We’ve read so many blogs, articles and watched so many videos on Caring for Dementia. And what they don’t go into it just how hard it can be. It’s a brutal, unforgiving and cruel disease. The common promise from typical care homes is an ‘easier time, stress-free and alleviation of your pain. But, what you know is that’s not completely true.

We can (and do) help as much as we can. Everything from the best environments down to meal plans (We’ll go into this later) but we can’t sit here and pretend we take away your pain.

So, before we get right into everything, we wanted to start by saying the most important thing to take with you as you care for a loved one with dementia is to lead with empathy, compassion and love. It’s hard, we won’t lie. But this part isn’t about you, its about caring for them.

What is it?

Dementia is not a specific disease but is rather a general term for the impaired ability to remember, think, or make decisions that interfere with doing everyday activities. Alzheimer’s disease is the most common type of dementia. Though dementia mostly affects older adults, it is not a part of normal ageing.

There are many different types of dementia. It is not always clear why some people get dementia while others don’t, it depends on a combination of genes, age, health and lifestyle.

There are several types of Vascular dementia. One type is caused by a stroke (called stroke-related dementia) another is caused by the poor blood supply to parts of the brain (called subcortical vascular dementia)

The word ‘Vascular” relates to blood vessels and is the result of problems with blood supply to the brain. Nerve cells need oxygen and nutrients from the blood to survive. Vascular dementia sometimes follows a large stroke (called post-stroke dementia) more often though it comes after a number of small strokes (called multi-infarct dementia)

How can you spot it?

Many loved ones and friends can find dealing with this more difficult than adjusting to changes such as memory loss. Some common changes you may see include:

• Restlessness – for example, pacing or fidgeting
• Repetition – for example, asking the same questions, or repeating an action, over and over
• Night-time waking, sleeplessness. Also known as ‘sundowning’ – is a term given for increased agitation or confusion in the late afternoon and early evening
• Putting things in unusual places, and then forgetting where they are
• Lack of inhibition, such as socially inappropriate behaviour in public. This is particularly common in the behavioural form of frontotemporal dementia
• Suspicion – for example, the person thinking someone has taken something which belongs to them when they have actually mislaid it.

How do you find the right home?

While some aspects are subjective, the core are not. Here are some of The Best Indicators of a Good Care Home:

Foreword: At the beginning of a search for a home, it is evident that rarely do they know what type of care is necessary i.e. residential or nursing, and so often they have had no help from social services and do not realise that an assessment needs to carried out before placement.  It is essential that a person is not admitted to the wrong type of home as a move can be traumatic for both resident and relative.

The best indication of a good home is that the residents appear happy & responsive and that individuals are treated with dignity and respect:

• Do staff speak to residents in a way the residents like?
• Are residents involved in activities or chatting?
• Are they properly dressed and well-groomed?
• Do they seem alert and interested?
• Do they talk to you as you walk around?
• Are they encouraged to do as much for themselves as they can – and if so, can you see any examples of this?
• Do they cater to the individual needs of residents? Food plans, to personalised environments.

Before this, there are of course other things to take into account:

• How close is the home, can you visit easily?
• What is the area like? Is it easily accessible?
• What are people saying about them? Word of mouth is so powerful, have you had a recommendation? What are their reviews like?
• Have they got room? If not, how long is the waiting list?
• Do you need full-time care, or are you looking for a respite care break?

How do you care for Dementia?

1) Specialised & Personalised Environments

A good indicator right off the bat, have they passed the “The King’s Fund Dementia Assessment“? This is an assessment tool guide on Dementia studies by The University of Worcester, which reflects the latest research evidence, best practice and survey responses from those who have used the tools in practice.

Toilets and bathrooms

By understanding that toilets and bathrooms need to be safe and easy places for a person with dementia to use. The right design and colour can help a person with dementia to maintain their independence and dignity for personal care. Our purpose-designed wet rooms and adapted baths offer extra peace of mind.

Lighting

Do you/ can you leverage natural daylight? Bright and airy space makes is particularly important for people with dementia as it can help them make sense of their environment.

Gardens

Specially adapted gardens to allow for easy (and safe) access. For example, our gardens are designed to be both “wheelchair and Dementia-friendly” we have specialist adaptations, such as “grab rails” low-level ramps and low easy to access flower beds, which residents can enjoy attending too.

Personalised environments:

A personalised environment is very important in a Care home. Part of making sure residents have the dignity and respect they deserve is freedom of choice. The freedom to decorate their space the same way they would if they were completely independent. 

2) Maintaining Dignity

All staff need to be professionally trained in Dignity and Respect for quality person-centred caregiving. Each care plan needs to be specially tailored to their needs. Maintaining dignity can be approached in many different ways:

• Involve Residents and families, to tailor their presences of care and support
• Respect all personal space and possessions
• Handle hygiene activities sensitively and discreetly
• Understand how to detect pain and to respond with medical assistance
• Promote social activities, which are meaningful to the individual
• Let people make their own decisions which give them empowerment
• Be available to always listen to how another may feel.

