CARE FOR DEMENTIA - CARERING FOR SOMEONE LIVING WITH DEMENTIA FIJI NATIONAL UNIVERSITY COLLEGE OF HUMANITIES & EDUCATION DEPARTMENT OF AGED AND CHILD CARE DERRICK CAMPUS, SAMABULA CARE FOR DEMENTIA - CARERING FOR SOMEONE LIVING WITH DEMENTIA

CARING FOR SOMEONE WITH DEMENTIA CARE FOR DEMENTIA CARING FOR SOMEONE WITH DEMENTIA Caring for someone with dementia can be challenging both physically and emotionally.  it’s important to understand that if their behaviour changes, it may not be anyone’s fault. It can be a good idea to talk to a health professional. Dementia can influence a person’s behaviour including wandering, depression, anxious or agitated states, aggression, hallucinations and false ideas, and loss of inhibition.

CARING FOR SOMEONE WITH DEMENTIA CARE FOR DEMENTIA CARING FOR SOMEONE WITH DEMENTIA Caring for someone with dementia can be challenging both physically and emotionally.  it’s important to understand that if their behaviour changes, it may not be anyone’s fault. It can be a good idea to talk to a health professional. Dementia can influence a person’s behaviour including wandering, depression, anxious or agitated states, aggression, hallucinations and false ideas, and loss of inhibition.

How do I manage our communication needs? CARE FOR DEMENTIA How do I manage our communication needs? You may notice changes in the way the person you care for communicates with you. For example, they may find it hard to find a word, speak fluently, understand, write, read or express emotions. They may also lose normal social conventions of conversation and may ignore what you’re saying or interrupt you.

Stay calm and allow time for them to understand and respond to you CARE FOR DEMENTIA Here are a few tips for communicating with someone who has dementia: Consider other causes of communication difficulties, for instance having their hearing and eyesight checked to make sure that they aren’t a factor Stay calm and allow time for them to understand and respond to you Remember that they still have feelings and emotions even though they may not always understand what you’re saying Use short, simple sentences and help orientate them by describing what you’re about to do, who is about to visit and their relationship with this person

CARE FOR DEMENTIA Here are a few tips for communicating with someone who has dementia: Try not to argue, be condescending, order the person around, ask questions that rely on a good memory or talk about them in the presence of other people Use positive body language and touch because this is an important part of communication Be consistent in your approach to communication try to avoid talking in a noisy environment.

How do I manage their eating and nutrition needs? CARE FOR DEMENTIA Here are a few tips for communicating with someone who has dementia: How do I manage their eating and nutrition needs? If someone has dementia, their eating and drinking habits should be carefully monitored no matter if they live in their own home or in an aged care home. This is because people with dementia may forget to eat and drink, and they may also find it difficult to chew and swallow.

CARE FOR DEMENTIA Here are a few tips to help you manage their eating and nutrition needs: ask their doctor to check that there isn’t a treatable cause of appetite loss, such as acute illness, depression or denture pain offer snacks and meals regularly, perhaps trying 5-6 small meals a day try an alarm or phone call to remind them about mealtimes only serve one course at a time serve foods that are familiar to them avoid using plates with patterns

CARE FOR DEMENTIA Here are a few tips to help you manage their eating and nutrition needs: demonstrate chewing if this seems to be the problem, and eat with the person so that they can copy you if they’re having difficulty with cutlery, perhaps serve them finger foods instead consider nutrition supplements, particularly in later stages of dementia when people tend to lose a lot of weight. Ask a dietician or doctor about what supplements might be helpful offer drinks regularly. This is particularly important in hot weather encourage and find ways for them to participate in regular physical exercise.

How do I manage their continence needs? CARE FOR DEMENTIA How do I manage their continence needs? When a person has dementia, their mental functions decline and this may result in incontinence (the term used to describe the loss of control of the bladder and/or bowel). This is because being in control of these functions depends on being aware of bodily sensations such as the feeling of having a full bladder and the memory of how, when and where to respond.

How do I manage their continence needs? CARE FOR DEMENTIA How do I manage their continence needs? observe patterns of when the person empties their bladder and/or bowel and use this pattern to remind them, at regular intervals, to go to the toilet watch for non-verbal clues such as pulling on clothes and increased agitation, and when this happens, use short, simple words to suggest they go to the toilet make sure the bathroom isn’t too far away, the bed isn’t too high to get in and out of, the toilet paper can be easily seen and the room the toilet is in is clearly marked

How do I manage their continence needs? CARE FOR DEMENTIA How do I manage their continence needs? consider installing nightlights in the hallways and in the toilet to help them find their way to the toilet at night install raised bars to help them get on and off the toilet use clothing with elastic and Velcro waistbands so they can easily remove clothing and put it back on again use continence aids and appliances such as pads if necessary introduce regular low-caffeine drinks, a high fibre diet and a regular exercise routine.

