​Refusing to bathe or eat, screaming and not sleeping at night are common challenges faced by caregivers of persons with dementia.

There are no quick fixes to prevent or stop such difficult behaviour, but getting to grips with the pillars of dementia care and focusing on areas that can be controlled can reduce their frequency and caregiver stress.

Nurse Clinician-Advanced Practice Nurse Esther Chua from the Department of Nursing at National Neuroscience Institute (NNI), a member of the SingHealth group, explains.

Tips for caring for a loved one with dementia

1. Understand the disease

Dementia causes physical changes in the brain that limit the person’s ability to think, plan, remember and communicate. This can be frustrating for the person with dementia, and their only means of sharing their likes and dislikes may be through shouting, screaming or lashing out.

Sensitivity to noise and changes to taste and smell are common, so favourite foods may become flavourless, which can cause a person with dementia to lose interest and enjoyment in food.

Such changes to the brain cannot be controlled, but caregivers can make adjustments to the environment and activities to reduce the risk of these changes causing challenging behaviour.

2. Lower your expectations

Caregivers often remember their loved ones as they once were: independent, capable individuals who worked hard to support the family and/or kept everything running smoothly at home. This can make it difficult for them to accept that their loved ones cannot manage to do tasks that they were once good at, such as finding their way or remembering important dates.

Basing your expectations on a loved one's current abilities and preferences can help reduce frustration for both caregivers and the person with dementia.

3. Simplify your communication

Dementia affects the way a person communicates. As the disease gets worse, persons with dementia often find it difficult to process information and respond appropriately. It helps if caregivers can simplify communication by:

  • Being patient.

  • Using simple words.

  • Using short sentences.

  • Giving two simple options instead of open-ended questions, for example, rather than asking what they would like for breakfast, ask if they would like a sandwich or porridge.

4. Set a routine

Having a daily routine with engaging activities can help persons with dementia feel more secure, reduce agitation, and improve their sleep. It also allows caregivers to schedule time to take a break and recharge, which is important to prevent burnout.

Establishing routines as soon as the person is diagnosed with dementia helps to reduce problems — such as refusal to bathe and being wide awake and active at night — as the condition progresses.

For more about routines, check out the NNI article on "Planning Routines for People with Dementia".

5. Avoid overstimulation

Persons with dementia may tire easily. As caregivers engage their loved ones in meaningful activities, it is also important to avoid too much stimulation. Factor in time and space for loved ones to take a break from the activity. For example, during festive seasons and family celebrations:

  • Caregivers can consider hosting relatives instead of bringing their loved one to a number of different homes in a day. This ensures that their loved one remains in a familiar environment and can take a break when needed.

  • Limit the length of get-togethers and number of visitors / visits based on their loved one’s threshold.

  • Look out for warning signs that a meltdown is about to happen, such as restlessness or irritability. If you spot such signs or the person with dementia says he or she has had enough, take the person home or encourage hom or her to take a break from the activity, e.g. by taking a power nap or disengaging from the environment.

Ref: J22

Check out other articles for dementia caregivers:

Dementia Caregiver Tips: Do's and Don'ts

How to Understand and Cope with Dementia Behaviours

Resource for Dementia Caregivers

How to Make Your Home Dementia-Friendly

How to Prevent Caregiver Burnout