Strategies for Supporting Individuals with Dementia in Daily Activities

Dementia is a syndrome that indicates the ongoing decline of cognitive functions. Dementia affects our memory, behaviour, speech, thoughts and feelings. According to the NHS, 1 in 11 people over 65 are living with dementia and this number is growing as life expectancy increases. Cases of dementia in the UK are predicted to reach 1 million in the next few years. 

Dementia is a progressive condition that usually gets worse over time. People living with dementia may begin to need increasing amounts of intervention and support to perform their daily activities such as cleaning, shopping, personal hygiene and organising finances. For some, living independently will become challenging or even impossible. 

There is currently no cure for dementia, although with the correct treatment and support, the progression of the illness can be slowed down, allowing people to retain their mental capacity for longer. People suffering from dementia require empathy, understanding and support from caregivers in order to try to maintain as much of their independence as possible. 

In this article we will discuss some of the common symptoms and challenges that living with dementia can pose as well as key strategies for supporting individuals with dementia in their daily activities. 

Understanding the Needs and Challenges 

Dementia affects people across a range of functions and can cause:

• Cognitive decline
• Emotional and psychological changes
• Physical limitations

Cognitive decline 

Dementia can have a significant effect on our memory and cognition. It can cause us to forget names, directions, locations and instructions. This can cause behaviour that is inappropriate and unsafe such as forgetting to eat or drink, walking out into the road without looking or going out and getting lost. 

Symptoms of cognitive decline associated with dementia include:

• Memory loss
• Slower thinking speed
• Problems with problem solving
• Issues with speech and language (including using words incorrectly or having problems speaking)
• Decreased mental sharpness

These cognitive changes can affect how safely and effectively a person with dementia can perform daily tasks, make decisions and judgements and function safely and independently. To support those with dementia it is helpful to find ways to help them to stay organised, make decisions and be involved in their daily activities.

Emotional and psychological changes

Dementia can cause emotional and psychological problems including angry outbursts, anxiety and mood swings. 

People with dementia sometimes struggle with social situations and start to lose interest in social events, seeing friends or maintaining relationships. It can also cause personality changes which can further impact interpersonal relationships, for example:

• Saying inappropriate things or appearing to have no filter
• Appearing to lack empathy, understanding or compassion for others
• Saying things that are (or appear to be) untrue
• Denying things have happened when they have
• Blaming others for things that are out of their control
• Claiming people are not who they are

It is important for those around the person to remember that these changes are a symptom of dementia and that the patient is not responsible for them. Try to be as understanding as possible, don’t take things too personally and avoid getting snappy or argumentative when someone with dementia says something that is offensive or upsetting. This is not always easy and is why it is vital that workers dealing with dementia patients are well trained in how to best support them and have a caring attitude. 

The loved ones of people with dementia require breaks from their caring responsibilities and should have access to support to help them deal with the challenges they face as their loved one changes. 

Physical limitations

Dementia can cause problems with movement and coordination. Dementia can also intersect with other problems commonly encountered during old age such as hearing or sight loss. 

It can be challenging to find the right balance between allowing a person with dementia to act independently and trying to keep them safe and look after their wellbeing. People with dementia may be resistant to having anyone intervening in their lives and may react by getting annoyed or frustrated. It is important that when supporting an individual with dementia you are able to stay calm under pressure and speak to them with empathy, understanding and kindness, even when they are being difficult.

Strategies for Supporting Daily Activities

Each person with dementia is an individual and should be treated as such. If you are providing care for a person with dementia then you should pay attention to what in particular they are struggling with, as well as what kind of approach they react most favourably to. 

Key areas that individuals with dementia may benefit from receiving ongoing support with include:

• Personal hygiene and grooming
• Meal preparation and nutrition
• Medication management
• Household chores
• Social engagement and recreation

By providing caring and effective support, anyone looking after someone with dementia can help them to live a more healthy, safe and happy lifestyle.

Personal hygiene and grooming

People with dementia often struggle with maintaining their personal hygiene and grooming standards. This can include forgetting to wash or brush their teeth, and not washing and drying their clothes. They may also develop sudden fears associated with water, falling down or privacy.

Some helpful strategies to support dementia patients with their hygiene and grooming include:

• Establish a consistent routine to reduce confusion
• Organise toiletries and clothes to make things easier to find
• Label the bathroom and toilet with clear and easy to read signage
• Offer calm, kind and empathetic assistance to support people with washing, dressing and grooming
• Don’t rush the process or make it overly stressful
• Provide plenty of reassurance to the patient that they are safe

Meal preparation and nutrition

Eating a healthy, balanced diet is vital for everyone as part of a healthy lifestyle. Weight loss is a common issue encountered by people with dementia as they may forget to eat, forget how to eat or fail to recognise foods. 

Using strategies that allow dementia patients to be involved in both cooking and eating fosters inclusion. It is also helpful to find ways to make mealtimes as straightforward, stress-free and enjoyable as possible, such as:

• Find ways to simplify meal prep, e.g. using easy-to-follow recipes and pre-portioned ingredients
• Involve the patient in mealtimes, ask them what they like to eat and what specific foods mean to them
• Try to ensure meals are nutritious and contain all of the necessary vitamins and minerals
• Adjust portion sizes, textures and flavours depending on the patient’s tastes (which may change suddenly)
• Set aside enough time to cook, eat and clean up. Keep mealtimes as calm, upbeat and stress-free as possible
• Offer finger foods if the person you are caring for struggles with cutlery
• Consider plastic cutlery and plates/bowls to avoid accidents or injury
• Be intuitive to a person’s dietary needs (including any allergies, intolerances, their religious or ethical beliefs)

People with dementia often forget to drink which can result in severe dehydration. This puts people at risk of:

• Urinary tract infections (UTIs)
• Constipation
• Headaches and dizziness

Being dehydrated or unwell can make the symptoms of dementia, including confusion, significantly worse, therefore it is vital that caregivers support people with dementia to remember to drink regularly and have access to fluids. 

