Dementia Home Care
Understanding Dementia's Impact
A quick overview of dementia and its symptoms
More than 400,000 Australians are living with dementia, and experts believe that number could more than double by 2058.
Contrary to popular belief, dementia doesn’t just affect older people. There are currently more than 28,000 Australians with younger onset dementia, including people in their 30s, 40s and 50s.
What is Dementia?
Dementia isn’t one specific disease, but rather a progressive set of symptoms stemming from disorders in the brain. It can impact memory, cognition, thinking, behaviour and overall brain function. The most common forms of dementia include Alzheimer’s Disease, Lewy Body Disease, vascular dementia and frontotemporal dementia.
No two people experience dementia the same way, and there is currently no known cure.
The progressive nature of dementia means that symptoms—such as memory loss, confusion and difficulty completing everyday tasks—often begin slowly and gradually worsen over time. However, with proper medical intervention and care, people living with dementia can continue to lead active and fulfilling lives after their diagnosis.
The value of home care for dementia
Healthcare professionals, medications and specialised therapies can all help manage dementia and its symptoms. Often, though, people with dementia rely on their family members, friends and caregivers as their primary care teams.
In fact, more than 1.5 million people in Australia are involved in the care of someone living with dementia. As a result, home care for dementia has become increasingly necessary.
Aged care and home care providers such as The CareSide deliver care services through home care packages and the Commonwealth Home Support Programme (CHSP). Professional care workers undoubtedly make a positive impact on the lives of those living with dementia, but much of the time, they serve as additional help to what’s already being provided by families and friends.
Perhaps you’re the person administering dementia home care services for a loved one, or maybe you’re here on behalf of someone you know.
Either way, it’s important to recognise the value and delicate nature of home care in a dementia journey. While it can certainly be fulfilling, it can also be overwhelming, frustrating and tiresome for everyone involved without the proper conditions in place.
Let’s review some of those conditions now.
Essential Home Adjustments for Safety
Dementia care at home
Familiarity is imperative for someone living with dementia.
A safe and comfortable home environment—whether it’s the person’s own home or otherwise—facilitates sustained independence and the best quality of life. The home should be a consistent presence – a predictable headquarters where things are easy to find and pathways are simple to navigate.
Sensory stimulation plays a huge role in home care for dementia.
The goal is to create an environment that is neither over-stimulating nor predominantly boring. That might require some experimentation and home maintenance, especially since no two people experience dementia the same way. Ultimately, a dementia-friendly home promotes the use of retained functions and skills.
Fortunately, some universal principles apply to dementia care at home.
The Dementia Enabling Environment Virtual Information Centre is a convenient resource that offers in-depth instructions on a room-by-room basis. On the website, you can click around interactive maps while learning best practices for in-home care, right down to which colours and patterns best meet the care needs of someone living with dementia.
Here are some universal principles you can incorporate into your care plan:
Clutter
Ensure spaces are easy to navigate by removing clutter, cords, loose rugs and furniture that might be in the way. Reduce other fall risks with non-slip surfaces and railings (especially in the bathroom).
Orientation
Decluttering doesn’t necessarily mean removing everything. Photographs and treasured objects help people living with dementia maintain familiarity with their environment. Similarly, calendars and clocks with large displays can assist with day and time orientation.
Lighting, Mirrors and Windows
Dementia care typically means greater-than-average light levels. Spaces should be sufficiently and evenly lit not only for safety reasons but also to reduce shadows—some people living with dementia find glare, reflections and shadows frightening and confusing.
Interests
Do your best to encourage the continuation of personal interests and meaningful engagement, such as by leaving a work-in-progress puzzle on the table. Additionally, utilise labels with words and images to help the person find things easier (particularly in the kitchen) and maintain their autonomy.
Day-to-Day Activities and Engagement
Routine Building: The importance of a predictable day
For any dementia home care program, routines are essential.
Meal preparation routines, bedtime routines, bathing and personal care routines all provide a level of predictability that empowers people with dementia to maintain sound habits as well as their independence.
The best activities in between those day-to-day tasks are ones that encourage communication and social engagement. A dementia diagnosis doesn’t mean someone has to give up doing all of the things they enjoy. Hobbies and interests can often be modified to fit that person’s current skill set, especially if they’re incorporated into routines of their own.
Just remember to keep it simple whenever possible. Leisurely, unhurried activities that have meaning and social contact are generally the pursuits that resonate the most.
Stimulating Activities: Puzzles, music and art for engagement
Even the simplest activities can make a positive impact. In your care plan, consider what makes the person you care for unique: their former lifestyle, recreational interests and experiences can provide clues into what activities might light them up.
Many people living with dementia relish games and creative hobbies, such as painting, knitting and playing musical instruments. These are great ways to stimulate the brain and facilitate new learning, but just as importantly, they can boost self-esteem while also preserving fundamental skills.
Physical Movement: Gentle exercises and outdoor walks
Believe it or not, people living with dementia typically retain their movement and rhythm longer than other abilities.
That means dancing, swimming, walking the dog, pedalling on an exercise bike, and even hiking are possible in a dementia care plan. In fact, being outside in any capacity can bring about all sorts of positive benefits.
The point is: Try not to eliminate activities before you give them a shot. You can set yourself and your loved one up for success by planning activities around times of the day when they are at their best, and you can even incorporate pets and other family members to arouse some positive emotions.
