"Nigel helps me to do things on my own. He lays out my clothes in the order that I should put them on. He also always shows me two shirts and I choose which I prefer." (Hector)
"I don’t take anything for granted now. I look at each situation and try to put myself in Ruth’s shoes in order to see what might be problematic for her and to find ways to make things easier. Doing that changes the way you look at life." (Graham)
Having dementia can make many everyday tasks increasingly problematic. People do lots of things automatically without thinking about it. With dementia, simple tasks like getting dressed, having a bath or making a cup of coffee gradually become problematic - it is no longer obvious what to put on first; it is difficult to switch from the shower unit to the bath tap; the coffee machine is complicated to work out, etc. As these tasks seem so easy and obvious, it can be frustrating and embarrassing to mention it to other people. Consequently, many people with dementia struggle on, trying to hide their problems.
Typical difficulties, which may affect a number of tasks, include:
- Difficulty remembering the order in which to do things (e.g. putting shoes on before socks)
- Forgetting what has already been done and therefore doing it again (e.g. putting sugar in coffee, checking the mail box or watering the plants several times)
- Forgetting to do something (e.g. to switch off the cooker after use, to open or respond to letters or to have a bath)
- Forgetting how to do things (e.g. how to put a tie on, how to operate the microwave, putting clothes on back to front)
- Not recognising what objects are for (e.g. that a hairbrush is for brushing hair)
- Not making connections (e.g. hearing the doorbell but not answering the door)
These difficulties are due to the changes which occur as a result of dementia. Nobody is to blame. It is necessary to concentrate not only on what is problematic, missing or damaged but also on what can be done to help the person with dementia to cope with such difficulties, losses or damage. It is important not to overlook the personal experience, history, current relationships and typical ways of dealing with traumas or stressful events that the person with dementia has developed over the years. This overall background will also influence how they deal with losses and fears and how their experience of dementia is expressed or lived. For this reason, it is a good idea for people with dementia and carers to get together and/or to confide in someone who can help in order to find practical solutions. Through careful observation and planning, it may be possible to prevent some problems.
For the person with dementia
- Concentrate on what you can still do/would like/need to do.
- Approach each task in a relaxed manner.
- Do things at times when you feel good e.g. in the morning, afternoon or evening.
- Take your time.
- Simplify tasks.
- Break them down into several stages.
- Only do one thing at a time.
- Allow yourself to grieve the loss of a skill.
- Try to find a way to carry on despite the problem for as long as you can.
- Don’t be overly self-conscious.
- Try to create and stick to routines. Carers should be able to help with this.
- Use any technique you find useful to help you cope.
- It may be possible to “relearn” how to do something, perhaps differently.
- Let others know what kind of help you do and don’t need.
For the carer
- Try to plan ahead.
- Anticipate difficulties based on what you notice or suspect may be difficult for the person with dementia.
- Make sure that you don’t draw attention to these difficulties especially in front of other people.
- Remember that you may need to adapt your solutions again and again.
- Be flexible.
- Don’t rush the person with dementia.
- If the person with dementia makes a mistake, don’t ask why and don’t criticise.
- Encourage the person with dementia to do as much as possible for themselves.
- Find clothes, footwear and headwear for the person with dementia that are easy to put on and take off e.g. with Velcro fasteners instead of laces, with zips instead of buttons etc.
- Pack clothes away that are not suitable for the season.
- Avoid too much clutter on the table at mealtimes.
- Make the bathroom comfortable and avoid unnecessary objects.
- When you encounter “challenging” behaviour, try to look for the need that the person with dementia is expressing through the behaviour.
- Sometimes behavioural problems are a sign of physical ailments, illnesses or pain. Also, sensory disturbances such as hearing loss and poor eyesight may lead to misunderstandings and hinder communication. Try to organise or encourage the person with dementia to have regular check ups.
- Respect the need for independence of the person with dementia.
Last Updated: Friday 11 September 2009