Dealing with someone who has dementia can sometimes be challenging, and dementia can come in various forms and severity. For some, they merely become forgetful or repetitive, but for others, they may become completely unable to care for themselves. Most stroke rehabilitation focus on the physical deficits that arise from an insult, but it takes just as much compassion and patience to help your loved one travel the road of cognitive impairment.
Conversation Strategies
Although it can sometimes seem impossible, the best way to speak with someone with dementia is with patience. If you feel yourself becoming impatient and want to lash out at your loved one, you should remove yourself from the situation until you calm down. It is important to remember that your loved one is not doing this on purpose. You may think that they know what you are talking about, but the simple reality is that they do not understand what you are trying to communicate. Try speaking slowly, carefully, and softly to get through to your loved one. Use short words and sentences, and try to direct them with purposeful, simple commands.If your loved one suffers from memory loss, give gentle cues and reminders to help them through their memory difficulty. Do not get frustrated that they ask repetitive questions, but realize that they don’t know they are repeating themselves. It is helpful to ask targeted questions when speaking to someone with dementia. For instance, do not ask, “What would you like for lunch?” Ask instead, “Would you like a sandwich or soup for lunch?” This is an example of a simple, directed question. Open ended questions are often not processed well by the cognitively impaired.
Navigating the Physical World
The key to helping someone with dementia navigate the physical environment is to keep it simple. Have a bed and a dresser in a bedroom. There is no need for a chair, nightstand, light fixture, and so on. A simple layout will help your loved one navigate the room and keep them from falling. Do not put down throw rugs anywhere in the house, as this is a primary reason for falls in the home.You may want to put large labels on different important items in the home. For instance, labeling the refrigerator, stove, and pantry will help your loved one remember what things are and what to do with them. This also comes in handy in the bedroom, because you can label drawers with their contents to aide memory. Remember that patience and encouragement will get you further than agitation. People with dementia tend to do things more slowly, but they are very capable of completing small tasks. Give praise when they are able to zip their own pants, pull on their own shirt, or tie their own shoes. Your job is to be a totally biased cheerleader. Even when they do not do something that well, it helps to be encouraging anyway.
Emotional Struggles
Both you and your loved one are likely struggling emotionally. For your loved one, they may experience anxiety as the night comes on. This is a common symptom known as “sundowning.” Gently reorient your loved one to the place and time and attempt to help them understand their surroundings. They may ask for your help, but not know what to tell you to do. Ask them short, direct questions aimed at primary needs. For instance, ask if they are in pain, hungry, thirsty, or need the toilet. Any of these needs may be lacking, and they don’t know how to ask for the help they need.For your own emotional struggles, it is important to take frequent breaks. It is quite difficult to deal with someone with dementia around the clock, and you should not expect yourself to. If your loved one is at home, see about getting other family members to come in and stay with your loved one for a few hours. If that is not an option, getting a hired professional to come in is a necessary expense to maintain your own mental health. Respite care is often the name that social services assign to this type of care. If your loved one is in a nursing home and they frustrate you during visits, take a break from them. You can also visit less frequently or keep your visits short. Your frustration will only lead to making them feel sad and confused about their condition.
In the end, calm, patient care is necessary for someone with post-stroke dementia. If you can calmly redirect your loved one, provide simple reminders, and ask directed questions, you will go a long way towards making life with your loved one as enjoyable as possible.
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