Why it's important

Following someone around is a common behavior among individuals with dementia. Often, it is because they don’t feel safe. Your loved one may be thirsty, hungry, in pain, or may have misunderstood something and felt threatened as a result. They could even be frustrated or bored. Seeking to understand why it happens, and not just classifying it as “confused behavior,” is an act of compassion. Figuring out what you can do is the best way to help them feel safer.

How to do it

When your loved one follows you around:

• Remind yourself that their behavior is a result of feeling unsafe and needing reassurance.
• Look around the room for clues to understand why they feel unsafe or anxious.
• Use a calming tone when talking to them to provide reassurance and comfort.

Benefits

• Promotes independence by addressing their underlying needs, helping them feel secure enough to engage in activities on their own.
• Makes you more attuned to your loved one's needs and emotional state.
• Improves communication by encouraging you to be more observant and responsive to non-verbal cues.
• Boosts your loved one's confidence by addressing their needs promptly and directly, helping them feel more secure and understood.

Remember

Understanding that your loved one still feels things the same way we do but lacks the ability to express their concerns properly is imperative. Keeping your demeanor calm and understanding will ultimately help your loved one feel safe and secure.

What it is

Mild dementia is the earliest stage of dementia and can last for many years. During this stage, individuals may experience symptoms such as memory issues, difficulty concentrating, and trouble planning activities. They may also express feelings of depression and anxiety and struggle with tasks that previously posed no difficulty for them.

What to expect

In this stage, your loved one may want to downplay their diagnosis or may not even want to go to the doctor for a diagnosis. They might become very angry, anxious, or depressed after being diagnosed, and these reactions are very normal and common responses to the onset of dementia symptoms.

Compassionate caregiving tips

• Acknowledge their feelings - understand that downplaying the diagnosis or refusing to see a doctor is a common reaction. Show empathy and patience.
• Be there to listen and reassure them, offering a calm and supportive presence to help manage their anger, anxiety, or depression.

Remember

It's important to approach mild dementia with understanding and support. Recognize that your loved one's reactions to challenging verdicts are normal, and be patient as they navigate this difficult stage in their life.

Why it's important

Nurturing plants together exercises fine motor skills and other physical capabilities while simultaneously creating moments for you two to connect and converse. It also gives your loved one reasons to feel useful.

How to do it

• Buy plants to put in the ground or purchase a plant that needs daily tending to keep in your house.
• Engage your loved one in watering the plant daily and caring for it, ensuring they feel involved and responsible.
• Use this time to connect by talking about the plants, their growth, and any memories associated with gardening or nature.

Benefits

• Engaging in regular hand movements and fine motor activities helps to maintain dexterity.
• Enhances physical well-being by promoting gentle physical activity through gardening tasks.
• Fosters emotional connections by providing opportunities to share experiences and conversations while caring for the plants.
• Boosts their sense of purpose by allowing your loved one to feel useful and responsible for the well-being of the plants.

Remember

Incorporating plant nurturing into your loved one's daily routine can be a therapeutic and fulfilling activity for both of you.

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Why it's important

Dementia impacts language processing abilities, making it challenging for your loved one to follow complex instructions. Simplifying the way you communicate reduces the risk of overwhelming or confusing them.

How to do it

Instead of saying:

• "Put on your coat and shoes, and grab an umbrella because it’s raining."

Break it down into simpler steps, and give one directive at a time to ensure clarity and manageability:

• Begin with "Put on your coat."
• Once completed, move to the next instruction, "Put on your shoes."

Benefits

• Reduces confusion and helps your loved one follow through with tasks more successfully.
• Decreases frustration for both you and your loved one.
• Promotes independence by enabling them to complete tasks one step at a time.

Remember

Patience and clarity are essential when providing care to those with dementia. Approach each instruction as an opportunity to support and empower your loved one, recognizing the challenges they face with their condition.

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Why it's important

When your loved one is restless or agitated in the late afternoon or early evening, perhaps pacing or wandering off, it is due to what is deemed “Sundowning.” It is thought that Sundowning happens because dementia interferes with a person's internal clock, often making them restless and agitated due to discomfort. These strange behaviors are efforts by your loved one to communicate that discomfort to you.

What to do

• Implement a short nap during the day to help reduce over-tiredness, which can worsen Sundowning symptoms.
• Create a calming evening routine with activities that promote relaxation, such as listening to soothing music, dimming the lights, and avoiding stimulating activities close to bedtime.
• Monitor their environment to ensure it is quiet and comfortable, minimizing noise and distractions that might contribute to restlessness and agitation.

Benefits

• Addressing potential causes of discomfort and providing a calming routine reduces agitation and restlessness.
• Improves sleep quality by helping regulate their internal clock and ensures they are well-rested.
• Enhances emotional well-being by creating a peaceful and supportive environment that reduces anxiety and stress.

Remember

By understanding and addressing the effects of Sundowning, you can help alleviate their discomfort and promote a more peaceful and comfortable routine.

Why it's important

Dementia fundamentally changes certain parts and functions of the brain, leading to behaviors that might seem odd or nonsensical to you but are entirely valid for your loved one. It's extremely important to understand that if the behaviors aren't harmful or pose a risk, the best course of action is to respect them.

How to do it

When your loved one is acting “odd”:

• Observe without interrupting. If your loved one is engaged in a positive hallucination like sweeping a clean floor, pacing without distress, or repeatedly taking pillows on and off the bed, allow them to continue.
• Make sure their activities do not pose any risk of harm to themselves or others. If the behavior is safe, let them proceed.
• Accept that their actions, though odd to you, are meaningful to them and validate their experience by not interfering.

Benefits

• Preserves your loved one’s dignity by respecting their actions and not dismissing their experiences as irrelevant or bothersome.
• Reduces conflict by avoiding unnecessary interruptions, which can lead to frustration or distress for your loved one.
• Promotes autonomy by allowing them to engage in self-directed activities that provide a sense of purpose and control.

Remember

One of the primary goals of compassionate caregiving is to honor your loved one while ensuring their safety. Respecting behaviors that may seem odd to you, as long as they do no harm, is a powerful way to show love and respect to the person you’re caring for.

Why it's important

Behavioral outbursts are often triggered by something your loved one cannot verbalize due to their condition. Approach each situation with patience and empathy, aiming to address their underlying needs and concerns while recognizing that your loved one's displays of upset aren’t personal.

What to do

• Stay calm, take deep breaths, and maintain a steady tone of voice.
• Use open body language by getting down to their level and avoiding crossing your arms.
• Get curious and try to understand the reason behind their behavior, whether it’s due to thirst, hunger, pain, needing the bathroom, or feeling misunderstood or confused.
• Redirect their attention if they are acting out, or walk away for a moment to de-escalate the situation.

Benefits

• Enhances your understanding of their behavior by recognizing their response is due to unmet needs or confusion.
• Staying calm and using open body language can help de-escalate tense situations and improve mutual communication.
• Seeking to understand your loved one's behavior without personalizing it fosters a more empathetic caregiving approach.

Remember

Your loved one’s anger is often a response to unmet needs or confusion, not a personal attack or a reflection of their feelings towards you.

Why it's important

By learning to accept the inaccuracies that result from memory loss and working with your loved one rather than demanding that they use the memories and rational skills no longer available to them, you create a safe environment for them.

How to do it

• Be patient and listen actively to their concerns and feelings.
• Avoid correcting their memories or perceptions; instead, gently guide the conversation to more comforting and present topics.
• Provide consistent reassurance by repeating calming phrases and offering physical presence or comfort.
• Use specific language to reassure them. Say things like "I am here with you" or "You are not alone; I understand."

Benefits

• Strengthens trust between you and your loved one.
• Enhances emotional well-being by creating a supportive environment.
• Promotes a sense of peace through continuous reassurance and presence.

Remember

Your loved one continues to learn experientially, and through their day-to-day experiences with you, they either learn that they are safe in your care or not. It’s important to respect their feelings and concerns, just as you would anyone else.

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Dealing with and understanding dementia can be incredibly challenging and emotionally draining for a caregiver. By educating yourself as much as you can about the broad spectrum of dementia’s symptoms, you'll be better equipped to manage daily challenges and provide compassionate care for your loved one.

How to do it

• Listen to the experts including doctors, specialists, and your loved one. Ask them questions about dementia, care tools, and the best ways to gain guidance and insights.
• Explore educational content by reading books, watching videos, and listening to podcasts featuring discussions with dementia care experts, caregivers, and people living with dementia.
• Join a support group to connect with other caregivers, share experiences and advice, and receive emotional support from people who are going through the same thing as you.

