Blog - ReaDementia

How to Help People With Dementia Remain Independent

Aziz Tarafder Blog March 1, 2021October 16, 2021dementia, independence, living with dementia

When caring for someone with dementia, it can be challenging to get the right balance between being helpful and supportive and allowing your loved one to retain their independence for as long as possible.

According to Dementia Carers Count, there are currently 700,000 people in the UK (15.7 million in the US) who care for someone with dementia, with 40% of these carers looking after their loved one 24 hours a day, 7 days a week.

Unfortunately, there is no manual for carers and most people who look after someone with dementia are simply trying to do their best on any given day.

However, trying to ensure that your loved one’s overall wellbeing is looked after while at the same time trying to help them maintain their dignity, confidence and self-esteem can be difficult.

Staying Independent with Dementia

That being said, with the right support, advice and guidance, carers can ensure that the person they look after is both safe and able to remain independent.

If you are personally struggling to help your loved one with dementia to retain their independence, the below practical steps should ensure that you are able to offer the right support without being overpowering.

Dementia medication made simple

One of the most prolific issues amongst families who care for relatives with dementia is medication adherence.

In fact, recent studies have shown that people living with dementia only manage to take the correct dosage of their prescribed pills 11% of the time.

Furthermore, due to the complexity of dementia medication and the fact that many people living with dementia also suffer from a wide range of other medical conditions and behavioral issues, it is crucial that carers and patients alike are able to effectively manage their medication.

Fortunately, there is a simple solution to this problem, yet many families who are affected by dementia are unaware of it.

The dementia aid in question is the automated pill dispenser.

This product is specifically designed to assist people with Alzheimer’s and dementia, as well as those who are visually or mentally impaired, by reminding them to take their medication in a highly specialized and effective way.

With the ability to set up to 6 daily audio and visual alarms and a fully automatic lock, this handy device is perfect for helping dementia patients to feel in control of their medication and retain their sense of independence.

Furthermore, it gives carers peace of mind that their loved ones are not forgetting to take their dementia medication, providing one less element of dementia care for them to worry about.

You can also find several other medication management products for people with dementia including:

Vibrating alarms watches
Timers
Pill boxes of various sizes and capacities
Pill grinders

The power of physical activity

Everyone knows the importance of regular exercise for maintaining good physical health, yet not many are aware of the link between physical activity and brain health.

As a part of Age UK’s “Staying Sharp Series”, The Global Council on Brain Health (GCBH) examined the evidence around achieving a brain-healthy lifestyle including the beneficial effects of regular physical activity.

The results were clear. A physically active lifestyle, as in one that incorporates movement into daily activities, lowers the risk of decline in thinking skills as you age.

Furthermore, “purposeful” exercise, meaning exercise that involves moderate to vigorous exertion, results in beneficial changes in both brain structure and brain function.

What does this mean for people with dementia?

Fortunately, for those that have dementia and are already experiencing a decline in their cognitive skills, exercise can be beneficial too, helping to combat changes in the brain that are associated with this disease.

In terms of specific exercises, there are several activities that are suitable for people in the early or middle stages of dementia including:

Simple ball games
Dancing
Swimming
Gardening
Tai chi
Indoor bowls
Walking

Remember that activities such as these can not only help dementia patients to stay physically and mentally independent for longer, but they also encourage social interaction which is vital for their overall confidence and self-esteem.

Plus, it can help to lower their stress levels, and yours as a carer.

Making home modifications

In terms of practical steps that you can take to help your loved one with dementia retain their independence, making modifications to their home is arguably one of the most crucial.

The way in which their home is designed and laid out can have a massive impact on how someone with dementia is able to carry out daily tasks such as cooking, cleaning and even just getting around the home safely and with minimal effort.

Fortunately, as a carer or family member, there are several modifications that you can make to ensure your loved one is both comfortable and safe in their own home.

Improve lighting

If you are concerned about the risk of falls or confusion, it can be a good idea to evaluate the lighting in the home.

You want to avoid too many shadows and reflections and reduce glare where possible as all of these can cause disorientation in someone with dementia.

Try and embrace natural light where possible by leaving the curtains open all day, avoiding blinds and cutting back any overbearing trees or hedges in the garden that are blocking the windows.

In terms of technology, you could invest in some automatic light sensors that will instantly turn on the lights when someone walks past them.

