Caring for a loved one who has developed dementia is a trying time for the designated caregiver. Caring for someone, particularly a loved one, who suffers from dementia can affect the caregiver physically, emotionally, and financially. The goal of this paper is to provide information for caregivers regarding what to expect when caring for an older loved one.
Behavioral Issues Exhibited by Individuals with Dementia
There are multiple issues that caregivers must be aware of as they prepare to care for someone with dementia. The Caregiver’s Guide to Understanding Dementia Behaviors (2004), published by the Family Caregiver Alliance, provides examples of the behaviors that are often exhibited by those with dementia. First, wandering is common. Those with dementia may wander to find something or someone perceived as lost, as a side effect of medication, or simply out of boredom. Second, agitation can occur.
Agitation may include “irritability, sleeplessness, and verbal or physical aggression” (“The Caregiver’s Guide,” 2004). Agitation occurs when the individual believes that they are not in control, and typically progresses in severity along with the level of dementia. Perseveration can also occur in individuals with dementia. While this type of behavior is typically not putting the individual in danger, it can be emotionally taxing to the caregiver. Many individuals with dementia also experience difficulty maintaining proper nutrition (Scheltens, 2009). Proper nutrition can be affected by medication side effects, dental issues, or just simply forgetting to eat or drink. Many of the behaviors described here increase as the day continues, a condition referred to as sundowning (Nowak & Davis, 2007). Experts believe that sundowning could be caused from overwhelming exhaustion from the day as well as the disruption of the body’s natural biological clock.
Behavioral Interventions for Individuals with Dementia
Interventions that can potentially limit or discourage the behaviors described above do exist. One such intervention is to regularly schedule time throughout the day for exercise. Also, the caregiver should attempt to create and maintain structure (Jensen & Padilla, 2011). This includes both a daily routine, as well as the placement of household objects such as furniture, clothing, and personal mementos. Also, meals and snacks should be scheduled at the same time each day and prepared with the loved one’s needs in mind.
Possible Outcomes of Behavioral Interventions
Experts believe that daily exercise can have a positive impact on individuals suffering from dementia (Littbrand et al., 2009). It can potentially minimize restlessness, help with weight management issues and related health issues, and ease the effects of sundowning. It is important to remember that exercise should be scheduled into the daily routine in order to have an effect. Maintaining structure, both in routines and location, can help minimize the level of agitation seen in the individual. Strategically placing familiar objects can help trigger pleasant memories, while constantly rearranging furniture can trigger anxiety and confusion. Scheduling meals and snacks into the daily routine can help reinforce the daily schedule, as well as providing a time to share a special moment with the loved one.
Support for the Caregiver
It is of utmost importance that the caregiver identifies the necessary supports to maintain his or her own personal wellbeing. This includes recognizing and maintaining stress levels, setting personal goals outside of caregiving, and asking for and accepting assistance when needed. Most importantly, it is important to remember that the way in which a situation is viewed, no matter how dire, is instrumental to the caregiver’s overall wellbeing.
- Caregiver’s guide to understanding dementia behaviors. (2004). Retrieved August 30, 2013, from http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=391
- Jensen, L. E., & Padilla, R. (2011). Effectiveness of interventions to prevent falls in people with Alzheimer’s disease and related dementias. American Journal of Occupational Therapy, 65(5), 532-540.
- Littbrand, H., Lundin-Olsson, L., Gustafson, Y., & Rosendahl, E. (2009). The effect of a high-intensity functional exercise program on activities of daily living: A randomized controlled trial in residential care facilities. Journal of The American Geriatrics Society, 57(10), 1741-1749.
- Nowak, L., & Davis, J. E. (2007). A qualitative examination of the phenomenon of sundowning. Journal of Nursing Scholarship, 39(3), 256-258.
- Scheltens, P. P. (2009). Nutrition and dementia. European Journal Of Neurology, 16(Suppl1), iii-iv.