Benefits

• Gain an enhanced understanding of dementia, giving you the ability to communicate better and provide excellent, adaptive care.
• Improve problem-solving by applying learned strategies to manage symptoms and behaviors whenever the need arises.
• Find emotional support through connecting with others who share similar experiences.
• Feel empowered, confident, and capable in your caregiving role.

Remember

Understanding dementia is a journey, and the learning takes constant effort. Stay curious, ask questions, and seek out resources to build your knowledge. Your commitment to understanding dementia not only benefits you but also enhances the quality of life for your loved one.

What it is

Alzheimer's disease is the most common type of dementia, affecting parts of the brain that handle memory, behavior, language, and thinking. It is a degenerative, progressive disease that begins with mild memory loss and most often leads to an inability to communicate and carry out tasks of daily living.

Why it happens

According to the U.S.A’s National Institute of Health (NIH), the causes of Alzheimer's disease probably include a combination of age-related changes in the brain, along with genetic, environmental, and lifestyle factors.

Compassionate caregiving tips

• Focus on your loved one rather than on their condition by understanding their personal needs, preferences, and feelings.
• Ensure that your loved one's emotional health is prioritized over trying to make them behave "normally."
• Be patient, offer reassurance, and provide a calm and supportive presence.
• Take care of yourself! Ensure that you are looking after your own physical and emotional health so you are able to provide the best care possible.

Remember

Patience, empathy, and self-care are key to effectively supporting your loved one with Alzheimer's.

Why it's important

Dementia can affect the language-processing areas of the brain, making it challenging for individuals affected by it to understand and respond quickly or effectively. By communicating with your loved one in a clear, calm, and patient manner, you show them respect and illustrate that their thoughts and responses are valued.

How to do It

• Before you begin the conversation, take a moment to breathe deeply and relax your body and mind.
• Think about how you will express your thoughts. Use simple, straightforward sentences and avoid complex or ambiguous language.
• After speaking, patiently wait for their responses. Give them plenty of time to process the information and formulate their reply. Avoid rushing them or finishing their sentences.

Benefits

• By avoiding rushed interactions, the likelihood of frustrating your loved one decreases significantly.
• Showing that you are willing to wait for a response demonstrates respect for their ability to contribute to the conversation.
• Clear and patient communication can help overcome some of the language barriers caused by dementia, leading to better mutual understanding.

Remember

Always approach conversations with a relaxed demeanor and a patient heart. A good attitude and approach can greatly influence the effectiveness of your communication and the emotional well-being of your loved one.

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Why it's important

People with dementia often interpret the present through the lens of past memories. Joining the reality of your loved one helps prevent distress and fosters a sense of safety and emotional connection between you.

How to do it

• Tune into their language and adapt your conversations to align with their reality.
• Instead of correcting them, go along with their perceptions.
• If they believe it’s a past year, play along with them in that context.

Benefits

• Avoids confusion and agitation for both caregiver and loved one.
• Helps your loved one feel understood.
• Respects and validates their experiences, ultimately supporting their dignity.

Remember

"Meet them where they are" isn't just a strategy; it's a compassionate commitment to ensuring your loved one feels secure, understood, and deeply valued. As long as their “reality” poses no risk or distress to themselves or others, join them in it!

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Why it's important

Verbal aggression from individuals with dementia can stem from their inability to adequately express their feelings, thoughts, and needs, which often results in frustration, fear, or confusion.

How to do it

If your loved one is verbally aggressive or screaming:

• Speak calmly and softly, using a reassuring voice to help de-escalate the situation and provide a sense of security.
• Talk to your loved one about someone they love or something they enjoy. This can help shift their focus away from the source of their anger.
• Divert their attention to an object or activity in the room that might capture their interest and distract them from their distress.

Benefits

• Speaking calmly and redirecting attention can help lower their stress levels and prevent escalation of their feelings.
• Creating a peaceful environment makes your loved one feel secure and valued.
• Redirecting to topics they love can foster positive interactions and strengthen your bond.

Remember

Verbal aggression is often a way for your loved one to communicate their fears and frustrations with you. Approach each situation with empathy and patience, recognizing that their behavior is a result of their condition and not because of actual anger or disappointment in you.

Why it's important

Feeling useful is especially important for people with dementia. Whether it’s a real holiday or your loved one believes it is, taking time to decorate and prepare for special occasions can create an atmosphere of holiday spirit and jog historical memories, allowing for conversations about past traditions.

How to do it

• Lay out tangible reminders for the specific holiday and use decorations that are familiar and may be sentimental to your care receiver. Let your loved one choose the decorations and help with placing them.
• Keep the environment simple and festive without overcrowding the space.
• Avoid twinkling lights to prevent overstimulation. Opt for static, gentle lighting that enhances the holiday spirit without causing discomfort.

Benefits

• Brings back memories by involving your loved one in decorating, helping them recall past traditions and reminisce over joyful moments.
• Fosters connection through shared activities and creates opportunities for meaningful conversations and bonding.
• Promotes a sense of accomplishment by engaging in familiar tasks, further enhancing your loved one’s emotional well-being.

Remember

Decorating for the holidays together can be a wonderful way to connect with your loved one and create a joyful, festive environment. Keep decorations simple and familiar to avoid overstimulation and confusion to ensure a positive and enriching experience for both of you.

Why it's important

Mental distortions such as hallucinations, delusions, and paranoia are common symptoms of dementia, and may be very real and frightening experiences for your loved one. By addressing these distortions as if they were real and validating their experiences, you help them feel safe, supported, and heard in your presence.

How to do it

If your loved one experiences any mental distortion symptoms:

• Acknowledge their fears sincerely. If your loved one expresses fear or concern about something they perceive, validate their feelings rather than dismissing them or trying to correct them.
• Take actionable steps to reassure them that you are there or can help with the problem. For example, if they “see” a man hiding in their closet, calmly tell your loved one that you will go and tell him to leave.
• Create a safe environment by ensuring their surroundings are calm, familiar, and inoffensive, which can help reduce the frequency of these mental distortions.

Benefits

• Enhances emotional safety by validating their experiences, which helps your loved one feel understood and less isolated in their fears.
• Builds trust through your consistent and compassionate responses, reinforcing their sense of security in your presence.
• Reduces anxiety by addressing their fears head-on and helps alleviate the distress caused by these distortions.

Remember

Recognizing and addressing your loved one’s fears, no matter how unfounded they may seem, demonstrates your commitment to their emotional well-being and ultimately creates a more secure and trusting environment.

What it is

Delusions occur when your loved one firmly believes something is true despite clear evidence to the contrary. This belief of theirs is unshakeable, and attempts to correct it often result in frustration or agitation for both you and your loved one.

Why it happens

Dementia can cause your loved one's brain to be affected by changes that cause memory loss and significant confusion. This condition can lead to:

• Misinterpretation of facts as the brain struggles to process and understand information accurately.
• Memory loss which can create gaps in knowledge that are then filled with incorrect or imagined information.
• Inability to distinguish reality from their imagination due to the progression of cognitive impairment.

Compassionate caregiving tips

• If the delusion is harmless and makes your loved one happy, support their belief and avoid confrontation - join their reality!
• Soothe and comfort if the delusion causes distress. Validate their feelings and then gently redirect their attention to another activity or topic.
• Speak softly and reassuringly to prevent escalating the situation and make sure to provide them with comfort and stability.

Remember

Empathy and patience are key when dealing with delusions. Enter their world with compassion and focus on their emotional well-being rather than trying to correct their misconceptions.

Why it's important

Cooking together creates opportunities for meaningful connections and conversations, fostering emotional bonds and slowing cognitive decline.

How to do it

• Select a recipe that is stage-appropriate, ensuring it matches your loved one's current abilities, interests, and tastes.
• Gather all necessary ingredients ahead of time to make the process smoother and more enjoyable.
• Engage your loved one in each step, from measuring and mixing to pouring and stirring, offering gentle guidance and encouragement throughout the process.

Benefits

• Maintains fine motor skills through tasks like measuring, mixing, and pouring.
• Fosters emotional connections through shared experiences and conversations.
• Provides a sense of accomplishment as you create a meal together, boosting their self-esteem and mood.

Remember

Cooking together is about more than just making a meal; it’s about enjoying the process and the time spent together. Celebrate each step, no matter how small, and use this activity to create joyful memories and reinforce a sense of routine and stability for your loved one.

