This blog post focuses on how a consistent routine and environment can benefit people with dementia and their caregivers on many levels. It is the sixth installment of a seven-part series on common sense caregiving for people with dementia. The series features seven principles that can improve quality of life for caregivers and their loved ones.
R-E-S-P-E-C-T is a helpful mnemonic (memory device) for remembering these tried and true tips:
The Seven Common Senses of Dementia Care
Providing consistency for people with dementia can be quite a challenge since their abilities change with dementia progression. Activities must therefore be thoughtfully planned, organized, and modified with regard to consistent environment (space) and timing. Therefore, maintaining consistency for someone with dementia is like solving a puzzle in four-dimensions.
Here is a countdown of ten smart approaches to consistency for a loved one with dementia:
10. Identify interests. Determine a loved one’s likes and dislikes by asking, observing, and/or relying on prior knowledge. Reassess at regular intervals since the abilities of people with dementia change over time and their interests may, too.
9. Up with the good. Pinpoint and maintain positive habits, including those underpinning Basic Activities of Daily Living, such as eating, dressing, hygiene and toileting.
8. Down with the bad. Avoid inactivity and social isolation.
7. Routine, routine, routine/Timing is everything. Mealtimes, bedtimes, wake-up times, and activity times should occur at routine times on routine days. Align these with a loved one’s preferences, personality and behavior.
6. Use a Calendar. Caregivers can benefit from the use of a calendar—whatever type works best for them. A large wall or refrigerator-mounted calendar may help a person with dementia.
5. Structure. Consistency is key for a daily routine and weekly schedule as well as within individual tasks.
4. Balance with novelty. Most people reading this article will probably be familiar with the concept that new things are good for the brain. But these become harder and harder to process as dementia progresses. So strive for a balance between novelty and familiarity and adapt as needed.
3. Back-up plan. Have someone or something to fill in the gap for an absent caregiver or cancelled activity.
2. Support/Supervision. To the extent possible, the caregiver(s) for an individual with dementia should be familiar and consistent.
1. Safety. Familiarity can provide comfort to all of us, especially for someone with dementia. However, safety and well-being should take precedence. At some point, a loved one with dementia may need in-home caregivers or require a move from a familiar home setting to more supervised living.
The principle of Tolerance, including flexibility and adaptability, will be discussed in the next and final installment of this series.
By Anne M. Lipton, M.D., Ph.D. Neurologist and Author of The Common Sense Guide to Dementia For more information on the Seven Common Senses, see Dr. Lipton’s book, The Common Sense Guide to Dementia for Clinicians and Caregivers.