If your parent, partner or friend has been diagnosed with dementia, it’s important to put steps in place now to help them and you, plan for the future. Setting up Power of Attorney for their property and their health is an important task and one to take care of early on. For more information on Power of Attorney, click here. They may also wish to draw up an advance decision stating their wishes for the treatment and/or care they would like to have in the future.
In early stage of the person’s dementia, you may notice memory lapses that will probably be fairly easy to cope with at first. The person may repeat things or ask the same questions. They may also forget routine appointments or occasions. You may need to remind them about appointments (or take them yourself) and also prompt them to take their medications. Sometimes a quick phone call reminding them about a visit or the need to take a tablet can be all that’s needed.
However, as the disease begins to progress, the person could become increasingly forgetful and you may need to make arrangements for a carer to come in and prompt their medication physically if you don’t live with them.
You might also need to enlist more help from friends, neighbours and home care agencies. It’s also important to ensure that the person is remembering to eat. It can be common for them to think they’ve already eaten or they may not be capable of making appropriate food choices. Some people with dementia can develop cravings for sweet foods and prefer chocolate or sweets to proper meals. Speaking to social services about arranging Meals On Wheels if the person lives alone is a good way to ensure they receive at least one nutritious hot meal every day. In some cases, having smaller but more frequent regular meals may be a good solution.
If they live alone, it’s worth checking their fridge for out of date foods that could make them ill. You might also want to make sure they have stored food appropriately – leaving milk out of the fridge or putting frozen items in the fridge rather than the freezer can be common occurrences.
Let neighbours you trust know that the person has dementia. You might also want to suggest that the person carries some identification with them, such as a piece of paper in their wallet with their name on and the telephone number of a person who can be contacted in the event of an emergency. It might also be worth having a key safe box installed outside their house to store a spare key (the box is opened using a code). This is an easy way for carers to access the house or for neighbours to let the person back in if they get locked out. Social services can help with this.
You may notice some mood swings that weren’t apparent before. The person may become angry, depressed, agitated or restless. They may also struggle to sleep at night and might be awake at regular intervals throughout the night. Cutting back on their caffeine intake before bedtime may help, but it’s advisable to seek advice from their GP if this continues.
Mood swings can be more challenging for loved ones, as they can be sudden and unpredictable. The person can be tearful one moment and laughing at a random incident the next. They may suddenly cry over the loss of a loved one or relative, and then laugh at a funny cartoon on the television. Rather than dwell too much on the tearful moments, it’s best if you can go along with their moods. It may be distressing for you to see them upset, but if they have moved past the tearful stage quickly then dwelling on the source of their unhappiness won’t help.
Aggression or depression can be symptoms of dementia. The person can become aggressive quite suddenly, often without any apparent reason. It’s best to change the subject or leave the room for a few minutes if it’s safe for them to be alone. If you respond to their anger and the situation escalates to an argument, they may not even remember the reason for their anger, or the argument, the next day.
They can also lose the ability to use verbal and physical restraint. They may make a hurtful comment about a person’s appearance. It’s important to understand that this is part of the dementia. They may be less inhibited and make inappropriate or sexual remarks to a stranger. Seek advice from their GP if this happens.
Another element of dementia can be what seems like paranoid or irrational behaviour. The person may think that someone is seeking to cause them harm. They may also suffer from hallucinations. Again, seek help from their GP. If the person is already taking medication, it’s also important to have it reviewed regularly – ideally every six months.
As the dementia progresses, memory and moods can deteriorate. The person can become more withdrawn and less capable when it comes to speaking and articulating their thoughts. It’s important to keep planning ahead. While you don’t know how quickly their care needs will change, there will come a time when they will need 24-hour care and help with basic tasks like washing, dressing and being prompted to eat. Plan and prepare for their future now rather than leaving it to the last minute.