Why it's important

Physical activity is a self-care tool that everyone can use anytime, anywhere, to enhance their well-being. It's a versatile and accessible way to improve health and combat mental fatigue, all while maintaining a positive outlook.

How to do it

• Choose an organized activity to your liking, such as taking a yoga class, playing tennis, swimming, or whatever gives you joy.
• Engage in home-based exercises like dancing around the room, jumping rope, or roller skating. Activities like these are fun and effective ways to stay active without having to leave the house.
• Incorporate physical activity into daily routines by riding a bike, walking around the block, or opting for stairs instead of the elevator.

Benefits

• Improves overall health by enhancing physical strength, endurance, and cardiovascular function while also boosting mental well-being through the release of mood-improving endorphins.
• Promotes better sleep by helping regulate your sleep-wake cycle.
• Increases energy levels and helps you stay alert and active throughout the day.

Remember

Consistency is key. Incorporate physical activity into your daily routine to reap the full benefits. By staying active, you not only take care of your own health but also improve your ability to care for your loved ones with a balanced and positive mindset.

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Why it's important

It's essential to handle conversations about deceased individuals with the utmost care to prevent re-triggering grief, sadness, anxiousness, or depression in loved ones with dementia. Reminding them of the death of a family member or close friend may cause them to re-live trauma and feel especially confused and upset.

How to do it

• Assess their awareness and try to gauge whether your loved one is temporarily confused or truly unaware of the death.
• If possible, subtly change the subject to avoid the topic of the deceased.
• Use compassionate deception if redirection does not work and distress seems imminent. Although it seems counterintuitive, in the case of dementia, it may be more humane to use a white lie. For instance, saying the deceased person is away and sending their love can prevent emotional turmoil.
• Always respond with empathy and maintain a reassuring, gentle presence to help them feel secure and loved.

Benefits

• Prevents emotional distress: Avoids the harsh impact of re-experiencing loss, which can be particularly severe for those with dementia.
• Maintains mental stability: Helps keep your loved one in a more contented and less agitated state.
• Encourages a peaceful environment: Fosters a calm and supportive living situation, which is beneficial for everyone involved.

Remember

Sometimes, "protective lies" can be an act of kindness, especially when the truth no longer holds the same meaning to someone whose cognitive abilities have declined. It's about preserving the emotional well-being of your loved one by carefully navigating difficult topics.

Why it's important

Your loved one often yearns to feel useful, so as caregivers, we should seek ways to enhance their quality of life, both physically and emotionally. Shredding paper is actually a great way to exercise their fine motor skills and other physical attributes, while also allowing for time to connect and have meaningful conversations.

How to do it

• Use a paper shredder and any paper that needs shredding, or manually rip the paper if you don’t have a shredder. Ask your loved one to rip the paper into smaller pieces, engaging their fine motor skills.
• Sit with them during the activity and follow along - it may seem like an odd activity, but your loved one will be enjoying the time spent with you. Use this time to have conversations and enjoy each other's company.

Benefits

• Enhances fine motor skills by engaging in an activity that requires eye-hand coordination, helping maintain dexterity.
• Creates moments of connection through shared activities, fostering emotional bonds and better communication.
• Promotes a sense of usefulness by involving your loved one in meaningful tasks, enhancing their emotional well-being.

Remember

Engaging in simple activities like shredding paper can significantly benefit your loved one’s physical and emotional health. By participating in this activity together, you make time for each other and have meaningful interactions, contributing to their overall quality of life.

Why it's important

All human beings are inherently valuable. Even though dementia may seem like an all-encompassing illness, your loved one still has sensory and perceptual awareness that allows them to feel how they are being treated, just like you. When we take time to remember the inherent values of a human being, we ensure our loved ones feel safe and loved in our presence. This approach will instill in both you and your loved one a sense of well-being and positivity.

What to do

• Radiate love and practice fairness by treating your loved one with respect, showing consistent affection, and ensuring their needs are met without discrimination.
• Show gratitude and express affection with gentle touches, kind words, and warm gestures that convey love and care, making your loved one feel cherished and valued.
• Show compassion and honor their autonomy by being patient, understanding their needs and emotions, involving them in decisions, and respecting their preferences and choices.

Benefits

• Enhances emotional well-being by making your loved one feel respected, valued, and loved.
• Positive and compassionate interactions foster a deeper connection between you and your loved one.
• Creates a nurturing and supportive environment where they feel safe.

Remember

By recognizing and honoring your loved one’s dignity and worth as a human, and not just a person with dementia, you create a foundation of trust and love that enhances their quality of life and strengthens your relationship.

Why it's important

Getting your thoughts and feelings on paper and out of your head through journaling is a useful stress-relieving tool and is often used as a form of therapy. Reducing stress in your mind will allow you to take care of yourself and, by extension, your loved one as optimally as possible.

How to do it

• Set aside time daily to write in your journal. Consistency helps establish a routine.
• Write down all your thoughts and feelings freely without worrying about grammar or structure. Don’t be afraid to doodle or draw anything that comes to mind, either.
• Use prompts if needed to guide your writing, such as "Today I am grateful for..." or "What challenged me today was..."
• Reflect on positive moments and express gratitude regularly to foster a positive mindset.
• Review past entries periodically to observe your progress and gain insights into your emotions and experiences and their evolution over time.

Benefits

• Enhances self-exploration and helps you understand your thoughts and feelings better.
• Cultivates gratitude by highlighting positive aspects of your day and life.
• Preserves memories of meaningful moments with your loved one, creating a valuable record to look back on.
• Improves emotional processing, making it easier for you to manage caregiving challenges.

Remember

Journaling is a personal and flexible practice, and it's important to note that there is no right or wrong way to do it. The key is just consistency and openness, and by allowing yourself the freedom to express whatever comes to mind, you will find that your mood and overall well-being will improve.

What it is

According to the U.S.A’s National Institute of Health, suicidal ideation is “a broad term used to describe a range of contemplations, wishes, and preoccupations with death and suicide.” It may present as your loved one vocalizing a desire to go to sleep and “never wake up again,” or more intense preoccupations with doing something harmful to themselves that would result in death. They may simply express that they “just want to die.” It is important to note that suicidal ideation can vary in intensity, duration, and character, often presenting in a “waxing and waning” manner.

Why it happens

In the early and middle stages of dementia, your loved one becomes aware of their eventual loss of memories, ability to care for themselves, and understanding of their surroundings and self. This awareness can lead to:

• Feelings of depression as they grapple with the loss of their identity and abilities.
• Intense fear and anxiety about the future and the progression of their condition.
• Overwhelming emotions that lead the brain to seek relief, sometimes fixating on suicide as a solution to escape these feelings.

Compassionate caregiving tips

• Stay calm and maintain a composed demeanor to ensure your loved one feels safe and supported—be their rock during these challenging times.
• Listen with compassion and empathy and offer validation. It might be difficult to hear, but acknowledge their feelings and let them know you understand why they feel this way.
• Assess the risk by asking them directly if they have a plan to hurt themselves. Research shows that asking about suicidal thoughts does not plant the idea but can actually provide relief by opening up space for discussion.
• Encourage them to talk about their feelings and ask clarifying questions to better understand their thoughts and feelings.
• Remind them that you are there to listen, support, and love them through their journey.
• Redirect the conversation to more hopeful and positive topics after they have had space to express their feelings.
• Seek professional help immediately if they indicate they have a plan or cannot move past their feelings.
• Ensure ongoing support by following up with a therapist, psychiatrist, and other supportive interventions outside of yourself.

Remember

Empathy, patience, and unconditional support are crucial when addressing suicidal ideation. By staying calm, listening with compassion, and seeking professional help when needed, you can help your loved one navigate these difficult emotions and provide them with the support they need.

Why it's important

Simplifying choices reduces the cognitive load on your loved one. Direct questions about preferences may require them to access memories that are no longer easily reachable and may cause them to become frustrated and emotionally distressed.

How to do it

• Serve the meal directly with a simple statement about what's being offered, such as, "Tonight, we’re having pasta for dinner." This approach avoids direct questions that demand decision-making or memory recall.
• Don't ask, just gently give guidance. Instead of asking your loved one if they want to go outside, gently guide them towards the door and suggest, "Let's step outside for some fresh air." This approach minimizes the need for decision-making and streamlines the activity.

Benefits

• Reduces stress and anxiety in your loved one during meal times by limiting the need for decision-making, which tends to be rather stress-inducing.
• Supports a sense of dignity by managing how choices are presented, making the process smoother and more respectful.
• Enhances the mealtime experience by focusing on enjoyment rather than decisions.