Reduce noise

Excessive noise can be distressing for people with dementia, especially if they rely on a hearing aid. Therefore, you should try and eliminate unwanted sounds and background noise where possible.

For example, turn off the television or radio when no-one is watching it, put rugs down if you have wood or laminate flooring and pull the curtains closed in the evenings.

Use labeling

If you find your loved one often gets confused when navigating their way around their home, displaying clear labels or signs can be extremely effective.

When creating signs you should ensure that they are understandable, are accompanied by a corresponding image and that they contrast in terms of color with the background that they are placed on.

Make the flooring safe

Trips and falls are a real worry for carers with people living with dementia three times more likely to suffer a hip fracture when they fall.

Therefore, it is crucial that you ensure their flooring is as safe as possible.
Ways in which you can make flooring more secure include:

Avoiding rugs or mats that pose a tripping hazard
Avoiding shiny or reflective flooring
Choosing a color that contrasts with the walls

When carrying out any of the above modifications it is important to be mindful of your loved one, as people with dementia can become distressed by changes to their routine or home environment.

Try not to make too many changes at once and involve your relative in the process through active communication and addressing any of their worries or concerns.

If you would like more information on how to make your home dementia-friendly, the Alzheimer’s Society has created a handy booklet full of top tips that you can download online or request a copy to be sent to you in the post.

Take advantage of technology

In recent years dementia-related technology has come a long way with a plethora of helpful dementia aids that can help your loved one retain their independence.

Known as “assistive technology”, the below innovations will not only promote self-reliance in someone with dementia but will also help to keep them safe in their own home.

Dementia clocks

People with dementia can become easily confused concerning the time of day and often cannot determine between day and night.

Dementia clocks are a great way to help your loved one with their routine, providing a clear and simple way for them to distinguish the time.

There are many different types of dementia clocks available with some that show the day, date and time, some that depict day and night and others that simply show the day of the week for those in the later stages of dementia.

Hydration cups

Dehydration is a common problem in elderly people in general but it is even more of a concern in people with dementia.

There are several reasons why someone with dementia can become dehydrated including:

They forget to drink fluids or forget where they have left their drink
An inability or difficulty swallowing
An inability to communicate that they are thirsty
Medications that cause frequent urination
Limited mobility

Elderly people are recommended to drink 2-3 pints of water a day, which is equivalent to 6 cups of tea, yet people with dementia regularly do not drink this much leading to common signs of dehydration including nausea, headaches and persistent fatigue.

Thankfully, help is at hand in the form of hydration cups such as the Droplet.

Designed in the same shape as a mug or cup to allow users to enjoy a sense of normality, these cups work by alerting the owner when they have not drunk for a while using both subtle flashing lights and recorded audio messages.

Communication aids

One of the key factors in helping someone with dementia to remain independent is ensuring that they do not become cut off from the outside world.

As the disease progresses, many dementia patients will prefer the comfort and familiarity of their own home, but that doesn’t mean that they can’t still stay connected with their family and friends.

Adapted telephones are a dementia aid that provides a simple way for people to stay in contact with their loved ones, with the ability to pre-program their most frequently dialed numbers and larger buttons for ease of use.

You may also want to show your loved one how to use Skype and FaceTime so that they can video call any family members or friends who live too far away to visit frequently.

Other technological innovations for dementia patients you may want to look into include:

Location tracking devices
Personal alarms
Automated temperature, smoke and carbon monoxide detectors
Memo minders

The bottom line

Finding ways to help your loved one to retain their independence, confidence and self-esteem is vital both for their overall wellbeing and your own.

Nobody likes to admit it but being a carer to someone with dementia is hard work.

Of course, it can also be massively rewarding and helping your partner, parent or friend when they need it most is arguably one of the most meaningful things you ever do.

That being said, there is no shame in admitting that you need help.

Whether that involves utilizing the latest technology to help your loved one manage their own condition or using an automated product to take the pressure off of you, even if just concerning one daily task.

Be sure to keep the lines of communication open between yourself and the person you are caring for and focus on their abilities as their condition progresses.

Encourage them to participate as much as possible but don’t be afraid to step in when necessary.

Whether you live with someone with dementia such as a partner or spouse, or you help care for a parent who lives alone, helping them to keep their independence for as long as possible will result in them leading a happier, healthier and more stress-free life.

