tells her they're dead. She asks about them nearly every day.

"We decided we had to lie to her, because what's the point in upsetting her?

"I hit on the idea of telling her they're on holiday. She's quite happy because she thinks they'll be back soon."

Continue to come

Some members of the Monday Club were caring for partners or family who have since died.

They are still included in the activities - and are an important source of support for the more recent members.

Coral Kathro runs the club for the Alzheimer's Society.

She said: "People come here and they are totally accepted - whatever their disabilities or problems.

"They become part of a family of concerned friends."

The Nuffield Council on Bioethics is also concerned about difficult practical decisions that families face - such as, when should the sufferer give up their privacy?

In need of help

Peter Pettigrew brings his wife Mary to the Monday club.

He is proud that he has done all the cooking, cleaning and personal care during her seven years of illness.

But he sometimes feels isolated and it is a strain - his eyes well up as he talks to me.

However, Mary will not tolerate having a stranger to help.

He said: "When she came out of hospital, they sent someone to change her in the morning and put her to bed at night.

"But she wouldn't have that, so it only lasted a couple of days.

"She likes her privacy still. She won't have anyone else in the house. So I'm just there on my own."

The UK's health departments are trying to develop policies that will respond effectively to dementia as the number of cases grows.

However, the authors of the Nuffield report point out that Gordon Brown's newly proposed Care Service for England would help people only in the later stages.

The report says people with dementia can still have a reasonable life.

Getting to that point seems to still be a case of "work in progress".