Remember

Be mindful of your communication. Aim to support their dignity and minimize emotional discomfort by simplifying interactions and avoiding requests for specific recollections or opinions.

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Why it's important

By adopting an approach that’s founded on positivity while making sure to smile, use pleasant tones, and display open body language, you can create a comforting and reassuring environment for your loved one.

How to do it

• Smile genuinely before you start speaking to convey warmth and friendliness.
• Use a pleasant, reassuring tone to express positivity and approachability, making your loved one more receptive.
• Adopt open body language by keeping your arms uncrossed, maintaining a relaxed posture, and orienting your body towards your loved one to show that you are fully engaged and attentive.

Benefits

• Enhances emotional connection by showing that you are happy to be in the presence of your loved one, fostering a stronger bond between the two of you.
• Reduces anxiety and discomfort for both you and your loved one by making interactions more pleasant and less stressful.
• Signals your openness and willingness to listen and engage, demonstrating to your loved one that you are committed to understanding and supporting them.

Remember

A smile does much more than just prepare your loved one to receive your words more kindly—it also sets a tone of compassion and reassurance, a crucial factor in navigating the challenges of dementia with grace and empathy.

Why it's important

Understanding the distinction between the "experiential self" and the "remembering self" is crucial for caregivers. While dementia impacts the ability to recall and remember past experiences, it doesn’t erase the capacity to experience joy and comfort in the present.

What to do

• Stay present by engaging in activities that your loved one enjoys and responds to positively, making sure to focus on and appreciate the current moment.
• Monitor your energy to ensure that the mood and tone you bring into interactions are positive, as this influences the overall environment.
• Connect emotionally through sensory activities such as listening to your loved one's favorite music, smelling fragrant flowers, or tasting a beloved treat.

Benefits

• Focusing on present experiences boosts joy and satisfaction, improving overall well-being and mood.
• By understanding that your loved one may not remember recent events but can still enjoy the moment, you can minimize both of your frustrations.
• Maintaining focus on what your loved one can still experience and appreciate helps strengthen your bond.

Remember

Approach each interaction with your loved one with empathy and patience, recognizing the importance of their ability to experience happiness in the present moment.

What it is

Agitation is a state of heightened emotional distress characterized by restlessness, irritability, and excessive motor activity. Our loved ones are likely to experience some agitation due to the symptoms of dementia, which can intensify feelings of confusion and frustration.

Why it happens

Agitation occurs when our loved ones feel confused, overwhelmed, distressed, fearful, depressed, anxious, or in physical pain. Their inability to understand their surroundings or what is happening can lead to feelings of being overwhelmed and agitated. Situations or environments that are unfamiliar or perceived as threatening may cause fear and can result in agitation.

Compassionate caregiving tips

• Engaging your loved one in a different activity can help shift their focus away from what is causing their agitation.
• Use redirection by gently steering the conversation or activity in another direction can help calm agitation.
• Sometimes a hug or a gentle touch can provide reassurance and reduce feelings of agitation.
• Go for a walk - a change of scenery and physical activity can help soothe restlessness and agitation.

Remember

Understanding that agitation is often a response to underlying feelings or physical discomfort can help you find effective ways to soothe and comfort your loved one.

What it is

Paranoia refers to feelings of suspicion or fear without a basis in reality, and can manifest in your loved one as beliefs that people are out to harm them, that someone is stealing from them, or that familiar individuals have ill intentions.

Why it happens

Feelings of paranoia are a result of dementia's effect on their brain, leading to misinterpretations of facts and inherent confusion due to memory loss. Several factors contribute to this symptom:

• Dementia impacts the brain's ability to process information correctly, leading to faulty belief systems and misinterpretations of situations.
• Memory loss results in confusion as your loved one may not remember events accurately, causing them to fill in the gaps with suspicion or fear.
• Sensory changes can alter their perception and cause ordinary situations to seem threatening, triggering paranoid thoughts.
• Emotional distress such as anxiety and fear are common in dementia and can exacerbate paranoid delusions.

Compassionate caregiving tips

Managing paranoia requires patience, empathy, and strategic responses from you. Here are some tips to help soothe and comfort your loved one:

• Avoid direct confrontation or correction of their fears, as this can increase their distress. Instead, focus on providing reassurance and understanding.
• Create a safe and familiar environment, minimize potential stressors, maintain a consistent routine, and reduce triggers of paranoia.
• Validate their emotions by saying, “I understand you’re feeling worried,” without agreeing with the paranoid belief.
• If paranoia becomes unmanageable, seek additional strategies and possible medication adjustments from a healthcare provider.

Remember

When your loved one is experiencing feelings of paranoia or distress, approach them with empathy and patience. Understand that their paranoia is a symptom of their disease, not a reflection of reality.

Why it's important

As a caregiver, it's common to sacrifice sleep to allot more time for caregiving duties. However, it's of the utmost importance to understand that prioritizing your sleep is the foundation of your overall health and greatly influences your caregiving abilities. By making sure you catch enough Z’s during the night, you set the stage for more effective caregiving and a healthier, happier life. Take care of yourself first, so you can take better care of others.

How to do it

• Keep your room dark, quiet, and at your preferred temperature. Use comfortable bedding and remove electronic devices from the vicinity that might disrupt sleep. This will help create a sleep-friendly environment.
• Read, listen to soothing music, or take a warm bath to establish a relaxing pre-sleep routine.
• Schedule enough time to sleep by setting a consistent bedtime and wake-up time, even on weekends. Aim for 7-9 hours of sleep each night to maintain your health.

Benefits

• Supports overall health by helping regulate bodily functions and immune response, providing you with the energy needed for caregiving.
• Reduces stress by allowing your body to relax and repair itself overnight.
• Boosts brain performance by improving cognitive functions such as memory and problem-solving skills, ensuring you have the mental clarity to provide the best care for your loved one.

Remember

When you prioritize your rest, you equip yourself to be more patient, attentive, and effective in your caregiving role. Your loved one benefits most when you are well-rested and healthy.

Why it's important

Many individuals with dementia consider "assisted suicide" as part of their journey as a way to accept their condition and regain control over their lives. Navigating conversations about assisted suicide with your loved one is undeniably one of the most challenging situations you may have to deal with, and as caregivers, it's essential to approach this sensitive topic with empathy, respect, and compassion.

How to do it

• Calm yourself down so you can create a safe space and take as many deep breaths as you need to steady your nervous system. Once you feel ready, sit down in a private place or choose a time when you both feel calm to discuss the subject.
• Listen without judgment and allow your loved one to speak so they can express their thoughts and feelings openly. Do your best to listen attentively without interrupting or imposing your own opinions.
• Validate their feelings by acknowledging their pain, fears, and the complexity of their emotions. Reassure them that you're here to listen.
• Express your love and support by reminding your loved one that you care deeply about them and are committed to helping them navigate this journey with dignity and respect. If this is against your morals or ethics, tell them that you love them and will help them find someone they can talk to about this topic.
• Encourage exploration of many options and offer to research and discuss various end-of-life options together. This may include exploring palliative care, hospice services, advanced directives, and other supportive measures.
• Respect their autonomy and affirm their right to self-determination. Let them know with words that you do.
• Provide resources by offering to find information about therapeutic options, services, and support groups that can help them make informed decisions about their present and future self.
• Stay present and compassionate - be patient and understanding throughout the whole conversation, and show empathy and compassion, even if you personally disagree with their choices.

Remember

Empathy, patience, and ongoing support are crucial when addressing discussions about assisted suicide. By staying calm, listening actively, and providing resources, you can help your loved one navigate this difficult topic with dignity and respect.

Why it's important

Dementia affects many mental abilities, but your loved one can still access "automatic thinking scripts" and "muscle memory", which allows them to perform familiar tasks even when other cognitive functions decline. Understanding these concepts can help you connect better and support their independence.

What to do

• Utilize your loved one’s familiar objects. If they used to play the piano, place them in front of a piano. If they were an artist, hand them a paint set and a canvas, and if they were gardeners, direct them to a pail of flowers, dirt, and a shovel.
• Create routine activities, encourage them to engage in daily routines they've performed countless times, like making a cup of tea, setting the table, or brushing their teeth.

Benefits

• Engaging in activities your loved one has muscle memory for, however small, creates moments of joy and recognition for them.
• Maintains independence by leveraging automatic thinking scripts, allowing them to function more successfully in their environment.
• Familiar tasks can reduce confusion and stress, making daily life more manageable for both of you.