How do I manage their sleeping habits? CARE FOR DEMENTIA How do I manage their sleeping habits? People with dementia may be confused between night and day, making sleeping during the night difficult. Their sleeping habits may also be affected by: • changes in their brain’s biological clock • medical conditions • side effects of medication • depression • urinary tract infections causing frequent need for toileting • arthritis • sleep apnoea

How do I manage their sleeping habits? CARE FOR DEMENTIA How do I manage their sleeping habits? People with dementia may be confused between night and day, making sleeping during the night difficult. Their sleeping habits may also be affected by: • changes in their brain’s biological clock • medical conditions • side effects of medication • depression • urinary tract infections causing frequent need for toileting • arthritis • sleep apnoea

How do I manage their sleeping habits? CARE FOR DEMENTIA How do I manage their sleeping habits? Sleeplessness can also be caused by: • going to bed too early • not getting enough exercise • drinking too much caffeine or alcohol • feeling hungry • feeling too cold or too hot • poor lighting • changes to daily routines

How do I manage their sleeping habits? CARE FOR DEMENTIA How do I manage their sleeping habits? Sleeplessness can also be caused by: • going to bed too early • not getting enough exercise • drinking too much caffeine or alcohol • feeling hungry • feeling too cold or too hot • poor lighting • changes to daily routines

CARE FOR DEMENTIA For Sleeplessness: Always refer or ask a doctor if the cause of sleeplessness can be treated. For example, the sleeplessness might be due to depression or the side effects of medication.

CARE FOR DEMENTIA How do I manage memory loss? Here are a few tips to help you manage if the person you care for has memory loss: • it’s important for them to carry appropriate identification at all times including their name, address and an emergency contact number. An identity bracelet is ideal for this purpose • you may need to consider a few home modifications such as sensor lighting and installing equipment such as automatic cut offs for hot water jugs and other appliances such as the iron • labelling doors and cupboards with what is in them such as plates and cutlery • place a communication book by the phone or somewhere handy to provide a list of what’s happening and who has been to visit • display emergency and commonly used telephone numbers near the phone.

CARE FOR DEMENTIA How do I manage if they are confused? Here are a few tips to help you manage if the person you care for is confused: • try not to make any changes to their familiar environment unless they are absolutely necessary. An example might be installing equipment such as a ramp for their safety • consider having someone to assist them with medications as they can be a common cause of confusion • use a dose administration aid to assist the person to self-administer their medications • use notice boards and reminder notes to list the things that are happening or need remembering such as medication • install nightlights in the hallways and in the toilet to help them find their way to the bathroom at night • easy to read clocks and large calendars can be helpful reminders of the time and date.

CARE FOR DEMENTIA How do I work with health care professionals? As dementia progresses, you’ll probably meet many health care professionals involved in the care of your family member or friend. Think of these people as part of your team. It is important to have a doctor who can provide you with good support, take time to answer your questions and show empathy for the person you care for. Remember, if you don’t understand what is being said, don’t be afraid to ask the doctor to say it again in a different way. You can find helpful information, including questions you might want to ask about medicines and dementia at NPS medicine wise.

CARE FOR DEMENTIA How will I know if they are sick and need medical or dental care? People with dementia are affected by the same illnesses as everyone else. The difference is that they may have difficulty communicating this to you or their health professional. For example, if they are in pain you can look out for symptoms such as behavioural changes, crying, facial movements or if they are reluctant to move. You may also consider regular dental appointments as people with dementia often suffer from problems such as reduced production of saliva, changed eating habits and reduced ability to look after their oral and dental health.

CARE FOR DEMENTIA How will I know if they are sick and need medical or dental care? People with dementia are affected by the same illnesses as everyone else. The difference is that they may have difficulty communicating this to you or their health professional. For example, if they are in pain you can look out for symptoms such as behavioural changes, crying, facial movements or if they are reluctant to move. You may also consider regular dental appointments as people with dementia often suffer from problems such as reduced production of saliva, changed eating habits and reduced ability to look after their oral and dental health.

CARE FOR DEMENTIA How will I know if they are sick and need medical or dental care? People with dementia are affected by the same illnesses as everyone else. The difference is that they may have difficulty communicating this to you or their health professional. For example, if they are in pain you can look out for symptoms such as behavioural changes, crying, facial movements or if they are reluctant to move. You may also consider regular dental appointments as people with dementia often suffer from problems such as reduced production of saliva, changed eating habits and reduced ability to look after their oral and dental health.

CARE FOR DEMENTIA How will I know if they are sick and need medical or dental care? People with dementia are affected by the same illnesses as everyone else. The difference is that they may have difficulty communicating this to you or their health professional. For example, if they are in pain you can look out for symptoms such as behavioural changes, crying, facial movements or if they are reluctant to move. You may also consider regular dental appointments as people with dementia often suffer from problems such as reduced production of saliva, changed eating habits and reduced ability to look after their oral and dental health.

CARE FOR DEMENTIA If you need to take them to the hospital: • try and remain calm • give hospital staff as much information as you can about the person you care for, especially what medications they take, their medical conditions and the health care professionals involved

CARE FOR DEMENTIA Carer support groups: Carer support groups can offer you a safe place to talk about your role as a carer. They can put you in touch with other carers who may be experiencing similar things to you so you can share advice and suggestions to support each other. Carer support groups can sometimes be organised around specific caring roles and the situation of the person you care for. For information about these groups in your area, read about caring for someone with a particular need or call My Aged Care - Toll-free line The National Dementia Helpline can also put you in touch with support groups around the country for carers of people with dementia. The groups let you share experiences, learn from others and discuss issues and emotions in a safe environment.

CARE FOR DEMENTIA References: 1.Health Services Framework for older people 2009-2016 2. https://vic.fightdementia.org.au/about-dementia/resources/help-sheets 3. alg.org / Alzheimer's association 4. . Egan K, Labyak M. Hospice palliative care: a model for quality end-of-life care. Oxford (England): Oxford University Press; 2006. 5. Shakeri Shemariani F. Culturally competent practice in hospice palliative care. Perspectives: BCASW newsletter. 2004 6. Wessel, E, & Garon, M. (2005). Introducing reflective narratives into palliative home care education. Home Health care ;

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