Communication Techniques for Dementia Home Care
Patience and Presence: Giving them time and undivided attention
The progressive patterns of dementia mean communication can become more difficult over time. It’s a frustrating and challenging obstacle for everyone involved.
Dementia can affect a person’s ability to retrieve words, speak fluently, understand what others are saying, read and write, and express their emotions properly. Social conventions can also diminish—people living with dementia might interrupt or ignore others, or they might not respond when someone is speaking to them.
It goes without saying, but none of that behaviour is purposeful.
Family members and carers who practice patience and show empathy not only create a home environment where the lines of communication remain open but also one in which the person with dementia can preserve their dignity and self-esteem.
Beyond that, health professionals such as audiologists (for hearing aids), optometrists (for eyeglasses) and speech therapists can give dementia patients the tools they need to continue communicating to the best of their ability.
Simplifying Language: Tips for Conversation
We all use verbal and non-verbal methods to communicate how we feel.
Body language, facial expressions, posture, tone of voice and words themselves all swirl together to paint a larger picture.
When talking becomes difficult for a person with dementia, they might lean more heavily into those non-verbal queues to express themselves. Caregivers, on the other hand, have to remain cognisant of their own queues—their verbal and non-verbal responses can have a palpable effect on a conversation, either positive or negative. People living with dementia can struggle to understand things, but they still have feelings and emotional responses.
Some tips for conversing
Short and Simple Sentences
Focus on one idea at a time and always allow enough time for the person with dementia to process what you’ve said and put together a response. Avoid the temptation to finish their sentences for them; simply listen, don’t rush.
Yes/No Questions
Questions with a yes/no response or a limited number of options make it easier for the person with dementia to reply. You can also incorporate specific details (“Sally, your niece”) or even sketch a quick picture to help your explanation of something land.
Body Language
It sounds so simple, but a smile or warm touch has the power to deliver a message when words fail. You can also utilise facial expressions, hand gestures and signals such as pointing to demonstrate whatever it is you’re trying to communicate.
Limited Distractions
We covered it above, but the environment truly matters. Competing noise from televisions, radios and elsewhere could over-stimulate someone with dementia, especially while they’re trying to focus on a conversation. As a carer, you’ll have a better chance at success if you eliminate those distractions and encourage everyone else—family members and other caregivers—to adopt similar communication strategies.
Handling Difficult Behaviors and Situations
Managing Agitation: Techniques to calm people with dementia
Verbal and physical aggression, agitation and anxiousness are all potential symptoms of dementia. It can be a very troublesome and painful experience for family members and caregivers to witness a loved one demonstrate these behaviours. However, there are two important things to keep in mind:
Such behaviours are symptomatic of a neurological condition and not meant to deliberately upset you.
Agitated behaviours often have a direct cause. For instance, if the person is feeling fearful or misunderstands a situation, they might express themselves in a defensive manner.
Eliminating those causes of stress can help extinguish stretches of unrest, as can maintaining a consistent routine, minimising changes to the environment and avoiding overstimulation.
The best thing you can do is stay calm and abstain from confrontation. Utilise distraction and other strategies recommended by Dementia Australia to handle your unique situation. If necessary, schedule a visit with the person’s doctor to investigate potential causes of behavioural shifts.
You can also reach out to Dementia Behaviour Management Advisory Services (1800 699 799), which is a free government-funded service that assists families and caregivers of people living with dementia.
Seeking Support and Taking Breaks
Joining Support Groups: Learning from other caregivers' experiences
When someone close to you is diagnosed with dementia, the first question you might ask is, “Where do I begin?”
Education can help clear up some of the mystery, and if you’re providing home care services to that person, it’s a necessary part of the job. Learning about the condition sets you and your loved one up for success, and it might even help you understand and manage your own emotions more effectively.
Here are some resources to get you started:
- Dementia Australia Support Programs
- Dementia Australia Counselling Support
- Health.gov
- The National Dementia Helpline
- Carer Gateway
Additionally, as you and your loved one consult healthcare professionals, it’s always a good idea to have a prepared list of questions. You can find suggested questions and tips for identifying the proper specialists in this dementia care guide by the Cognitive Decline Partnership Centre.
Respite Care for Dementia: Understanding its value and where to find it
Dementia home care can be a full-time job.
Too often, family members and friends providing dementia care services to a loved one neglect their own physical, emotional and mental health.
Support programs like the ones listed above are helpful, but sometimes, it’s necessary to step away from providing health services altogether—even if it’s just for a brief period.
Respite care provides short-term breaks so primary carers can focus on their own well-being—all while ensuring care recipients are left in safe hands. Respite services are flexible so you can mix and match them to fit your needs.
Subsidised respite care is available through the Commonwealth Home Support Programme (CHSP), Home Care Package (HCP) and National Disability Insurance Scheme (NDIS) funding, and the Department of Social Services for those who qualify. Private respite care services are also an option, but they can be expensive and are not covered by any government-funded programs.
Unlike other aged care services, respite care does not require a means assessment. The amount you pay depends on the type of respite care you choose. Visit My Aged Care to learn more about eligibility and respite care fees, including basic daily fees and common service fees.
Still need help with dementia home care?
If you still have questions about home care for dementia or need help in any way, contact The CareSide on our website form or by calling 1300 85 40 80.
We are an approved provider managing home care packages, home support services and CHSP services. We understand how complex care can be. Our team can help you with residential care and home care for dementia—we’ll answer your questions, explain complicated government language, and provide assistance if you’re searching for palliative care or end-of-life services.