Art Therapy And Dementia Benefits

Rok Krivec Blog, Prevention March 1, 2021October 16, 2021art therapy, dementia

If you have dementia or know someone with the illness, you may be interested in the topic of art therapy and dementia.

British Association of Art Therapies defines art therapy as a type of psychotherapy that uses art media as its primary communication mode.

Persons who engage in art therapy do not need any skill or experience in art.

In most cases, a professional art therapist will steer the art therapy sessions. Their main aim is to help clients use art materials in a safe environment to grow and change on a personal level.

In the past, paintings and drawings have been categorized as a useful part of therapeutic processes within psychological and psychiatric specialties.

How does Art Therapy Help Dementia

Now that you have an idea of what art therapy is, let us get into some of the reasons persons with dementia will benefit from art therapy.

Art Therapy Stimulates the Brain

Art projects create an avenue where patients with dementia can express their creativity in a fun and relaxed manner.

Therefore, art therapy can stimulate the brain in different ways.

This can help to stir memories and at times it can even encourage speech. Some studies confirm that art therapy activities can help boost cognitive function in several areas of the brain.

This, in turn, helps to enhance the functions of the brain, communication, and social interactions.

Engages Individuals in a Myriad of Activities

When it comes to art therapy and dementia, ill persons get a chance to engage in tons of activities that can help create pleasant experiences and memorable moments.

Nowadays, art activities go beyond drawing on blackboards of papers.

Participants can enjoy other fun activities, like:

Using dough or clay for sculpting
Paint by numbers
Painting using watercolors
Pencil or charcoal drawing
Creating jewelry
Making cards
Being part of community art projects and much more

These art activities help relieve stress, stimulate senses, and boost hand strength.

Art therapy has a way of making somebody with dementia laugh, smile, move, or speak which is great especially when it comes from non-verbal seniors.

They can also create a sense of accomplishment and purpose as many persons usually feel proud and fulfilled after finishing one of their creations.

Improves Psychological and Behavioral Symptoms

A high percentage of people with dementia will exhibit symptoms such as anger, restlessness, anxiety, depression, sadness, and other psychological and behavioral symptoms as the disease progresses.

Experts believe that when persons with dementia take part in art activities, it can help regulate mood and help them express themselves in a comfortable and safe environment.

Negative emotions are reduced significantly when someone with dementia takes part in artistic activities.

Additionally, impaired individuals can strengthen self-control through free-form creations which ultimately helps to improve their quality of life reducing incidences of psychological and behavioral symptoms.

This is another reason why it is important to look into art therapy and dementia seriously.

Enhances Social Skills and Communication

Through art therapy, caregivers understand the inner world of persons with dementia better, thus, improve communication with them.

In group settings, individuals with dementia get a chance to express themselves not only to the art therapist but their peers as well as helping improve their social skills.

This is because they can form good interpersonal relationships where they no longer have to suffer the negative consequences of social isolation.

Studies focusing on art therapy and dementia revealed that even those with severe dementia were able to strengthen their sense of belonging in a group after voluntarily engaging in coloring activities under caregiver guidance.

The individuals with the illness enhance their social skills by focusing more on eye contact and the exchange of body contact.

It is also common for patients with dementia to become more vocally active when they are participating in art topics they are familiar with.

This is because the topics may stimulate pleasant past memories which trigger their interest in specific art activities, hence promoting social skills and self-expression.

Helps Alleviate Caregiver Burden

Taking care of people who have dementia is quite challenging. This is especially because there is no textual description of how the disease progresses. The condition will also not affect all persons identically.

Carers must, therefore, examine for subtle changes in the persons they are looking after when their communication abilities start to diminish.

With art therapy, caregivers can know the proper steps to take when offering care depending on how the individual behaves while engaging in various activities.

For instance, abrupt changes in art style may be an indication of further progression of the illness.

During group sessions, caregivers also get a chance to interact with each other where they can get emotional support as they share pointers on care experiences.

Closing Thoughts

It is undeniable that there are a lot of positive things that persons with dementia get when they participate in art therapy.

In addition to opening up a new effective communication channel as well as reduce negative emotions, art activities can also help strengthen and develop fine motor skills through hand and brain coordination.

Studies are also going on concerning the benefits of art therapy and dementia.

For your information, there are also many other alternative therapies for dementia that help with the patient’s condition.