Strategies for supporting people with dementia to stay hydrated include:

• Offer fluids in a clear cup/glass that has handles and is easy to hold
• Use straws to assist with drinking
• Always have a drink available with meals
• Gently encourage the patient to drink throughout the day
• Try a range of drinks and keep their personal tastes in mind
• Consider Jelly Drops – water-based sweets with added vitamins and electrolytes that have been shown to help people with dementia stay hydrated

Medication management 

Medication non-adherence is a significant risk factor for people with dementia. This can be due to confusion, forgetfulness or the patient refusing to take their medicine. 

To support a dementia patient in taking their daily medication, you may want to try some of the following strategies: 

• Use pill organisers labelled with the day and loaded with the correct dosage
• Set alarm reminders and leave notes around the house
• Coordinate with doctors to streamline the medication process and ensure medication administration is as simple as possible
• Set a routine for taking medication
• Make sure medicine is administered in a calm and quiet environment – failing to do this this may add to the stress and confusion that sometimes accompanies medication time

Household chores

People with dementia, especially those who live alone, may struggle with staying on top of the housework, gardening and shopping. This can lead to unclean, untidy and disorganised living spaces that pose a hazard to the patient and increase their stress levels.

• Use labels or signs on cupboards, drawers and doors that say what is inside
• Use visual aids to help them stay organised
• Let them know that help is available with their household tasks and encourage them to engage with help
• Allow people to take part in basic chores as far as they can (laying the table, weeding the garden, washing the dishes)
• Break tasks down into smaller, more manageable components to make them less overwhelming
• Ensure the environment is adapted to be as safe and easy to navigate for dementia sufferers as possible (e.g. securing gardens, using assistive aids, ensuring tools and equipment are well organised and easy to find)

Social engagement and recreation

Staying active and getting gentle exercise supports our overall wellbeing. Being outside in nature has been shown to boost our mental health and exercising can boost endorphins (feel-good hormones), improve blood flow and increase oxygen levels. 

Physical activity does not have to be high impact or strenuous. Activities to promote social engagement and recreation as well as encourage physical movement include:

• Walking
• Yoga
• Tai chi
• Swimming
• Dancing

People with dementia should be encouraged to take part in fun activities that match their interests, skills and physical limitations. Being sociable and staying active may help patients to live well with dementia and may keep them healthier and active for longer. 

Common activities enjoyed by dementia patients include:

• Music therapy
• Arts and crafts
• Gardening
• Memory cafes (also called dementia cafes)

People with dementia often withdraw from social situations which can lead to loneliness and isolation. It is important to try to keep their spirits up and to gently encourage them to get out and about, meet people and have experiences rather than retreat into themselves.

Creating a Supportive Environment

It is important that patients with dementia are able to live in a safe and supportive environment. An environment that is adapted to their individual needs will help them to cope with the limitations of having dementia and can keep them feeling calmer and happier. 

To support individuals with dementia in their living space you should:

• Notice triggers (such as light or noise) and take steps to reduce them
• Make physical adaptations where necessary to make the home safer (such as walk-in showers, alarms or additional security, ring cameras)
• Engage with occupational therapists who can recommend supportive equipment (such as a walking aid) to make life easier

People with dementia may develop problems sleeping:

• Place a clock by the bed with large, easy to read numbers
• Try to encourage them to get sufficient exercise and fresh air during the day to help them sleep
• Try to ensure their living space is light and airy during the day and dark at night (unless they are triggered by light/dark in some way)

Utilising Professional Support and Resources

After a dementia diagnosis, it is perfectly normal to feel anxious about losing your independence and having to make changes to your life. Having a strong support network around you and engaging with available resources may help you to live independently for longer. 

If you have dementia, you should book a needs assessment with your local council’s adult social care department. This assessment should be done face to face and can help to identify areas where support may be needed such as help with housework, self-care or meals. 

Support resources include:

• Healthcare professionals
• Support groups and services
• Charities and community organisations
• Join an online forum such as Alzheimer’s Society Dementia Forum to share experiences of living with dementia with others

You can also get support from:

• Your GP
• Age UK
• Dementia Connect Support Line (0333 150 3456)
• Dementia UK

Monitoring and Adapting Care Plans

Dementia progresses through stages and each individual will experience the condition in their own way. This means that dementia care plans are subject to change and need to be regularly monitored and adapted in order to ensure that they are providing patients with the right support. 

Changes may be required to reflect a person’s reduced mental or physical capacity. This might mean carers visiting more often, physical adaptations being made to their home or even that they are no longer able to live independently and will need to move into a nursing or care home. 

Patients and their families should be involved in the decision-making process as far as possible and any changes should be in the best interests of the patient. 

Conclusion

Dementia is a progressive illness that currently has no cure. The symptoms of dementia can have a significant impact on a person’s cognitive skills, causing them to become increasingly reliant on the help and care of others. 

If you are tasked with caring for someone with dementia, consider implementing some of the strategies discussed in this article as you support them in their daily activities. Additionally, you should make an effort to engage with available resources, ensuring the care you provide is patient centric, with a focus on maintaining the patient’s dignity and independence as far as possible. 

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