Another problem he faces is loneliness and isolation. He has no conversation. He no longer has the television or radio on, a newspaper or visits from friends. I can be with him for two or three hours, yet two minutes after I’ve left, he forgets I’ve been. So what does he do to fill this void? He telephones me. Not just once or twice during the evening. The record is 22 times in half an hour, but each time the phone is answered he doesn’t say anything as he cannot remember why he has rung.
Some people with dementia live alone. Sometimes carers are unable to provide accommodation for them, but often it is because they do not want to leave their own home. It can be difficult to care for someone with dementia who does not live in the same home, particularly if they also live in another town or region. You may need to travel some distance to visit and have to rely a great deal on reports from other people as to how they are coping. This might cause feelings of guilt and anxiety. To make matters worse you may be limited as to how much you can help by what the person will allow. There may come a time when you feel that it is necessary to look for another solution, but meanwhile you can take certain measures to help the person stay at home and live as fulfilling a life as possible. But whether or not the person with dementia lives with you, you may have children who find it difficult to cope when someone in your family has dementia. The second part of this chapter addresses the issue of telling young children and teenagers about dementia and helping them to cope.
How to cope when the person with dementia lives alone
Try to make the person’s home a safe and secure environment
Apart from general safety measures (please see chapter on safety), there are a few additional precautions to take if the person with dementia lives alone.
- To prevent the possibility of flooding look into the possibility of installing tap adaptations or an automatic cut-off system and make sure that sinks and baths have an overflow.
- Check the wiring system. Rewiring might be necessary if the person has lived in the same house for many years and the wiring has become worn and dangerous.
- Regularly check light bulbs. If suddenly plunged into darkness, the person might panic.
- Check that they have a safe heating system. An automatic system would be best.
- Make sure that they do not wear worn out shoes which might cause them to trip.
- You can remind the person to do or not do something in your absence by strategically placing messages (please see chapter on communication).
- Ask a neighbour to keep an eye on the person, their home and people they let in (if they do not recognise people, they may tend to let anyone in).
- Find out about a locking mechanism for doors and windows which ensures maximum safety.
Medication and personal care
As the person with dementia may be unaware of health problems, you should organise a medical check-up or home visit. If they need to take medication, there is a risk that they will take too much, forget to take it or take the wrong tablets. You could leave messages or telephone to remind them. Alternatively, compliance packs may prove useful. They separate tablets, show when to take particular medication and allow both people with dementia and their carers to see at a glance what has been taken. If all else fails, you may need to arrange for someone to supervise the taking of medication on a daily basis. It is important to throw away any unnecessary medication to limit the possibility of confusion over which to take.
You may find it necessary to advise, shop, cook and even supervise eating, depending on the abilities of the person with dementia. Check that decayed food is removed from cupboards and the fridge, kitchen waste disposed of, commodes emptied and disinfected and pets fed and taken out. If this is not possible due to the distance involved, you could perhaps arrange for outside help, either from friends or social services.
Visits and telephone calls
Regular visits and phone calls are useful ways to make sure that the person with dementia has not had an accident or is in need of something. They give you the chance to see how the person is coping and what kind of help is necessary as their needs change. Visits can also break the isolation of living alone and help mark the passing of time by creating a routine (please see chapter on disorientation). It might also be the only time that the person has any contact with other people or has the opportunity to go out and get some fresh air.
Help the person with dementia to deal with everyday matters and formalities
Try to warn shopkeepers of the possibility of the person leaving without paying for goods. You might be able to come to an agreement on how to deal with this situation. With regard to the payment of bills, you could offer to organise this yourself and keep accounts, arrange for standing orders or sort out an Enduring Power of Attorney which would give you the official power to act on behalf of the person with dementia. You could also inform service companies so that they understand and may be less likely to withhold services or cut off gas and electricity.
"Wandering" and identification
Try to make sure that the person with dementia always has some form of identification on them (e.g. a bracelet). It might be better to have a neighbour or friend’s name and address on it. It is a good idea to make sure that you always have a recent photo of the person.
Last Updated: jeudi 06 août 2009