What is dementia?
Dementia refers to mental mature adult who has progressive intelligent degeneration. This degeneration is sufficient to disrupt the patient's social and occupational functions. Then, it also endangers the daily life self-care ability of patient and is often happened in the elderly.
 
The aims of ideal dementia home care:
It is relatively difficult to care a dementia case compared to care a normal elderly. Family members should support each other to assist the work and care of the patient.
  1. Supporting dementia patient: People with dementia are given appropriate care and support.
  2. Enabling family members to handle care along with related affairs, and reduce stress: The family members must find a balance between the needs and responsibilities in the care process of dementia.
  3. Cognitive-behavioral therapy interventions: focus on diminishing negative thoughts and increasing positive activities, can effectively decrease depressive symptoms for dementia caregivers.
 
Providing the supporting care:
Dementia patient care should include care plan and substantial care. In general, we need establish and prepare a care environment for providing care with rolling adjustment to ensure well-being, safety, and comfort.
  1. Understand home caregiver’s role: Caregiving for dementia will need much time and energy, and will affect many aspects in daily life.
  2. Long-term care plan: Care plan has to adjust as the dementia patients get worse.
  3. Create safe environment for dementia patients.
  4. Learn essential caregiving skills: Dementia patients find it difficult to understand others or explain what they want, and they have difficulty in conducting normal activities. 
  5. Learn the importance of meaningful “activities”: You can improve the quality of life of someone with dementia using many things like simple conversations, fun-filled activities and telling old time stories. 
  6. Targeted ways in solving specific problems: These are things you need to do for particular situations and problems. For example, when dementia patients get angry, withdraw or wander.
 
Provide food and fluid:
Inadequate consumption or inappropriate food and fluid choices can contribute directly to a decline in a client’s health and well-being.
The following practices are recommended:
  1. Provide good screening and preventive systems for nutritional care.
  2. Assure proper nutrition and hydration, given dementia client preferences and life circumstances.
  3. Promote mealtimes as pleasant and enjoyable activities.
 
Improve the quality of life of dementia patient:
  1. Provide a relaxed environment and emotional support
    People find their favorite things for relaxation, depending on their personality and interest. There are many relaxing methods, such as: 
    1. Breathing meditation. 
    2. Instrumental music.
    3. Pet therapy. Dementia patients like pets may respond well to pet therapy.
  2. Help dementia patients feel safe and comfortable
    1. Adapt the home living and adjust the daily routine of dementia patients so that they feel comfortable and safe. 
    2. Try to reduce any confusion of dementia patient related to time and space. When helping them, give just suitable assistance so that they feel capable and independent remain safe, and don’t get frustrate. 
  3. Add meaningful activities
    Reducing activities may make dementia patients feel useless and worthless. Looking for activities that make them feel useful and meaningful. For example:
    1. Spreading clothes to dry, or picking them up and folding them.
    2. Removing stones from deal rice. 
    3. Sharpening pencils, stacking newspapers.
    4. Explaining a recipe to a grandchild.
    5. Walking with a pet.
    6. Doing laundry and retrie ving clothes.
    7. Re-arranging photos in photo albums.
      Activity selection may depend on the abilities and problems of dementia patients. Doing activities that involve exercise, such as walking or yoga. These activities have health benefits to reduce frustration and aggression for providing a sense of well-being.
  4. Add fun-filled activities
    These activities include: 
    1. Painting.
    2. Playing board games.
    3. Simple games like stacking colored rings.
  5. Spend time talking with dementia patient
    Caregivers often forget to spend happy hour with loved ones who have dementia. Appropriate use of music can be particularly powerful for dementia patients. Smells of spices, aroma or favorite food can also help patients. Discussion with other family members about what can trigger pleasant memories for the dementia patient. The family can spend time together as followings:
    1. Listening nostalgic music and discussing favorite songs.
    2. Watching nostalgic movies together.
    3. Watching family album, or re-arranging photos in them.
    4. Sharing anecdotes from the past.
Reminiscence therapy has been successfully used in dementia patients. The project uses weekly meetings with groups of dementia patients and their family caregivers (from 12–18 weeks) to revisit their shared past experience. This was explored using creative ways such as music, drama, art, objects, multi-sensory stimulus and non-verbal communication.
 
 
Reference
  1. Durepos, P., Wickson-Griffiths, A., Hazzan, A. A., Kaasalainen, S., Vastis, V., Battistella, L., & Papaioannou, A. (2017). Assessing palliative care content in dementia care guidelines: A systematic review. Journal of pain and symptom management, 53(4), 804-813. http://doi.org/10.1016/j.jpainsymman.2016.10.368
  2. Giebel, C., Roe, B., Hodgson, A., Britt, D., & Clarkson, P. (2017). Effective public involvement in the HoST-D programme for dementia home care support: From proposal and design to methods of data collection (innovative practice). Dementia, 1–14. http://doi.org/10.1177/1471301216687698 
  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. Rapaport, P., Livingston, G., Murray, J., Mulla, A., & Cooper, C. (2017). Systematic review of the effective components of psychosocial interventions delivered by care home staff to people with dementia, BMJ Open, 7(2), e014177. http://doi.org/10.1136/bmjopen-2016-014177
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