Remember

Always focus on activities that resonate with their past experiences. By honing in on who they were before the disease, you tap into their retained abilities and enrich their life, as well as your interactions together.

Why it's important

Your loved one primarily experiences the world through intuitive thought, which means they may not fully understand what you're saying or recognize you completely. However, it’s very important to note that they can deeply feel your presence and emotions.

What to do

• Mind your reactions when interacting with your loved one. Even if they might not understand all the details, they can sense your emotions and body language and react accordingly.
• Pay close attention to non-verbal cues and trust your gut feelings to guide your responses to what they say or do.
• Maintain a calm and positive tone of voice. This helps create a reassuring environment and makes them feel more secure and loved.

Benefits

• By tuning into your instincts and reactions, you can foster a deeper bond. The more your loved one feels understood, the safer and happier they will feel when with you.
• Keeping your interactions light and positive can help alleviate stress and anxiety for both of you.
• When you are calm and present, it's easier for your loved one to engage in activities, enjoy sensory experiences, and appreciate the beauty around them.

Remember

Always check your own emotional state before engaging with your loved one. A calm and happy demeanor can make a big difference in how they perceive and interact with you.

Why it's important

Dementia affects your loved one's perception of sensory information, which can impact their quality of life. If they feel sensory overload, they may be unable to tell you with language what is bothering them and as a result, their behavior might seem odd or bothered. To help mitigate this problem, understand what could be bothering your loved one and aim to decrease those distractions or stimuli in their environment.

What to do

• Scan your loved one's room for sights that may be too bright. Adjust lighting to a softer, more comfortable level and use curtains or blinds to control natural light.
• Minimize background noise, turn off unnecessary electronics, and use soft music or white noise machines to create a calming atmosphere.
• Identify smells that may be too strong. Ensure the room is well-ventilated and use mild, pleasant, natural scents if needed, avoiding strong perfumes or cleaning products.
• Remove unnecessary clutter to create a more organized and calming space.

Benefits

• Reduces the chance of sensory overload by creating a calmer and more controlled environment, which can help minimize behavioral issues.
• Getting rid of clutter and potential hazards improves safety, making it easier for your loved one to move around their space.
• Promotes relaxation through a well-organized and sensory-friendly environment, contributing to better overall mental and emotional health.

Remember

Regularly assess and adjust the environment to meet the changing needs of your loved one. By paying attention to their sensory experiences, you can create a space that supports their comfort and well-being, helping them feel more secure and at ease.

Why it's important

Talking about what you are going through with a trained professional is known to decrease your emotional burden, anxiety, and loneliness that arises from caring for your loved one. Therapy can also teach you how to compassionately set boundaries and manage stress on your own. Additionally, your therapist can offer interventions to address issues such as anticipatory grief, anticipated loss, and plans for your future.

How to do it

• Join a caregiver group to connect with others who understand your experiences and can offer support and advice.
• Explore individual therapy by finding a therapist who specializes in caregiver support. You can choose in-person sessions, online therapy, or even text-based therapy to suit your schedule and preferences.
• Consider family therapy to improve communication and understanding among all family members involved in caregiving. This can help manage conflicts and ultimately create a supportive environment for everyone.

Benefits

• Reduces stress and emotional burden by providing a safe space to talk about your feelings and challenges.
• Improves problem-solving skills and helps you find effective strategies to cope with caregiving demands.
• Enhances emotional resilience by helping you process difficult emotions like anger, resentment, and anxiety.
• Strengthens communication and relationships by teaching you how to set boundaries and communicate more effectively with your loved one and other family members.

Remember

Taking care of your mental and emotional health is just as important as caring for your loved one. Therapy can provide the support and tools you need to navigate the challenges of caregiving and ensure that you remain as resilient and effective in your role as a caregiver and as a person.

Why it's important

Dementia can impact the physical abilities of your loved one, making it essential to find activities that maintain dexterity and physical engagement. Sorting objects of any kind helps exercise these skills.

How to do it

• Collect small objects like coins, clothing, nuts and bolts, pens, and pencils, or any other objects you have around the house.
• Set up a sorting area, a clean, well-lit space where you can lay out the items. Use bowls or small containers for sorting.
• Guide your loved one, demonstrate how to sort the items into different piles. For example, separate coins by denomination, pens by color, or clothing by type, which you can also fold together for further exercise.
• Gently encourage your loved one to join in, offer support and praise as they sort. Use this time to engage in conversation, asking questions about the items or sharing memories.

Benefits

• Enhances fine motor skills by regularly engaging in sorting activities that help maintain dexterity and hand-eye coordination.
• Spending time sorting together fosters meaningful conversations and strengthens your relationship.
• Provides a sense of accomplishment by successfully sorting items, which can boost your loved one’s confidence and self-esteem.
• Sorting requires attention to detail and categorization, which stimulates cognitive abilities.

Remember

These moments of shared activity may seem trivial but actually support physical health and create lasting emotional connections.

Why it's important

As written in “The Dementia Handbook” by Judy Cornish, we should "approach caring for people…by evaluating their personal limitations, their perceptions of reality, and then changing their environment to make it more supportive of their emotional needs and cognitive abilities.” By following this method, we can meet the person where they are and avoid upsetting them.

How to do it

If your loved one believes it is their birthday—join their reality!

• Accept their belief and join in the celebration. Say, "Happy Birthday! How would you like to celebrate today?"
• Decorate the space with balloons, streamers, or other birthday decorations to make it feel special.
• Share happy memories, and reminisce about past birthdays or joyful events, and focus on positive and uplifting stories your loved one is able to recall.

Benefits

• Reduces anxiety and agitation by avoiding corrections that might upset your loved one.
• Enhances emotional well-being by creating a joyful and engaging environment.
• Strengthens your bond through shared celebrations and positive interactions.

Remember

Meeting your loved one where they are avoids unnecessary distress and creates a supportive environment.

Even if your loved one’s perception of things might be off, embrace their reality with compassion and creativity, and make each moment special for both of you.

Why it's important

As caregivers, we seek activities that our loved ones can participate in and benefit from. Doing puzzles not only exercises their fine motor skills, but also provides opportunities for meaningful connections and conversations as you spend more time together.

How to do it

• Select a puzzle with bright colors to make the activity visually stimulating and engaging.
• Evaluate the difficulty level by choosing the number of pieces your loved one can manage comfortably so that the activity remains enjoyable and free of frustration.
• Create a comfortable space with good lighting and clutter-free surfaces to keep the focus on the activity and ensure an optimal space for puzzle-solving.
• Work on the puzzle together, providing gentle guidance and encouragement as needed to foster a sense of accomplishment and teamwork.

Benefits

• Maintains fine motor skills by keeping the hands and fingers active, which is crucial for being able to complete daily tasks.
• Enhances cognitive function by stimulating the brain through problem-solving and pattern recognition.
• Fosters emotional connections through shared activities, which can promote conversation between you and your loved one, bringing you closer.
• Provides a sense of achievement as puzzles are completed, boosting their self-esteem and mood.

Remember

Puzzles are not just about completing a task but about enjoying the problem-solving process and the time spent together. Celebrate small successes and use this activity as a way to create joyful memories and reinforce a sense of routine and stability for your loved one.

Why it's important

Spending time outdoors with your loved one is a wonderful bonding experience that fosters connection, conversation, and provides opportunities to share your observations and emotions with each other.

How to do it

• Try taking your loved one outside to a garden, park, or any natural setting.
• Point out and name different types of flowers, trees, and animals you see to stimulate visual and cognitive senses.
• Ask them to turn their face toward the sun to feel its warmth and boost their mood through exposure to the sun's warm rays.
• Pause to feel the wind on your skin, smell various flowers, and, if possible, pet friendly animals like dogs to engage touch and olfactory senses.

Benefits

• Enhances mood and well-being by engaging with nature and its calming effects.
• Stimulates the senses through sight, touch, smell, and sound, which is known to help improve cognitive function.
• Improves sleep quality by exposing your loved one to natural light, which helps to regulate their circadian rhythm.
• Strengthens your emotional bond through shared experiences and conversations about the natural environment.

Remember

Outdoor activities are a fantastic way to help bridge the gap created by dementia symptoms and create a fertile ground for emotional connections. Use these moments to create joyful memories and reinforce a sense of routine and stability for your loved one.

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Why it's important

Mindfulness techniques help caregivers cope with the daily pressures of caring for someone with dementia, which in turn supports both their well-being and their ability to provide care for their loved one.

