No matter what setting—at home, adult day care, assisted living, or in a skilled nursing facility—caring for a person experiencing the onset and progression of dementia can be a challenge. Family caregivers are unpaid, largely untrained, and struggle to understand the ups and downs of cognitive decline. Understanding a little bit about the brain changes that occur with dementia and learning the difference between treatable and irreversible aspects of dementia can reduce caregiver stress.
For professional caregivers, learning about dementia will help them in their jobs and help them educate family members. Learning about the physiology of brain deterioration and how the changes affect a person’s behavior, and their ability to communicate and participate in social activities is a must for professional caregivers.
Without a doubt, dealing with behavioral symptoms of dementia is one of the most difficult aspects of family and professional caregiving. Interventions based on person-centered care, meaningful activities, and appropriate physical activity can have a profound effect on the difficult behaviors often associated with dementia.
Because such a high percentage of people experiencing cognitive decline also have acute and chronic pain, caregivers must understand how pain affects older adults. This is especially true for people with dementia, who often have trouble explaining or describing what they are feeling. Pharmacologic and non-pharmacologic methods for managing pain and discomfort begins with proper assessment of pain and includes an understanding of polypharmacy and drug-drug interactions.
Purposeful, meaningful activities provide predictable and relaxing routines and schedules. A well-designed physical environment, easy-to-use assistive equipment, and other well thought out technologies can promote independence and significantly reduce stress for people with dementia and their caregivers.
Common sense, education, and respect for caregivers will improve the way we have been approaching the care of people with dementia. Much of what we have accepted in the past—antipsychotics, restraints, and warehousing of older adults with dementia simply has not worked. There is no doubt that learning about cognitive decline and implementing a person-centered, thoughtful approach to care is urgently needed.