Confusion and Daily Tasks: Tips for Dealing with Dementia

Daily tasks differ when the person you are caring for is mentally confused because of Alzheimer's disease or another form of dementia. More than half of family members caring for someone with dementia felt they were "on duty" 24 hours a day, according to researchers reporting in the New England Journal of Medicine. Ensuring a person's safety can be difficult. Abilities typically wax and wane from day to day and even hour to hour. "Sundowning" — increased confusion that becomes more apparent as night approaches — is common, too. Despite this, a person may find it comforting to engage in familiar productive tasks, such as peeling vegetables or folding laundry.

Some of the general suggestions listed in this report will work well, of course, but you may find that the following tips, aimed specifically at those caring for individuals with dementia, are also helpful.

Use simple phrasing and short sentences, but be careful to avoid talking to the person as if he or she were a child. Also, try to be patient. Give someone with Alzheimer's or dementia time to complete a sentence or thought. Try not to interrupt.

Mealtime

Stick to a calm, simple mealtime routine to avoid agitation. Try to have the person use the bathroom beforehand. Limiting choices by offering one food at a time with the right utensil and eliminating distractions may be wise. It helps if eating places are well lit and food contrasts rather than blends in with the plate. Cut food into small pieces. Switch to softer foods if choking occurs easily or the person often fails to chew.

Curved spoons, plates that are divided or have high sides, and straws can make it easier for a person to feed himself or herself. If eating is messy, put down a wipeable tablecloth, use spillproof cups, and offer an apron to keep clothes clean. If certain foods are off limits, keep them out of sight. Because poor nutrition and dehydration are common among those with Alzheimer's and dementia, watch for signs of these problems.

Keep a record of when the person urinates and has bowel movements, and remind him or her to use the bathroom at regular intervals. Restlessness or agitation may indicate bladder or rectal fullness. If the person has trouble urinating, have him or her blow bubbles through a straw in a glass of water.

During the middle stages of Alzheimer's, a fear of bathing often arises, possibly in response to faltering motor skills and an inability to process information. It's important to set a routine that closely mimics what the person used to do and to stick with it. Put out everything — towel, soap, bathrobe or clothes, etc. — and fill the tub or start the shower before bringing the person to the bathroom. Be gentle, calm, and reassuring while talking through the steps of the bath or shower one by one. Short phrases help. Rushing often upsets people. Privacy may also be an issue. Respect modesty by covering portions of the person's body with a towel, but never leave a person alone in the tub. If a loved one resists bathing or becomes agitated, stop and try again later when he or she is in a good mood.

Bathing is a good time to check for rashes, reddened skin, or sores, so these problems can be treated before they grow worse. Applying cornstarch can help minimize chafing; baking soda also helps and has deodorizing properties.