Pressure Ulcers, Bedsores and Dementia

Laura Herman Blog March 1, 2021September 7, 2023bedsores, dementia, pressure sores, pressure ulcers

When it comes to bedsores and dementia, it is important to know how to approach with treatment, or even better, have a prevention plan in place.

Bedsores can develop quickly – in as little as a few hours. It’s best to prevent them if possible. If they do develop, it is vital they are tended to promptly.

Prevention & Treatment for Bedsores and Dementia

They can be extremely challenging to treat and can be quite detrimental to a person’s health and quality of life.

What are Bedsores?

Bedsores are also known as decubitus ulcers, pressure sores, pressure ulcers, or pressure injuries. They develop when an area of skin and underlying tissue loses blood flow and starts to die.

This can occur when a shoe, medical device, or other object presses against the skin over an extended period of time.

One of the most common causes of pressure injuries is when skin and tissue are compressed for a sustained period between a person’s skeleton and a surface such as a mattress or a chair.

People who are able to move and reposition normally will adjust their weight frequently enough that blood remains flowing and skin remains healthy.

People who aren’t able to reposition themselves easily, and who spend a lot of time sitting or lying down, are at the greatest risk for developing a pressure ulcer.

Why are Pressure Ulcers a Problem?

While pressure ulcers often develop quickly, they can take an extremely long time to heal.

Factors that contribute to their development – such as limited circulation, impaired mobility, poor nutrition or compromised health – often work against their healing.

Pressure sores are associated with many complications, especially infections.

They often take a great deal of bodily energy to heal – energy which people in poor health usually lack.

Pressure ulcers can be very uncomfortable or painful, detract from quality of life, and in some cases, they can contribute to an earlier demise.

Suggested Products to Assist People with Bedsores and Ulcers

	Product	Features
	HITHINKMED Alternating Air Pressure Mattress, Pressure Pads for Bed Sores	Hospital or home use Mattress pad Ultra quiet electric pump Fits most beds Promotes blood circulation
	Foot Pillows Heel Protectors Heel Cushions Heel Protection Effective Pressure Sore and Heel Ulcer Relief	Swollen feet comfort Heel protection 2 pack
	Skil-Care Heels-Off with Gel Insert	Helps healing ulcers Improves circulation Prevent pressure sores
	Lunderg Bedsore Pillow Positioning Wedge - with 2 Non-Slip Pillowcases & Adjustable Slope - Pressure Ulcer Cushion	Bed sore prevention Stay on side and stay off back Inc 2 non-skid pillowcases 1 year warranty
	MedVanceTM Silicone - Bordered Silicone Adhesive Foam Dressing Size 4"x 12" (2.4"x10.4" Pad) Box of 5 dressings	Promotes healing Easy to apply & remove Semi-permeable Super absorbent Individually wrapped Multi-layered

A Particular Challenge in People with Dementia

People with dementia may have difficulty moving their bodies.

Even if they are painful, they may not recognize that moving would relieve the pressure and pain.

They may not understand the need to reposition themselves to prevent a pressure injury, and may not be compliant with caregivers’ attempts to do so.

For example, a person may prefer to sleep on his or her back all night. He or she may resist lying on the side, or may scoot back to their back shortly after moving off it.

Once a pressure ulcer develops, someone with dementia may not be compliant with the measures needed to heal it.

Aside from keeping pressure off the affected area, bedsores often require painful wound care.

People with dementia may react with uncooperative or resistant behaviors, including pushing, hitting or kicking at caregivers.

In many cases, people with pressure injuries are repositioned every two hours around the clock. Being awakened frequently can cause sleep deprivation and an array of physical and emotional effects for people with dementia, including:

Uncooperative or difficult behaviors
Daytime sleepiness
Withdrawal from social interaction or activities of interest
Decreased physical strength and coordination
Decrease in cognitive function
Increase in emotional volatility
Changes in eating, appetite, nutritional status and weight

Four Stages of Pressure Sores

Pressure ulcers are categorized into four stages based on their severity.

Stage 1

Stage 1 pressure injuries are the first, and mildest, stage. The skin is not yet broken, but it usually looks discolored – usually reddened in light skin, and slightly purple or blue in darker skin. (Dark purple or maroon usually indicates a deeper injury.)

When pressed with a finger the area does not turn white.

A stage 1 bedsore may be warmer, cooler, firmer or softer than surrounding skin. It may or may not be tender or painful.

