During your CNA training program, you spent a day in a Memory Care unit and fell in love with the care and residents. They walked and talked and were mostly pleasant. You loved the experience so much that you chose a Memory Care unit for your first job.
However, you’ve been working there for a few months and see a new side of dementia. Many of the residents wander and become combative. Some residents are even confined to a chair or bed all of the time. You recently cared for a resident who died from the complications of dementia, and it was a challenging event to witness. You’re starting to wonder if you know the best care strategies for this population of residents and if this is the best unit for you.
Before you throw in the towel, let’s review some of the basics and provide you with care tips you can use for residents living with dementia.
What is Dementia?
According to the National Institute on Aging, dementia is the loss of cognitive functioning. This includes things like thinking, remembering, and reasoning. Dementia interferes with the person's daily life and can make it difficult to control emotions. Some people living with dementia will experience personality changes too.
Dementia affects about one-third of all people ages 85 and older. However, it’s not a normal part of aging. Many people live their entire lives without any symptoms of dementia.
Residents with dementia often need more supervision than they can get living at home or in an assisted living facility. This is when a stay in a memory care unit can be helpful. Memory care units provide:
- Meaningful engagement and activities designed specifically for the individual
- Enhanced safety features such as secure exits and alarms
- Care that includes visual cues like signs or pictures to support independence
Signs and Symptoms of Dementia
The term dementia covers a disease that ranges from mild to severe symptoms. In its mildest form, dementia may affect the person’s functioning in minimal ways.
However, as dementia advances, the person will likely depend completely on others during all activities of living. Common symptoms of dementia include:
- Wandering or getting lost even in familiar settings
- Memory loss
- Poor judgment
- Difficulty speaking
- Inability to handle bills and money
- Repeating questions
- Using incorrect or unusual words for familiar objects
- Completing normal activities much slower than normal
- Problems with balance and movement
- Hallucinations, delusions, or paranoia
It’s critical to know that dementia is progressive. This means it will worsen with time. Each person will decline at a different pace depending on their overall health. The National Institute on Aging reports that the deaths linked to dementia could be as much as three times higher than reported on death certificates in the U.S. However, most people die from complications like pneumonia, falls, stroke, or malnutrition.
Best Tips You Can Use
Working with people living with dementia takes patience - and lots of it! You will have some days when you feel like this is your calling and others when you fail miserably. This is normal.
When you’re new to memory care, it can take months, if not the entire first year, before all the tips and tricks of caring for residents with memory issues come naturally. The information below will help but remember that dementia care is a specialty, and being a pro will take time.
Get Their Attention Before Providing Care
Providing care to someone living with dementia in the middle of a busy day-room will probably not go well. They may pay attention to the TV or others when you’re trying to get them to focus on a task. Try minimizing distractions by:
- Turning off the TV and music
- Taking them to a separate room or area when providing care
- Grouping residents with similar abilities together during meals
- Giving them your undivided attention during care
- Calling them by their name and providing simple instructions
Use Simple Words and Phrases
It’s never a good idea to use long sentences and lots of details when giving directions. Instead, speak slowly and clearly while using short sentences and simple words. Keep your tone happy and light and never yell or raise your voice. If you need to repeat instructions, don’t vary the words too much, or it will sound like new information to someone with dementia. Instead, try repeating the same thing a few times before deciding they don’t understand.
Set a Positive Mood
People living with dementia may have trouble understanding your words, but they are still perceptive. They will pick up on your body language and facial expressions and know when you feel frustrated. Remain pleasant and respectful during all interactions. Keep your tone friendly while controlling your facial expressions and touch.
Ask Simple, Answerable Questions
When working with residents without memory issues, you might be able to ask them open-ended questions. For example, “What would you like to wear today?” is an excellent question.
However, for someone living with dementia, this type of question can be overwhelming. So instead, offer two options and say something like, “Do you want to wear the red shirt or the blue shirt today?” This question achieves the same outcome but makes it easier for the person with dementia.
Listen with More than Your Ears
These residents may not be able to tell you how they’re feeling. They might be frustrated, sad, or even experiencing pain but never use those words. You must learn to listen with your eyes, ears, and even your heart. Here are a few ways to communicate with someone living with dementia:
- Give them plenty of time to speak
- Watch facial expressions and body language for hints about how they feel
- Be aware of your nonverbal communication
- Use a gentle touch to show compassion and encouragement
- Observe for cues that tell you when they need to use the toilet, are ready for bed, or need to eat
Break Tasks Into Smaller Steps
Many people living with dementia have trouble remembering how to do tasks they’ve always done. So breaking complex tasks into smaller steps makes it easier for them. For example, instead of telling them to get dressed, ask them to remove their shirt first. Then, once done, prompt them to put on a clean shirt. You can use this same strategy with just about any task you want them to do.
Distract and Redirect
If you know a particular activity causes stress, try distracting them instead of forcing them. For example, if they don’t like toileting but enjoy brushing their teeth, you might tell them it’s time to brush their teeth to get them to the bathroom. Once there, you can direct them to use the toilet. This strategy can reduce the risk of them becoming frustrated when asked to do something they don’t like.
Take a Walk Down Memory Lane
People living with dementia might not be able to tell you what they did last week, but their early life memories are usually intact. Ask them to tell you stories about their youth or play the music that was popular when they were young adults. These simple activities can make them happy and less combative. You may also get to see them differently, which can deepen your understanding of who they are as a person.