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Routine in Dementia

Uncategorized Apr 16, 2020

 

Welcome back, Careblazer!

I hope you’re all hanging in there through this Corona virus. Since this virus has interrupted so many lives, closed down senior centers and adult day health care centers, reduced or totally stopped extra help from coming into the home, I thought we could spend some time talking about how to make a dementia routine at home. This idea came from Dr. Regina Koepp, geropsychologist in Georgia who told me many of the caregiver she sees are struggling with how to get through the days as best as possible without all the usual outside supports. So thank you Dr. Koepp. She also recently started a podcast called the Psychology of Aging

Whether this Corona virus has totally changed your caregiving schedule or whether it’s really made no difference at all, this will be helpful if you spend a large amount of your day with someone with dementia. I’ll go over why a routine in dementia is helpful and how you can make your own daily routine or schedule, mistakes to avoid, and I’ll give you specific ideas you may want to include. 

Why should you try to have a daily routine/schedule. 

Having a routine in dementia care helps: 

  • Maintain Functions: Practicing an activity regularly, whether it's a physical or mental task, may increase the likelihood of that ability remaining.
  • Reduces Anxiety: The predictability of a routine can decrease anxiety. The person with dementia may feel more comfortable and confident if he knows what to expect.
  • Decreases Caregiver Stress: Routines can lessen the stress for those caring for people with dementia by making the day more organized and possibly decreasing the chance of challenging behaviors.
  • Allows for Some Independence: Activities that have been practiced regularly, such as daily folding the laundry, can increase self-esteem and confidence because the person can perform it independently. Especially in the earlier stages of dementia when people are more likely to be aware of cognitive deficits, independence in a task can be an encouragement to them.

When you think about what you want to put on your daily routine you want to: 

  • Tailor it as much to your loved one's preferences and past activities as possible. As you’ll see, one of the area you’ll want to include in the daily schedule is some sort of pleasant event or leisure activity. You’ll want to think about what they’ve enjoyed in the past when you are thinking about what activities to include. 
  • Think about their abilities and what they can realistically do. We want to set them up for success and prevent extra stress on you from any frustration that may arise from having them trying to do things outside of their ability. 
  • Include them and their help in as many of the activities as possible. It’s not just about crossing it off the list and getting it done. It’s about the interaction and connection that occurs during the activity. So for example, if breakfast is on the schedule, perhaps the preparing or cleaning of the breakfast includes them as well keeping in mind their ability level. 
  • You also want to avoid trying to fill up every hour in the day. Leave some blank space in the day for when there’s an interruption, something out of the ordinary, or any of the other many things that pop up during the day that gets us off schedule no matter how well we plan. You also want to make sure you leave enough time for everything.
  • Be flexible and willing to adjust. As you implement this schedule take note of how your loved one responds, what works well/ what doesn’t and adjust as needed. lunch and after lunch is tv and after tv is nap and after nap is a walk

Now what exactly should you include on this daily schedule. The main themes include: 

-Personal hygiene (bathing, toileting, brushing teeth, getting dressed)

-Medical needs (medication, breathing treatments, etc.)

-Eating (breakfast, lunch, dinner, snacks)

-Physical activity within their means

-Pleasant events (social, spiritual, intellectual) You can rotate them. 

-Rest

-Wake/sleep schedule: trying to stick to a regular sleep and wake cycle is helpful in dealing with sundowning and other sleep difficulties. 

 

Consider putting the schedule in a place for your LOVE to see so they know what to expect. You can use a white board and change out the specifics day to day or simply use a new piece of paper. It doesn’t really matter, whatever works best for you. If you do decide to use this approach of using a sign or white board for them, be sure to keep it as simple as possible. Too many words can make it complicated and hard for them to understand.

I hope that developing a daily routine helps you feel less stressed and helps your LOWD feel less anxious. Be patient with yourself as you implement this, it can take some time for someone with dementia to adjust to something new, but having a routine is helpful and is part of the reason so many adult day care centers and senior facilities are helpful because they’ve built this in the day to day. 

And before I end, I just want to encourage you to cut yourself a break. You aren’t looking for perfection with this. Just a bit of progress. I’m thinking of you Careblazer. Hang in there. I’ll be back next week. Bye.

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