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norestforweary Asked December 2012

How important is routine for a person with dementia/Alzheimer's?

Would especially like expert anaswers and rationale regarding this! Thanks

EXPERT Carol Bradley Bursack, CDSGF Dec 2012
Very. Since dementia, especially Alzheimer's, affects the memory, it's far easier to follow a routine than to have things changed often. That's why holidays can frequently be upsetting to someone with dementia. The routine is changed and sometimes even the environment is changed. This can cause anxiety and confusion. Naturally, families want to celebrate with their loved ones who have dementia, but often keeping changes as few as possible is good.
Take care,
Carol

ramking Jan 2013
My mom suffers from dementia and I have learned that routine is VERY important. Even times, which you would think a dementia patient wouldn't be as aware of, is very important. I bring meals at the same time, bring her pills at the same time, and set her tv to tune her favorite shows at the same time each day. She is very aware of time. And I always put things in the same place. Her pills, remote, etc. She lives on our property and has her own small house and making sure that things are always in the same place and on the same schedule really helps her feel safe and confident.

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marksburg Jan 2013
I agree with the expert. In my husbands case nothing could be even moved in slightest in his bedroom - if, after dusting the bookshelves, one of the "memory pictures" I put there for him, was moved from the right to the middle, I saw him become confused, agitated by watching his hand. He would move it from side to side and it was for me to find out what was causing his distress. So would point from picture to picture and watch his eyes - and bingo, one was not in the right place. Once it was back were he thought it ought to be, he smiled and relaxed. Everything needed to stay the same for him to feel comfortable, move something and he was lost. The same with the routine of daily bathing - washing first, then shaving, then brushing teeth. Tried to brush his teeth before shaving and he would simply clamp his mouth shut. It took me a while to figure it out: routine in everything as much as possible. I think of dementia as being stuck in the snow with your car - the wheels are spinning but you are not going anywhere. The loved one is stuck in a place and time that he knows and feels secure, and in my case I had to figure it out . Since we had been married for 46 years I could read his eyes, they always gave me a clue if something was off.
Hope that helps.

jeannegibbs Jan 2013
As all these answers indicate, routine can be very comforting and reassuring and even essential. The degree to which it is critical depends on the personality, the age, and the type of dementia, and the stage it is in. You get to know your own loved one and become a good judge of how much to conform to routine. (Don't knock routine without trying it, though!)

You get to learn, too, when it is worthwhile to break the routine. When going to an afternoon concert is worth the disruption to the routine. When a vacation from routine is just what is needed. My husband's neurologist said many times "novelty-seeking experiences are therapeutic." He always asked if we'd taken any interesting trips or done anything out of the ordinary since we'd last seen him.

Balancing the benefit of routine and the benefit of breaking routine sometimes is another one of those skills we learn on the job!

Corinne Jan 2013
Daisy, without you realizing it, you are blessed that your mom doesn't want to come home. Please don't ask her again. She might say YES and then you'd be sorry. Caring for dementia patients at home, even with paid caregivers is difficult beyond words. The stress would take a toll on you. No one can afford that extra burden. Sending hugs and blessings for you and Mom. Corinne

dusbunny Jan 2013
Routine is paramount for my mother (age related dementia) as well. Same time for meals, bedtime, pills, everything. She can no longer tell time, but she comes at the same time each day to see if meals are being prepared, if I have fed the dogs, etc. Sundowners really affects her, too, so every day I turn on the lights as soon as the afternoon sun starts to fade. While it is often inconvenient for me to stick to her routine, it certainly is less stressful if she is content.

daisy001 Jan 2013
My mom entered an assisted living facility 4 months ago, and she is like a different person than when she was alone at home. Her self esteem has improved because she is able to ' be present' and do things she could never do if she was not there. Still confused and demanding [and not so nice to me at times] but we are all able to handle these changes as they come up. She tends to blame the assisted living facility for her confusion, but when I ask if she wants to come home, she says 'no!'

sadandpuzzled93 Jan 2013
I am soooo thankful for this web site and to be able to read and learn from other's experiences. It's been only one month since my 93 yrs old mom (with Alzheimer's) is living with my husband and I already think I'll be gone before she does. The "sundowner" thing is the worst. Even finding a geriatric Primary Physician that takes Medicare is proving to be impossible, so placing her in a nursing home is a dream at this point. I have realized that it takes 3 shifts of trained personnel to take care of these patients, not an untrained daughter on a 24 hour shift! Thank you all for your input. I'm learning a lot. Thanks to the staff that makes the web site possible!!

peoplepleaser Jan 2013
Agree with gropup. Routine is acually beneficial to us all, but especially as we age. I hate it when my parents housecleaner decides to organize their pantry or medicine cabinet the way she thinks it should be. I have to tell her - it's been this way for 30 years - they won't be able to find anything! Sometimes the rigidity is frustrating and boring for me, but I tell myself I will be there someday.

tlhanger Jan 2013
Mom expects the same breakfast every morning. I can add things to it, but that scrambled egg, yoghurt, and Little Debbie cinnamon roll better be there. The coffee must have the cream there. Gets flustered when I take a second to get it.

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