Stage 1 pressure ulcers are the easiest to heal, but they will progress into stage 2 quickly if the pressure is not relieved.

Consult with the person’s doctor if they don’t resolve within 24-48 hours after relieving pressure.

Stage 2

Stage 2 pressure injuries feature broken skin with pink or red moist wound beds. Blisters may be present, but no underlying tissue is involved.

Stage 3

In stage 3 pressure injuries the tissue beneath the skin is visible. Stage 3 pressure injuries can be very extensive beneath what is immediately visible.

Stage 4

In stage 4 pressure ulcers muscles, tendons or bones may be visible. Black, dead tissue may be present.

Stage 3 and 4 pressure injuries are serious medical issues and require the support and guidance of a medical team to help them heal.

You should consult the individual’s doctor for all pressure injuries. Even Stage 1 pressure injuries should be viewed as a warning taken very seriously.

The doctor should take measures promptly to ensure they don’t worsen or recur.

Sepsis: A Medical Emergency

Pressure ulcers can easily become infected, especially if they are exposed to bacteria from stool or other bodily fluids.

Signs of an infected pressure sore may include:

Redness, soreness or heat in the skin around the pressure injury
Pus or drainage from the wound
Foul odor from the wound
Fever

When you notice signs of infection, notify the person’s doctor promptly.

Because it is easy to miss signs of infection, it’s important to be alert for signs of sepsis in people with pressure ulcers, even if there isn’t a known infection.

Sepsis is a severe reaction to an infection in which the body’s organs shut down.

Without emergency medical treatment, it can rapidly lead to death. Get the person to the emergency room right away and tell them you suspect sepsis.

Look for:

Signs of infection
Temperature changes (high fever or abnormally low body temperature)
Mental changes (increased confusion, extreme sleepiness)
Signs of extreme illness (shortness of breath, discomfort, weakness, pain)

What Contributes to Bedsores?

Pressure sores are especially common in areas over bony prominences that experience sustained contact with a chair or bed.

Areas that are particularly prone include:

Ears
Shoulder blades
Spine
Tailbone
Elbows
Hips
Knees
Ankles
Heels

Sustained pressure

Pressure ulcers can start to develop within a mere two hours when the pressure between the person’s bone and a chair, bed or object has cut off blood flow to the skin and underlying tissue.

Friction

Friction occurs when skin rubs against another surface, such as when a person is pulled up in bed by caregivers.

Shear

Shear occurs when skin stays in one place while bones move. This pinches off blood vessels and restricts blood flow. A common example of shear is when the head of a bed is elevated and a person slowly slides downward.

Poor nutritional status

Dehydration, unplanned weight loss and general malnutrition are known to be significant risk factors for developing pressure ulcers.

Incontinence or wetness

Urine and feces are especially caustic to the skin. Moisture from incontinence, perspiration or other sources can weaken the skin and make it more susceptible to damage.

Immobility

When someone spends a great deal of time in bed or in a chair and doesn’t move or reposition themselves frequently, they are at high risk for developing pressure ulcers.

Can Bedsores Heal?

Bedsores can heal, but it is far easier to prevent one than it is to heal one. Catching and treating it as early as possible makes a huge difference.

Compliance with keeping all pressure off the affected area is extremely important – and often, extremely challenging. It may be necessary to alter one’s sleeping or sitting position for an extended period.

Usually, the pressure ulcer develops in the first place because the person favors that position for some reason. (Such as someone who sleeps on their back due to breathing or discomfort may need to adapt to sleeping on their sides instead).

Refraining from it can be uncomfortable, inconvenient, or present other challenges.

How to Prevent Bedsores

Repositioning

Most people without mobility impairments reposition themselves frequently when sitting or lying.

If someone doesn’t reliably reposition themselves independently, a caregiver should remind and assist him/her to do so.

Many facilities use every two hours as a standard for repositioning, however, the need will vary by individual. Also, there is rising concern about the detrimental effects of sleep deprivation when people are repositioned this often.

The person’s doctor or medical team should determine the frequency of repositioning based on their unique situation.

Repositioning doesn’t necessarily need to be a significant amount of movement.

A shift in weight or a slight turn to one’s side may be sufficient as long as it relieves pressure.

Use pillows under arms or legs, between knees, or behind backs to support their body as needed.

Minimize Friction and Shear

Keep the head of the bed elevated only as much as needed, and elevate the feet to reduce sliding and minimize shear.

