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What is dementia?
Dementia is caused by neuronal degeneration in brain that affect cognitive and physical function. The short term memory loss usually happen in the early stage.  As dementia progresses to the middle stage, symptom of memory loss become more obvious. Behavioural symptoms, including wandering, sleep disturbances, violent agitation, and psychological symptoms, such as hallucination, and depression may occur.  In the late stage of dementia, memory and physical function are overall decline or even being bedridden.
 

The aims of dementia home care:
It is relatively difficult to care for a dementia case compared to care for a normal elderly. Family members should support each other and share the task and care responsibility. The aims of dementia home care include:

  1. Provide the patients with dementia appropriate care and support.
  2. Family members must find a balance between the needs and responsibilities during the care process of dementia. Enable care givers to handle care along with related affairs and reduce stress.
  3. Focus on diminishing negative thoughts and increasing positive activities, which can effectively decrease depressive symptoms for dementia caregivers. 
Provide supportive care:
 
Dementia patient care should include a long-term care plan and substantial care. Ensure the patient’s safety and comfort according to patients situations.
  1. Understand the home caregiver’s role: Caregiving for dementia demands a lot of time and energy and affects caregiver’s many aspects in daily life. You should find a short rest period and a way to relieve your emotions.
  2. Long-term care plan: A care plan must be flexible as dementia patients get worse. Long-term care and support to dementia patients are needed. Also, family members should support and encourage each other.
  3. Create a safe environment for dementia patients. If you have corridor, stairs or bathroom, make sure there is handrail. Remove dangerous objects from the home or storing them in a locked cabinet.
  4. Learn the essential caregiving skills: Communication skills can be hard for people with dementia because they have trouble to explain what they want and understand others. Use simple and short words. Speak calmly and repeat instructions. Reassure the person to help the person feel being care and more secure. Avoid arguing and criticizing when dementia patients have inappropriate behaviors or anxiety. Try distracting the person with an activity.
  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. Try distracting the person to avoid conflicts.
  7. Provide proper nutrition and fluids: Inadequate consumption or inappropriate food and fluid choices can contribute directly to a decline in a dementia patients’ health and well-being. Serve meals in a pleasant place that can increase person’s appetite.
Improving quality of life for patients with dementia:

Provide a relaxed environment and emotional support
  1. Create a comfortable, relaxed environment and give emotional support: People find their favorite things for relaxation, depending on their personality and interest. For example:
    1. Meditation and Deep breathing.
    2. Read aloud books and newspapers.
    3. Music and instrument.
    4. Pet therapy: Dementia patients respond well to pet therapy. It also called animal-assisted therapy.
  2. Help patients with dementia 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 patients related to time and space. Arrange furniture simply and consistently. When helping them, give just suitable assistance so that they feel capable and independent, remain safe, and do not get frustrated.
  3. Arrange meaningful activities. Meaningful activities can reduce dementia patients’ frustration, aggressive behavior and create a sense of well-being. This may decrease dementia patients feel useless and worthless. Look for activities that make them feel useful and meaningful. For example:
    1. Simple daily tasks, such as hanging clothes to dry, folding laundry, washing rice, pick vegetables and stack of newspapers.
    2. Talk to your grandchild.
    3. Walk with a pet.
    4. Re-arrange photos in photo albums.
  4. Add fun-filled activities:
    1. Painting and puzzle.
    2. Playing board games(tabletop game, playing cards, checkers, Chinese checkers, image recognition)
    3. Simple game, such as color stacking rings.
  5. Arrange group reminiscence therapies or relaxing activities for individuals with dementia and their family carers at least once weekly. Use of creative and nonphamocological reminiscence activities including music, drama, arts and smell favorite scents or foods, multiple senses stimulation, and nonverbal interaction to help patients recall  positive memories and review their past experiences together. 
 
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. 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
  3. Tseng , Y.H., Yang , C.H., Shin, Y.M. & Jao, J.Y.(2020). Exploration of nursing assistants' experience in caring for residents with dementia in a nursing home.  VGH Nursing ,37(3), 232-243. https://doi.org/10.6142/VGHN.202009_37(3).0002
  4. Tsou, C. T. &Tang, L. Y. (2019).Cognitive impairment nursing.Psychiatric nursing: Concept and practice, (pp. 523-557). Farseeing Publishing Group.
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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
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