How to do it

• Practice breath work by focusing on slow, deep breathing to center your thoughts and calm your mind.
• Conduct a “body scan” by mentally progressing through each part of your body to identify and release any areas of tension or stiffness.
• Engage in meditation by setting aside time to sit quietly and free from distractions, focusing your mind or repeating a calming word or phrase.
• Utilize your senses to fully experience your environment, such as noticing the small details of scenes and sounds around you, or the sensations of touch and smell.

Benefits

• Mindfulness lowers stress by reducing reactivity to challenging situations, allowing you to react more calmly under pressure.
• Regular mindfulness practice can help lessen feelings of depression and anxiety, making it easier to manage the emotional challenges of caregiving.
• Mindfulness nurtures a compassionate attitude from within you, improving your patience and understanding toward the person you're caring for.
• By focusing on the present and acknowledging emotions without judgment, mindfulness helps prevent feelings of being overwhelmed and decreases the risk of caregiver burnout.

Remember

Mindfulness is about being present in the moment without judgment. It's not about achieving a perfect state of calm, but rather about recognizing and accepting your feelings and thoughts as they come. This acceptance can profoundly shift how you face the challenges of caregiving, leading to a healthier and more fulfilling experience.

Why it's important

Caregiving can be incredibly stressful, impacting both your body and mind, and when you're stressed**—which is probably more often than not—**it becomes harder to provide the best care for your loved one. The physiological sigh is a powerful, proven technique to quickly reduce stress in “real time” and allow you to reset your mind and body. By mastering this simple practice, you can maintain your well-being and ensure that you are calm, focused, and capable of giving optimal care.

How to do it

• Take one deep inhale through your nose followed immediately by another deep inhale through your nose to reach maximum lung inflation.
• Release this breath through a full exhale of your lungs through your mouth.
• Repeat as needed to quickly reduce stress until you feel a sense of calm.

Benefits

• Reduces stress rapidly, helping you stay calm and focused.
• Improves your emotional regulation by quickly calming the nervous system.
• Enhances caregiving ability by maintaining a clear, stress-free mind, allowing you to provide the greatest care possible.

Remember

The physiological sigh is a simple yet powerful technique to quickly reduce stress. Practicing this regularly can help you manage your stress levels effectively, ensuring you are at your best for your loved one.

Why it's important

Directly correcting the perceptions or memories of someone with dementia can lead them to feel confused and distressed. Integrating gentle reminders whenever you communicate with one another keeps the tone of the conversation calm, ensuring that loved ones with dementia feel secure and connected when speaking to you.

How to do it

• Avoid direct corrections. If your loved one forgets that they already drank coffee in the morning, avoid saying something like, “Remember when we stopped for coffee this morning?” They might not be able to recall it, which could end up upsetting them.
• Integrate reminders through storytelling. Weave in reminders as part of a shared story. You might say, “I really loved going for coffee this morning with you.” This approach maintains a connection to a shared experience without challenging their reality.

Benefits

• Minimizes stress and anxiety by avoiding confrontational corrections that can confuse and upset your loved one.
• Creates a comforting routine by using familiar stories and gentle reminders, you can help stabilize the emotions of your loved one and promote a sense of normalcy and security.

Remember

Validate their experiences. Accepting and integrating events into their reality with patience and love is crucial for effective communication. Use reminders not as corrections but as ways to enhance your bond and understanding of one another.

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Why it's important

Controlled breathing techniques are a great tool for learning how to regulate your emotions. Being able to manage anxiety and depression through breathwork not only helps in reducing conflicts, but also ensures that your interactions with those you care about are positive and easier to navigate.

How to do It

• When you feel anxious, take a slow breath in through your nose for 4 seconds, then exhale slowly through your mouth for 8 seconds. You can repeat this several times until you feel more relaxed.
• When you feel depressed, inhale deeply through your nose for 8 seconds, followed by a quicker exhalation through your mouth for 4 seconds. You can repeat this several times until you feel your mood lighten a little.

Benefits

• Longer exhalations during anxious moments can help tap into the calming response of the parasympathetic nervous system, and through that, placate your mind.
• When feeling down, shorter exhalations can help activate the sympathetic nervous system, increasing your energy levels and improving your mood.
• Mastering these techniques allows for better emotional control, which is beneficial in caregiving situations where patience and understanding are paramount.

Remember

Breathing techniques are a powerful tool for emotion management. They are most effective when practiced regularly, not just when you are already feeling overwhelmed or down. Try to incorporate them into your daily routine to improve their effectiveness and your overall well-being.

Why It's important

Staying hydrated is a cornerstone for maintaining optimal physical and mental functioning. It enables caregivers to feel and perform at their best, which is essential when looking after others.

How to do it

• Keep water accessible by always having a water bottle on hand, whether at home or on the go.
• Aim to drink at least 8 glasses of water a day to ensure you are properly hydrated.
• Set reminders on your phone or use a hydration tracking app to maintain regular water intake.

Benefits

• Water helps brain cells communicate and clears out toxins that impair functioning.
• Proper hydration helps carry nutrients to the brain and throughout the body, supporting overall health.
• Regular water intake can increase your energy and reduce fatigue, making caregiving easier.

Remember

Even slight dehydration can affect your mood and energy levels. Keep water within reach and take regular sips throughout the day to support both your well-being and caregiving abilities.

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Why it's important

Open communication allows for deep, honest conversations about your loved one's wants, needs, hopes, and preferences, enabling you to be the best caregiver and journey partner possible. In later stages, you may not be able to have these important discussions, so it's essential to communicate openly while you can still do so.

How to do it

• Communicate openly in the present to ensure important topics are discussed while your loved one can fully participate.
• Be brave and initiate conversations about their preferences, wishes, and concerns.
• By being vulnerable and sharing your own feelings and thoughts, you create a space of mutual trust.
• Be specific in your discussions, covering key areas such as medical preferences, daily routines, and personal values.

Benefits

• Respects their autonomy by involving them in decisions about their care and future.
• Strengthens your bond through meaningful and honest conversations.
• Provides clarity for both you and your loved one, reducing uncertainty and stress.
• Ensures their preferences are known and respected, enhancing their quality of life in the present as well as later down the line.

Remember

Approach these conversations with empathy and patience. It's a courageous act to discuss difficult topics, but doing so openly and honestly honors your loved one's dignity and strengthens your caregiving relationship.

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What it is

Sundowning is a phenomenon commonly observed in individuals with dementia and is characterized by increased agitation, confusion, and restlessness during the late afternoon and early evening. This can manifest as pacing, wandering, and difficulty calming down, ultimately creating challenging situations for caregivers and their loved ones.

Why it happens

The exact cause of sundowning is not fully understood, but several factors are believed to contribute to this behavior.

• Dementia can interfere with the body’s internal clock, leading to confusion between day and night.
• Being overtired can exacerbate symptoms of dementia, making it harder for individuals to remain calm and focused.
• Environmental factors such as low lighting, shadows, and changes in daily routine during the evening can increase confusion and anxiety.

Compassionate caregiving tips

• Add a short nap in your loved one’s schedule. A brief nap in the early afternoon can help prevent your loved one from getting overtired, which is known to worsen sundowning symptoms.
• Maintain a consistent routine. Keeping a regular schedule for meals, activities, and bedtime can help reduce confusion and anxiety.
• Engage your loved one in relaxing activities such as listening to calming music, reading, or gentle exercises to ease agitation or restlessness.

Remember

Always approach sundowning with patience, support, and empathy, understanding that this behavior is a symptom of dementia, and not a deliberate action.

What it is

Moderate dementia is the middle stage of dementia and can last many years. At the beginning of this stage, your loved one may still be able to dress, eat, bathe themselves, and live alone. However, they often experience agitation due to difficulties following directions, getting lost while driving, and blaming others for misplaced items. Emotional outbursts and tears can occur without clear triggers, reflecting the confusion that marks this stage.

What to expect

As moderate dementia progresses, your loved one will become increasingly dependent on you for activities of daily living such as dressing, bathing, eating, and using the restroom. They may experience hallucinations, paranoia, delusions, mood swings, irritability, anxiety, and depression. Wandering, pacing aimlessly, and having difficulty communicating are also common in this stage.  

Compassionate caregiving tips

• Provide consistent support and be prepared for increased dependency. Make sure to kindly offer consistent assistance with daily activities to ensure their safety and well-being.
• Maintain open communication by using simple language and practicing patience, understanding that communication difficulties are a part of this stage.

Remember

Navigating moderate dementia requires patience and empathy. Recognize the increased dependency and emotional challenges your loved one is facing, and provide a supportive and understanding environment for them.