When pulling someone up in a bed, lift them fully off the bed, rather than letting them drag against the sheets.

Special friction-reducing sheets designed for this purpose may be helpful.

Nutrition

Wound healing benefits from extra calories, protein, zinc, certain vitamins and amino acids.

Hydration is an extremely important factor in both preventing and healing pressure ulcers.

Different people have different nutritional needs.

For example, people with kidney impairment may need to avoid too much protein or limit fluids. Consult with a doctor or dietician regarding an individual’s nutritional plan.

Keep Skin Clean and Dry

Remaining in a wet or soiled brief is extremely hard on the skin. Ensure to promptly clean all incontinence episodes.

For frequent incontinence, use a barrier cream to protect the skin.

Incontinence products designed for overnight use can help. Such products aim to hold urine away from the skin so it stays dry.

These products tend to be more expensive, but worth the extra cost in some cases.

Minimize episodes of incontinence by following a person-centered toileting schedule when possible.

Mobility

Encourage and assist an individual with dementia to retain their mobility to the extent possible.

When safe and practical:

Move the person out of a wheelchair into a dining chair to eat
Get up to the toilet, move about or switch seats every two hours
While it can feel natural to essentially wait on someone who has difficulty getting up, look for opportunities to allow them to get up and do for themselves. What we don’t use, we lose!

Consult with a doctor, physical therapist or personal trainer regarding ways to keep the individual mobile.

Be sure to find a physical therapist or trainer who has the experience and is comfortable working with dementia.

Because people with dementia may not remember their instructions, it takes a particular skill set to achieve the best benefit.

Finding the right therapist or trainer can make all the difference in the person’s success.

Routine Skin Checks

Make a habit to visually inspect the person’s skin routinely. Pay special attention to their bony prominences including toes, ankles, heels, knees, hips, tailbone, spine, shoulder blades and ears.

The recommended frequency of routine checks will vary based on the individual and their unique health status. Check with their doctor for specific recommendations.

Generally, it’s a good idea to inspect all areas of skin at least daily for high-risk persons.

The coccyx should be inspected with each brief change when incontinence and limited mobility are concerns.

Diabetic Feet

Pay extra attention to the feet of someone with diabetes. The impaired circulation to these lower extremities exacerbates the risk terribly.

Socks and shoes should always be clean, dry and fit properly.

Specialty cushions or equipment

Pressure reduction products, such as cushions and other equipment, are available to help reduce the risk of bedsores.

There are many factors that contribute to pressure injuries, and they vary considerably by an individual.

It is important to select the proper equipment for the person’s needs.

Choosing the wrong product can make the difference between effectively preventing or healing a pressure sore, and not.

Consult with the individual’s doctor or healthcare team to ensure the choice of an appropriate product.

Prevention is Key

Pressure sores can be extremely detrimental to a person’s health, comfort and quality of life, but they can usually be prevented with awareness and precautionary action.

Final Thoughts – Bedsores and Dementia

Older people are more susceptible to bedsores and dementia, especially if they have trouble with mobility. In addition, older people who carry weight, suffer from conditions such as diabetes, incontinence or poor nutrition are at greater risk of developing pressure sores and ulcers.

Bathing And Dementia: Best Practices

Laura Herman Blog February 28, 2021September 7, 2023bathing, dementia

Bathing and Dementia challenge- lots of people with dementia don’t want to bathe – for lots of different reasons.

When you are trying to help someone who doesn’t want to bathe the first step is to figure out why they don’t want to do it.

Only when you know why they don’t want to bathe will you be able to figure out how to overcome the resistance.

Bathing Practices for Someone with Dementia

There are so many unique individuals with multiple reasons for not wanting to bathe. There are quite literally thousands of potential strategy combinations to try.

Common Reasons to Resist Bathing

There are many reasons people with dementia may resist bathing. Often there are multiple reasons at play.

It’s important to investigate the cause, or causes, of each individual’s resistance so that their hygiene needs can be met without causing emotional turmoil or trauma.

Common reasons for bathing resistance can include:

Physical Discomfort

The bathroom is cold, bright or otherwise uncomfortable.
They are in pain.
Bathing is tiring.
Their sensory processing can become hypersensitive, leading to extreme sensitivity – almost pain – to heat, cold, touch, hearing or other sensation.