3) Exercise and a Healthy Diets:

Activity/ Exercise:

Activity is crucial. Not only exercise, but keeping the mid active with hobbies and interests. For example:

• Creating a scrapbook or photo album
• Playing games or cards and doing word, number or jigsaw puzzles
• Reading books, newspapers or magazines
• Listening to audiobooks, the radio or music
• Doing arts and crafts – for example, knitting, painting, singing, dancing, writing and poetry
• Gardening, which could be inside or outside, for example – tabletop gardening
• Studying – for example, open university or Udemy. Any free (or paid) courses online or by postal

Exercise is key to a healthy lifestyle. The important thing is to find exercises that are enjoyable and safe for their ability level. Breaking exercises down into Simple, Moderate and advanced, you can tailor plans to individual capabilities/ requirements. Some examples include:

• Short walk  (Simple)
• The sit to stand exercise (Simple)
• Stretches and/or strength exercises (Moderate)
• Gardening (Moderate)
• Dancing (Advanced)
• Exercise class (Advanced)

More examples, and a comprehensive breakdown here.

Healthy Diet:

Setting a meal plan, listing all favourite meals and dietary requirements, and setting out a familiar, regular routine is crucial to maintaining a healthy diet.

Setting the scene for Dementia Friendly mealtimes

A familiar, sociable environment can help a person with dementia to feel more comfortable eating and drinking. At Atkinson’s Private Nursing Home’s we strive for Mealtimes to be an enjoyable experience.

• turning off noisy TVs and radios, or playing some soothing, familiar music
• being flexible about mealtimes, avoiding times when the person is tired or distressed
• giving the person lots of time to eat, so there is no rushing
• eating with the person if they enjoy the social side of this. It might be encouraging for them to see you eating, but bear in mind some people may be self-conscious and embarrassed eating with company
• making sure the room is well-lit and describing the food. This might help the person recognise the food they are eating more easily
• using plain coloured plates and cups so they can see the food easily. Specially adapted cutlery is available for people with dementia

Encouraging a person with dementia to eat

Involve the person by asking them what they would like to eat. If they struggle to decide, you could give them two options of simple things you know they like and can manage. If appropriate, you could involve them in the food preparation. You could try:

• offering something easy to eat, that you know the person likes
• giving the person small, regular portions rather than large meals
• being flexible: a person with a sweet tooth might like to eat their dessert first. You could add sweet condiments like ketchup or apple sauce to savoury food
• offering a small snack before a meal to see if that helps the person realise, they are hungry
• using different tastes, smells, and colours to stimulate the appetite

Encouraging a person with dementia to drink

A person with dementia may not always be able to recognise when they are thirsty, or they might not be able to communicate their thirst. But nevertheless, it is recommended to aim for about eight glasses of fluid per day. You could try:

• having a drink beside the person always
• adding a little flavoured squash if the person is not keen on water
• offering a choice of hot and cold drinks
• helping the person if they are struggling to pick up or hold a cup
• offering the person different shapes and sizes of cup
• finding out if they have a favourite cup, they like to drink from

If you have any questions regarding your current situation, please don’t hesitate to get in touch and we’d be delighted to find a way to help. We also published a blog on finding the right home.

4) Day to day

Having dementia doesn’t mean you need to stop doing the things you enjoy, but it can make things more difficult. Here are some quick tips on planning the day to day:

• Put a regular routine in place – you might find it easier and more reassuring to do things at the same time each day or week. If you find you feel better at certain times of the day try to arrange activities for this part of the day.
• Keep things straightforward – simplify your routine or daily tasks to make them more manageable.
• Take things one step at a time – try to focus on one thing at a time and break each task down into smaller steps.
• Put out the things you need before starting an activity so that you have a visual prompt – for example, tools for gardening or ingredients for cooking.
• Try to reduce any distractions – for example, background noise if you are trying to read.

Thank you for reading!

By no means have we covered the complete complexity that is Dementia Care. But, this is a working blog – meaning we will constantly be updating and adding to it.

A bit about us

We are a proudly independent, family owned and managed Care Group, offering Respite & Full Time Care in the Heart of Royal Berkshire. We have three care homes:

• Fourways Residential, Sandhurst
• Longlea Nursing Home, Maidenhead
• Haldane House Nursing Home, Sandhurst

Get in touch, we can cover:

• Your needs, wishes and expectations of a care home
• A comprehensive, professional opinion on the best care plan for you and your needs. 
• What you should keep an eye out for while choosing your home. 

Our goal is to provide the best advice. Whether you choose us, or another home, we want to arm you with the tools to make the right choice for you.