Why it's important

Flat affect, or emotional blunting, is a common symptom in various forms of dementia. Understanding that your loved one’s lack of emotions through facial expressions is not a reflection of your care or their feelings is crucial.

How to do it

• Ask your loved one how they feel to gain insight beyond their facial expressions. Verbally addressing your loved one instead of relying solely on facial expressions is the best way to understand them.
• Pay attention to other non-verbal cues like gestures, tone of voice, and physical actions.
• Remind yourself that flat affect is a part of the condition, not a reflection of their feelings.

Benefits

• Reduces misunderstandings by helping you better interpret your loved one’s emotions.
• Enhances communication by encouraging reliance on verbal and other non-verbal cues.
• Strengthens relationships by fostering a deeper understanding and empathy towards your loved one’s condition.

Remember

Your understanding and consistent support significantly improve your loved one's well-being while strengthening your relationship.

Why it's important

Taking time for yourself is a necessity in any situation, and looking after a loved one with dementia is no exception. By prioritizing your own well-being, you set the stage for sustainable caregiving.

How to do it

• Identify open time slots each week that can be dedicated solely to activities that rejuvenate you, such as early mornings, late evenings, or specific half-hours earmarked as non-negotiable me time.
• Ask for help to arrange replacement care if possible, by setting times with family members or friends to step in. Remember that the responsibility of care does not fall solely on you and that asking for help is encouraged.
• Engage in activities that reflect your personal interests and passions, which might have been sidelined after becoming a caregiver. Whether it's reading, painting, or hiking, do something just for you.

Benefits

• Prevents burnout by reducing stress and mental fatigue, keeping you mentally and physically healthy.
• Increases productivity and the quality of care you can provide, as a well-rested person can perform caregiving tasks more effectively and genuinely.
• Improves personal happiness and fulfillment, as taking time for yourself helps maintain your identity beyond being a caregiver.

Remember

Caring for yourself is not an act of selfishness; it's crucial to avoid caregiver burnout. Like securing your oxygen mask first on an airplane, you must prioritize your own well-being to effectively care for others.

Why it's important

Using the Butterfly Tap is a “trick” that can help calm you down and activate your parasympathetic nervous system while you’re feeling anxious. The bilateral stimulation in this technique is effective because it inhibits responses from the amygdala, the part of the brain responsible for the fight, flight, and fear response. It can also be used to strengthen a connection between good memories and the body, allowing for a sense of well-being.

How to do it

• Place your hands on your chest with palms down and thumbs entwined to form the shape of a butterfly.
• Slowly tap one hand after the other on your chest for bilateral stimulation. This helps ground yourself and calm your nervous system.
• Take deep, slow breaths simultaneously while tapping for a few minutes to enhance the calming effect.

Benefits

• Calms the nervous system by engaging the parasympathetic response, reducing stress and anxiety.
• Inhibits the amygdala which helps manage the fight, flight, and fear response, promoting a sense of safety and calm.
• Strengthens connections to good memories by linking positive experiences with the physical act of tapping, enhancing overall well-being.

Remember

The butterfly tap is a quick and effective technique to soothe your nervous system. Regular practice can help you manage stress and anxiety, and ultimately provide you with a simple yet powerful tool for emotional regulation.

Limiting ads on the phone of someone with cognitive needs is key to keeping things simple and stress-free. Ads can be distracting and might make it harder for them to focus or understand what’s important. By cutting out unnecessary ads, you’re helping them navigate their phone more easily and avoid confusion. It creates a smoother, more comfortable experience overall.

Step-by-step tutorial

1. Open Settings: Go to your phone’s Settings app.
2. Network & Internet: Tap on Network & internet.
3. Advanced Options: Scroll down and select Advanced.
4. Private DNS: Tap on Private DNS.
5. Configure Private DNS:
   • Select the option for Private DNS provider hostname.
   • Enter dns.adguard.com‍
6. Save Changes: Press Save or OK to apply the changes.
7. Test the Configuration: To ensure that AdGuard DNS is working, you can visit an online DNS test site or check for reduced ads in your apps and browsers.

Additional Notes

• This setup will block ads and trackers across all apps and browsers on your device, though it may not block ads on platforms like YouTube or Spotify.
• If you encounter any issues with certain apps or websites after enabling Private DNS, consider temporarily disabling it to see if it resolves the problem. For a visual guide, you can refer to video tutorials available on platforms like YouTube, which provide detailed walkthroughs of the process.

Why it's important

Presenting your loved one with too many options at once can be overwhelming and confusing for them. By offering only two clear choices, you can support their autonomy while ensuring they don't feel burdened by decision-making.

Avoid

Open-ended questions like "What do you want to eat, wear, or do?" can be confusing and overwhelming for your loved one.

Instead

• Ask simple, direct questions such as, "Would you like an apple or a banana?" This limits choices to manageable options, making decision-making easier.
• Offer clear, specific choices like, "Would you like to wear this white shirt or the blue one?" This helps your loved one focus on the options without confusion.
• Use familiar locations for choices such as, "Would you like to sit on the bench by the park or the one by the post office?" This can help them feel more secure and confident in their decisions.

Benefits

• Limiting choices to two options makes it easier for your loved one to make decisions without feeling overwhelmed.
• Offering them choices empowers your loved one and allows them to feel more in control of their daily activities.
• Enhances communication: Clear, simple choices improve understanding and reduce frustration for both you and your loved one.

Remember

By simplifying choices, you help them navigate their day with confidence and ease, maintaining their dignity and independence.

Why it's important

Bubble blowing has a direct link to childhood memories of playfulness and fun. It can serve as a quick and effective calming technique for you and your loved one by providing visual stimulation and a sense of levity to redirect moments of anxiety or frustration.

How to do it

• Blow bubbles for or with your loved one, encouraging them to participate at their comfort level.
• Encourage gentle blowing, which can help strengthen fine motor skills and serve as breath work to promote calmness.
• Create a safe and enjoyable environment, making sure there’s enough space to move around and enjoy the bubbles without obstacles.

Benefits

• Improves mood by evoking childhood memories of playfulness and joy.
• Provides a calming effect through the gentle, rhythmic motion of blowing bubbles and watching them float.
• Promotes deep breathing as part of the activity, which can help reduce anxiety and frustration.

Remember

Bubble blowing is not just a playful activity but a meaningful way to connect with and calm your loved one. Use this simple yet effective technique to create joyful moments to help manage stress, and it can easily become a valuable part of your caregiving routine.

Why it's important

Engaging with your loved one in household chores helps them utilize their remaining skills and can foster a sense of purpose and connection in them. This activity helps calm them and gives them purpose while keeping them active and involved in their environment.

How to do it

• Hand your loved one a dusting brush or a squirt bottle of soapy water and a sponge. These simple tasks can make them feel useful and involved.
• Ask for help folding napkins or washcloths. This repetitive task can be soothing and give a sense of accomplishment.
• Encourage them to pair socks together. This activity can be both engaging and mentally stimulating, enhancing their sense of contribution.

Benefits

• Familiar chores can soothe anxiety and promote a feeling of purpose.
• Physical activity, even in simple forms like dusting or folding, helps maintain mobility and energy levels.
• Shared activities strengthen your bond and create opportunities for meaningful interactions.
• Participating in household tasks helps them feel more in control and connected to their environment.

Remember

Incorporate these chores into your daily routine and invite them to participate to create a stable and engaging environment. Celebrate their contributions and enjoy these moments of togetherness, reinforcing their sense of purpose and connection.

Why it's important

Loved ones with dementia may often forget to eat or may not recognize hunger pains. Maintaining a regular eating schedule is vital for keeping their physical health and energy levels at their best.

How to do it

• Gently put a plate of their favorite food in front of them without forcing them to eat.
• Join them at the table and begin eating; this act of sharing a meal can promote companionship, encourage participation, and enrich the dining experience.
• Remind them of their love for the food you’re eating, as sharing cherished memories can stimulate their interest in the meal as well as improve their mood.

Benefits

• The familiar sight and smell of favorite foods can naturally trigger appetite and interest in eating.
• Regularly shared meals can help maintain a sense of routine and structure, which are often comforting to people with dementia and can lead to better eating habits.
• Reminding loved ones of precious memories associated with certain foods can enhance emotional connections, making mealtime a more pleasant and anticipated event.

Remember

Always respect where they are at the moment. If they refuse food, give them space and try again later. Seeing progress takes time and isn’t linear, so approaching each attempt in a calm and respectful manner helps create a routine and sense of normalcy that can gradually ease their eating challenges.

