Activities such as dressing, grooming, bathing and eating can form a pattern in daily living. Routines help the person with dementia know what to expect, and help them continue to do things on their own. Doing so will make them feel better about themselves.
People with dementia will eventually lose the ability to carry out these everyday routines and will depend on others to help. So it is important for them to do as much as they can for themselves, for as long as they can. This will help them feel good about themselves, for greater dignity and confidence.
It will be easier if you continue the routines they have used to for much of their life. For example, if they are used to bathing in the morning, try to make morning bathing the pattern. Carrying out the activities in much the same order each day will also help them know what to expect.
Reminders will help, particularly during the earlier stages of dementia. These can be written notes on the fridge to remind them to eat, or signs on a cupboard to tell them what is inside.
If they no longer understands words, try using colour cues or pictures. Cues such as a toothbrush on the counter will remind them to brush their teeth. Clothes laid out in the order they are to be put on will make it easier for him to get dressed. Regular reminders might be needed to get them to go to the bathroom.
Helping with routines
If you are supporting a person living with dementia, you may find it difficult to know how to help and how much to help. Sometimes they may need help but want to look after personal care independently. This can be frustrating, especially when you know you could carry out the task more quickly, or help do the task more efficiently. Try to avoid the temptation to take over, even if they are really struggling. The loss of confidence could make it harder for them to keep trying.
When you do offer help, try to do the task together, rather than doing it for them. This will help them feel more in control and more involved. When talking through activities like this, try to focus on what they can do, rather than on what they can’t.
Keep in mind that it’s hard for people with dementia to learn new ways of doing things, remember steps involved in instructions, and stay focused for long on a task. Take things slowly, try to be patient, and take breaks. Be encouraging, and try to maintain your sense of humour.
Tips for making routines easier
- Try breaking the task down into sections. For example, they may find it easier to continue dressing themselves if you put the clothes out for them in the order that they need to put them on. Or you could pass them the next garment, holding it out ready to grasp at the right place, or encourage them to put their shirt on over their head before you straighten it down for them.
- Even if they can't complete a full task, carrying out one or two steps of it—particularly the final step—can give them a sense of achievement.
- Make sure that any reminders or instructions are simple. Use short sentences, with gestures and body language to add meaning.
- Be tactful. Try to imagine that you are the person receiving help, and speak in a way that you would find helpful if you were in their position.
- Try doing things together, such as folding clothes or drying dishes.
- If there are activities you do regularly, try integrating them into the daily routine.
- Make sure they don't feel like they are being supervised or criticized in any way. This means checking your tone of voice as well as the words you use.
- When their dementia gets to a more advanced stage, try pointing, demonstrating, or guiding an action rather than giving a verbal explanation. For example, they may be able to brush their own hair if you hand them the brush and start by gently guiding their hand. Try using your voice to make reassuring and encouraging sounds rather than using actual words.
(This list was adapted from Alzheimer’s Society (U.K.) http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=115