Memory & Mood

Caring for a Loved One with Dementia

Occasional trouble remembering things as we get older can be a normal part of aging. But many older adults experience a more serious type of memory loss that gets worse over time and interferes with daily living — a condition called dementia. “Dementia is a chronic disease that causes the progressive loss of brain function,” explains UAB geriatrician and palliative care specialist Caroline Harada, MD. “Usually memory is affected, but the condition can also affect other cognitive domains, including language and reasoning ability.”

Alzheimer’s disease is the most common form of dementia, although the condition can also be caused by a stroke, head injury, tumor, or another disease, such as Parkinson’s. While many older adults never develop dementia, the condition is fairly common — by age 85, about 35 out of 100 people are affected.

If you have a loved one with dementia, you may be concerned about how to provide the best care in a safe, secure environment. “It’s important to encourage and assist someone with dementia to be autonomous and independent for as long as possible,” says Dr. Harada. “At the same time, families should be aware of the many aspects of care that are important for the continued health and well being of their loved one with dementia.”

Be sure medications are taken consistently and safely. “Often, medications are used to treat the cognitive and behavioral symptoms that can accompany dementia, as well as other common symptoms, such as depression and sleep difficulty,” explains Dr. Harada. It’s important to make sure that your loved one is taking medications correctly — a task that’s often difficult for those with dementia. “Using a pill box or memory aid can be helpful,” adds Dr. Harada. “Also, talk to your loved one’s doctor about the risks and benefits of all medications.”

Involve you loved one in decisions about future care. “It’s important to get advance directives early in the course of the illness so that your loved one can be involved in making decisions about future care,” stresses Harada. Make it a priority to help your loved one write a living will and durable power of attorney. A living will specifies the type of medical care your loved one wants when he or she is no longer able to be involved in decision-making. A durable power of attorney allows your loved one select someone as a health care agent to make important decisions that may not be addressed in the living will.

Take a close look at home safety issues. There are several things you can do to help your loved one stay safe at home — especially if he or she is still living alone. To reduce the risk of falls, get rid of throw rugs and install hand rails in bathrooms. “It’s also important to make sure that people with dementia keep their doors locked and that they don’t open the door to strangers,” says Dr. Harada. Family members should also help to make sure electrical appliances and faucets are being turned off when not in use. Most patients with dementia also lose the ability to drive safely at some point, and family members should be on the lookout for this.

Get educated about care options. Because dementia gets worse over time, your loved one probably won’t always be able to live alone. “If an older adult is having difficulty performing daily tasks, an alternative living arrangement must be made.” While some families are able to care for a loved one with dementia, work obligations or financial constraints may make this responsibility difficult — if not impossible — for other families. “Adult day care programs are a good option for some families,” says Dr. Harada. “The drawback to these programs is that they are usually private pay only. Also, many older adults with dementia may resist leaving the familiar setting of home for the entire day.” For many families, assisted living or nursing home care is the only viable option. “The level of care varies considerably among assisted living facilities, so it’s important that families make sure the facility they’re considering will provide the care their loved one needs,” says Dr. Harada. “Also, because dementia is progressive, it’s best to choose an assisted living facility that is associated with a nursing home so that when a person’s care needs become too much for the assisted living to handle, they can easily transition to the nursing home.” While families may often feel guilty about the decision to admit a loved one to a nursing home, it’s important to remember that these facilities can help an older adult with dementia have more independence and security than in a home setting.

Get caregiver support. For families taking care of a loved one with dementia, the caregiving role can be emotionally and physically exhausting. “Caregiver stress is very real, and the constant demand of caring for someone with dementia can lead to caregiver burnout,” explains Dr. Harada. If you’ve assumed the caregiving role for your loved one, be sure to enlist help from friends, family, or other community resources — no one can be on duty 24/7. “We also encourage caregivers to attend support groups with others who are facing the same challenges,” adds Dr. Harada. “And if the caregiver role becomes too overwhelming, it’s probably a good idea to consider an assisted living facility or nursing home for your loved one.”