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Why it's important

Dementia can be frustrating, upsetting, and unnerving for both you and your loved one to deal with. These emotions often lead to challenging interactions and increased stress. By practicing patience, however, you can create a calm and supportive environment to mitigate that.

How to do it

• It’s okay to feel frustrated, but when you do, take a moment to breathe deeply and collect your thoughts before you respond.
• It’s imperative to understand that your loved one may need more time to process information or complete tasks. Adjust your expectations accordingly.
• Acknowledge and praise your loved one's efforts and accomplishments, no matter how small. Positive reinforcement encourages a supportive atmosphere and boosts their confidence.
• Practicing mindfulness or meditation can help you stay present and manage your emotions more effectively, ultimately making it easier to remain patient in future challenging situations.

Benefits

• Practiced patience helps lower your stress levels, leading to a more peaceful caregiving experience.
• By learning how to be patient, you continue to create a safe space for your loved one, fostering trust and emotional closeness.
• Calm and patient communication can lead to more successful interactions and help reduce the frequency of frustrating situations.

Remember

Patience is a skill that takes time to develop, but by prioritizing patience, you create a supportive and loving environment that benefits both you and your loved one on this journey.

Why it's important

Flower arranging practices skills your loved one needs to maintain, and can also cultivate a moment of purpose and connection with you and the environment. This activity promotes a sense of accomplishment and joy, allowing for meaningful interaction and communication.

How to do it

• Choose the right activity depending on your loved one’s abilities. It can be: trimming and arranging flowers in a vase, making flower crowns, creating pressed flower art, or anything you find fitting.
• Pick flowers together. If possible, going outside to pick them together can add an extra layer of engagement and sensory enrichment.
• Set up a comfortable and clutter-free area where you can arrange the flowers together.
• Help your loved one as needed, offering gentle suggestions and encouragement while allowing them to express their creativity.

Benefits

• Maintains fine motor skills through the careful handling and arranging of flowers.
• Fosters communication and connection by engaging in a shared, purposeful activity.
• Promotes a sense of accomplishment as your loved one sees the beautiful result of their efforts.
• Provides sensory stimulation through the colors, textures, and scents of the flowers, enhancing their overall well-being.

Remember

Flower arranging is an error-free activity that brings joy and a sense of achievement. Use this time to connect with your loved one, create beautiful memories, and foster a sense of purpose and calm in their life.

What it is

Your loved one may see, hear, feel, or smell things that are not actually there. These are known as “hallucinations,” and are false sensory experiences that can be distressing or confusing for the individual experiencing them.

Why it happens

Hallucinations arise from various factors associated with dementia. Several contributing elements include:

• Dementia’s impact on the brain's sensory processing, which leads to false perceptions that can cause your loved one to experience things that are not there.
• Memory loss and cognitive decline cause confusion and disorientation, making hallucinations more likely.
• Neurological changes, such as changes in the brain's structure and chemistry due to dementia, can lead to abnormal sensory experiences.
• Emotional distress and anxiety are common in dementia and can exacerbate the likelihood of hallucinations.

Compassionate caregiving tips

Managing hallucinations requires empathy, patience, and strategic responses. Here are some tips to help soothe and comfort your loved one:

• Assess the hallucination's impact; if it’s not causing harm, it may be best to join them in their belief.
• Acknowledge their experience without arguing or trying to correct them by validating their feelings and saying, “I understand you’re seeing, hearing, or feeling that,” without challenging the hallucination directly.
• Provide reassurance by offering physical comfort, like holding their hand or speaking in a soothing tone to help reduce anxiety.
• Redirect their attention by gently shifting focus to a different activity or topic that they enjoy or find calming, which can help to distract them from distressing hallucinations.
• Seek professional advice if hallucinations become frequent or severely distressing, consulting a healthcare provider for additional strategies and possible medication adjustments.

Remember

Your loved one's hallucinations are a part of their new reality due to dementia. By maintaining a calm and supportive presence, you can help them navigate these challenging experiences with greater ease and comfort.

Why it's important

Your loved one might have episodes in which they ask many repetitive questions, which is a common behavior among individuals with dementia. This behavior stems from your loved one's uncertainty, confusion, and frustration. Seek to understand them with active listening and compassion.

How to do it

When your loved one repeatedly asks the same question:

• Remind yourself that their repeated questions are a result of confusion and a search for comfort, and that they themselves might not even be aware that they’ve asked you the same thing multiple times.
• Before responding, find a way to reduce your own frustration. Practice breathing techniques or any other method that will help you maintain a calm tone when responding to them.
• Redirect their attention to another activity or topic to break the cycle of repetitive questioning.

Benefits

• Reduces frustration for both you and your loved one by addressing the underlying cause of repetitive questions.
• Improves communication through active listening and compassionate responses.
• Creates a peaceful atmosphere by utilizing calming activities to ease anxiety.

Remember

Always approach repetitive questions with empathy and patience. Recognize that your loved one's behavior is a reflection of their need for reassurance and understanding. By staying calm and providing comfort, you can help alleviate their anxiety and foster a more supportive environment.

What it is

Severe dementia is the end stage of dementia and can last for many years. At this stage, your loved one will lose their ability to communicate with language, and their ability to walk will be severely compromised. They will continue to experience severe cognitive impairment, become incontinent, and unusually restless, often requiring complete physical, emotional, and spiritual care.

What to expect

In this stage, your loved one will need comprehensive care as they will lose the ability to perform basic functions independently, such as being unable to communicate effectively, having difficulty walking, and experiencing significant cognitive decline. Incontinence and restlessness are common as well, necessitating round-the-clock care to meet their physical, emotional, and spiritual needs.

Compassionate caregiving tips

• Provide complete care - be prepared to offer full support for all activities of daily living, including feeding, bathing, and toileting, ensuring their comfort and dignity.
• Focus on comfort and their dignity - create a calm and soothing environment and ensure their physical, emotional, and spiritual needs are met with validation and respect.

Remember

Even in severe dementia, your loved one’s inherent worth remains intact! Approach their care with patience, empathy, and a deep respect for their dignity and well-being.

Why it's important

Fully understanding the reasons behind restlessness and agitation in individuals with dementia is essential. Although seemingly surface-level to you, these behaviors often stem from discomfort and serve as a means for your loved one to communicate their needs when words fail them.

How to do it

When you notice signs of restlessness or agitation in your loved one, it's important to approach the situation with a detective-like mindset:

• Scan the environment for potential causes of discomfort. Look for things like excessive noise, clutter, or other factors that might be overwhelming your loved one.
• Offer essentials like water or food, as a lack of these basic needs can often be the source of discomfort.
• Use short, reassuring phrases to help clarify any misunderstandings or reassure your loved one that everything is alright.
• Assess them for other discomforts such as pain, fear, or boredom, which can all lead to agitation.

Benefits

• Directly addressing physical or emotional triggers reduces your loved one’s distress.
• Adapting to and understanding the cognitive capabilities of your loved one makes interactions more effective and less frustrating.
• Reducing triggers of restlessness and agitation contributes to a more peaceful and supportive living space.

Remember

Patience and attentiveness are key in managing dementia-related behaviors. Regularly taking the time to understand and address the needs of your loved one not only alleviates their discomfort but also strengthens your connection with them.

Why it's important

Establishing a soothing bedtime routine for individuals with dementia helps maintain a regular sleep schedule - a vital component of brain health, as it helps clear metabolic waste that accumulates during the day.

What to do

• Create a calm and comfortable environment that encourages sleep. This includes controlling the temperature, reducing noise, and dimming the lights.
• Try to go through the bedtime routine at the same time every evening to help regulate their internal clock.
• Dress them in something soft, choosing breathable fabrics that keep them at a comfortable temperature throughout the night.
• Play soothing music. Instrumental or classical music without loud or abrupt changes is ideal.
• A light spritz of lavender spray on the pillow can have a calming effect and may enhance sleep quality. Make sure your loved one enjoys the scent before using it.

Benefits

• Enhances brain function by promoting quality sleep, which is essential for the clearance of metabolic waste from the brain.
• Reduces stress and improves mood. A predictable routine minimizes anxiety and helps maintain emotional balance, making daily interactions easier and more pleasant.
• Boosts immune function and overall health by mitigating sleep-related disturbances that can affect the body's ability to fight illness.

Remember

Consistency is comforting. Keeping bedtime rituals consistent not only helps in signaling that it's time to sleep but also provides a sense of security and familiarity, which is incredibly reassuring for someone with dementia.