1. Nursing Instruction
  2. Overview
  3. Psychiatry
【Major Points】
  1. Dementia is a progressive degenerative disease of the brain's nerve cells.
  2. The goal of care is to provide appropriate care for patients and support for caregivers and families.
  3. Providing a safe and comfortable home environment is essential.
 
Why is it necessary to understand home-based care for dementia?

Dementia is a progressive degenerative disease of the brain's nerve cells, which affects memory, judgment, behavior, and psychological status. As the disease progresses, daily living activities become more challenging, and patients become entirely depending on others. Understanding home-based care for dementia can assist caregivers and the entire family in reducing the burden of care.
 
Goals of home-based care for dementia:
  1. Providing appropriate care for patients and support for caregivers and families.
  2. During the process of caring for patients, family members can assist caregivers in performing various care tasks and reduce stress.
  3. Reducing patients' negative thoughts and increasing positive activities to effectively reduce the caregiver's depressive symptoms.
 
Principles of care:
  1. The role of family caregivers: Long-term care and mutual support are necessary, and caregivers need to allocate time for short respites and channels of emotional expression
  2. Understand essential care techniques
    1. Patients are unable to express their needs and have low comprehension. It is recommended to repeat the explanation in short and easy-to-understand words, and use reassurance techniques to relieve disturbed and anxiety.
    2. When there are behaviors of anger and uncooperativeness or anxiety, it is not advisable to confront them directly or accuse them on the spot. You can smoothly transition them to other activities or topics.
    3. You can take a walk in the natural light in the morning or evening and maintain regular daily routine.
  3. Providing a safe and comfortable home environment:
    1. As the disease progresses, different symptoms will appear, so the environment should be adjusted to ensure safety and comfort.
    2. The decoration should be simplified to reduce confusion about time and space.
    3. If symptoms of mental illness occur, dangerous items should be stored or locked.
  4. Non-pharmacological applications:
    1. Listening to music, group singing, painting, watching dramas, pet therapy, horticultural therapy, smelling good smells, or the aroma of favorite foods, can stimulate eyes, ears, noses, and tongues, and bring pleasant memories to patients.
    2. Interesting activities, such as puzzles, playing board games (such as playing cards, checkers, chess, and card recognition), or stacking colorful blocks.
  5. Ensuring adequate nutrition and hydration: A pleasant dining environment can promote the appetite, and lack of intake may affect the patient's health.
  6. Arranging simple activities to increase the patient's sense of value:
    1. Simple housework, such as hanging clothes, folding clothes, washing rice, picking vegetables, etc.
    2. Talk and interact with grandchildren.
    3. Take pets for a walk.
    4. Browse through photo albums and rearrange photos.
 
Reference
  1. Li, K. L. (2022). Application of nonpharmacological intervention to the elderly with dementia at home. Changhua Nursing, 29(3), 19-28. http://doi.org/10.6647/CN.202209_29(3).0005
  2. Baker, F. A., Lee, Y. C., Sousa, T. V., Stretton-Smith, P. A., Tamplin, J., Sveinsdottir, V., Geretsegger, M., Wake, J. D., Assmus, J., & Gold, C. (2022). Clinical effectiveness of music interventions for dementia and depression in elderly care (MIDDEL): Australian cohort of an international pragmatic cluster-randomised controlled trial. Lancet Healthy Longev, 3(3), 153-165. 　https://doi.org/10.1016/S2666-7568(22)00027-7
  3. Lee, M., Ryoo, J. H., Chung, M., Anderson, J. G., Rose, K., & Williams, I. C. (2019). Effective interventions for depressive symptoms among caregivers of people with dementia: A systematic review and meta-analysis. Dementia, 1471301218822640. http://doi.org/10.1177/1471301218822640
  4. Sousa, L., Sequeira, C.,Ferré‐grau, C., Costa, R.,Pimenta, S., Silva, S.,& Graça , L. (2022). “Living together with dementia”—A psychoeducational group programme for family caregivers. Perspect in Psychiatric Care,28(4),2037-2042. 　http://doi.org/10.1111/ppc.13025
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    1. Nursing Instruction
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    Self-care / Home Care
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    Taipei Veterans General Hospital 
    No.201, Sec. 2, Shipai Rd., Beitou District,  3e72dadb9904d06fa0fb3744e4ed2612.png
    Taipei, Taiwan 11217, R.O.C.
    Tel: +886-2-2871-2121 #04
    • Smoking and chewing betel nut significantly induce oral cancer. Obesity will potentially increase the risk of breast cancer and colorectal cancer. Please control body weight and keep away from tobacco and betel nut.
    • Information provided above can’t overcome physician's treatment and replace physician patient relationship.
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