Emotional Discomfort

They feel embarrassed about needing help.
They’re uncomfortable undressing in front of others.
They are fearful of water in their face.
They are frightened to step into the tub.
Bath mats or drains may look like dangerous holes.
Reflections from the mirror may make it seem like there are many people in the room.
They have traumatic memories that are retriggered by the experience.

Changes in Cognitive Abilities

They believe that they already have showered, or that they will be doing it soon (for example, when they “get home”).
They no longer know how to sequence the steps to complete a shower.
They don’t understand they need help, or what you’re doing to them.
They don’t understand that they need to bathe (even if it seems drastically obvious to you).

How often Should Elders Shower?

Experts tend to agree that traditional showers or baths are the ideal way to achieve cleanliness.

Bathing removes dead skin cells and bacteria that accumulate and lead to rashes, infections and skin disorders.

However, bathing every day can wash away protective oils from the skin.

Elderly people often have dry, fragile skin. Daily showering can actually worsen its condition.

Depending on the individual’s situation, bathing 1 – 3 times per week is generally recommended for elders.

Using a washcloth on the hands, face, feet, underarms and genitals on the other days is ideal.

There is little ideal about dementia care. In reality, we do our best with what we can in each unique situation.

There are many people who can’t bathe traditionally because they are bedbound, or for other reasons.

If someone with dementia won’t get in a bath or shower, a sponge bath using non-rinse soap is a very good substitute.

A careful sponge bath can remove as much dead skin, oil and bacteria as traditional bathing. Furthermore, alternative bathing has been proven to significantly reduce behavioral challenges for people with dementia.

Finding a way to meet the person’s hygiene needs without upsetting them makes a huge difference – on their quality of life, on your relationship with them, and on the safety of everyone involved.

Suggested Products to Assist Bathing People With Dementia

	Product	Features
	Dove Body Love Beauty Bar Soap Dry-Cracked Skin	Hypoallergenic fragrance Instant dryness relief Dermatologist approved Hydration
	Basis Sensitive Skin Bar Soap - Cleans and Soothes with Chamomile and Aloe Vera	Body wash or hand soap No fragrances No dyes Rinses easily
	Nurture Valley Sponge Bath Wipes - Large Disposable Wash Cloths for Adults, Seniors, Bedridden, Home Care	No rinsing Disposable sponge wipes Bath with no soap Ultra thick
	Carousel Sliding Shower Chair Tub Transfer Bench with Swivel Seat	Premium padded Pivoting arms Adjustable space saving design Professional grade Robust
	Bath Bench Seat Suspended, Bath Tub Shower Chair	Heavy duty alloy Adjustable Comfortable Lightweight
	Inflatable Bedside Shampoo Basin kit, Bedridden Shower System for Disabled& Elderly	High quality PVC Holds 2.5 gallons of water Set of 6 Easy and comfortable

Bathing Basics

When helping someone with dementia to bathe it may help to do some of the following:

Cover the person with towels for warmth and modesty.
Help/encourage them to participate – use the washcloth to wash what they can. This can help give them greater control, and can distract their attention from any uncomfortable feelings while someone else washes what they can’t reach.
Set up supplies ahead of time.
Be aware of, and minimize, stimulation where possible. Brains can easily become overwhelmed in a bathroom environment by bright lights, reflections or loud noises.

Mix and Match Tips for Successful Showering

The strategies that will ultimately be effective in successful bathing will depend on the reasons for the resistance.

Be creative and flexible, mix and match approaches, try and err until you find what works for a given individual in the given moment.

Keep in mind that what works may vary from day to day or over time.

Don’t Ask

Generally, you should NOT ask someone with dementia if they want a shower. The answer will be no.

Instead, try walking them to the shower area without talking about it.

Have the shower running already and have everything you need already in place. Towel, washcloths, change of clothing, soaps, shampoo, lotion etc.

Give a Choice

Some people respond better if they have a choice in the matter. Try to offer two options that are both acceptable, such as “Would you rather have a bath or a shower?”

Even if they always make the same decision, having the choice can be important for helping them feel in control.

Choose your Words Wisely

Sometimes it’s a good idea to avoid a specific word, such as “shower” or “bath.” In many cases, avoiding the word itself will avoid resistance.

Simply using different verbiage, such as “Time to wash up”, or “Here’s a warm washcloth,” can make a 100% difference in these cases.

Pay Attention to your Non-verbal Messages

Are you dreading the experience as much as you think they will? Are you inadvertently showing signs of stress, anxiety or tension when it’s shower time?

Most people with dementia pick up on non-verbal messages, such as body language, tension and tone of voice, extremely well.

Relax, open your mind, use a bright, enthusiastic voice – and watch them follow suit.

Who’s Asking?

It can be worth experimenting with who is trying to get the person to shower.

Some people will do anything their son suggests, for example, and seemingly oppose every one of their daughter’s ideas.

Some people respond well to a letter or phone call from the doctor’s office reminding them to take a shower.

Hire a Professional and Work as a Team

Some people don’t want to accept help from a family member, but may be amenable to help from a professional.

On the flip side, other people may be more receptive to a trusted family member.

Professional care staff and family may have to work together to accomplish the task in a way that feels safe and acceptable to the person living with dementia.

Consistency is extremely important when it comes to hiring a professional.

Once you find a good match, use the same person each time to the extent possible. It may take several sessions to build up trust and rapport enough to accomplish the bathing.

Gender may Matter – a Lot

While it doesn’t make a difference to everyone, some people are much more comfortable with members of their same gender.

Others however will tend to do more for someone of the opposite sex.

Play the Part

Other non-verbal cues can include the environment or the outfit that the helper is wearing.

A home bath aide who is wearing scrubs, or a white lab coat, may look more like a nurse and therefore inspire more cooperation.

A home care aide can also come under the guise of a “Nail Care Technician”, “Masseuse” or “Skin-care Nurse”, for example.

One advantage of these options is that they spare the person’s ego.

If the resistance results from being embarrassed or unaware that they need help with bathing, these can be effective approaches. They can meet the person’s hygiene needs while preserving their self-esteem.

Music

Sing or play their favorite music from young adulthood.

Keep their attention wrapped up in song and their mood high. Dance a bit as you help them through the process of changing or sponge bathing and be amazed at what you can accomplish.

Massage

Some people love massages.

Having a massage appointment in which they are massaged using warm washcloths and non-rinse soap can be just the ticket for some.

Beauty Shop

A beauty shop appointment can be very effective for washing hair. Try printing out a “gift certificate” on the computer and presenting it to the person with much ado.

They may just be swept along with the enthusiasm of the moment.

Spa Treatment

Try presenting a bath as a spa treatment. Pamper the person with champagne (or bubbly water) and chocolates in the bath.

Break out the facial mask, cucumber slices, seaweed wraps – or anything else that might sell the experience.

Mani – Pedis

Use manicures as an excuse to provide excellent fingernail care, washing and lotioning skin from the hands up to the elbows, or even beyond.

Likewise, pedicures can provide the perfect opportunity to clean the feet and lower legs up to or even beyond the knees.

Chest, Back and Underarms

Gaining access to this area can be tricky in some cases. Again, presenting the non-rinse soap as a skin treatment can be helpful.

Try to time this for a moment when they are changing their shirt if possible.

Incontinence Care

If the person is amenable to assist with cleaning up after an incontinence episode, this can be a great time to sponge bathe the entire perineal area, thighs and abdomen.

If the person prefers to wash this area independently, provide warm washcloths with non-rinse soap.

It may help to explain that the non-rinse soap is a skin treatment to prevent infections and skin concerns (which is true, after all).

Go for a Swim – or Just Dress Like It!

For people who swim regularly (or may enjoy starting), a pre- or post-swim shower can be a good opportunity to work in a routine shower.

This can be effective because it is an expectation of everyone who swims. There is no singling out, no implications about the person’s needs or detriments, no embarrassment.

If urinary incontinence is a concern, consider adult incontinence briefs made especially for swimming.

Standard incontinence briefs aren’t suitable for submersion underwater.

Wearing a swimsuit in the bathtub can also be effective when modesty is a concern.

Aim for the time that works best for them

This will vary by individual. The best time may be:

What they’re used to.

Have they always liked a bath at bedtime? It might help to keep up that routine.
It may help to have a quick shower or sponge bath every day at the same time, even if it’s not completely necessary for hygiene, it may help them to build that routine so they can thrive with that consistency.

During their best time of day.

If they tend to be more alert during mornings, it may help to aim for a morning shower or sponge bath, even if they used to prefer bedtime baths.
Other people find that midday tends to be when they function at their best, and some (although not too many) even do better cognitively later in the day.

When they’re already changing clothing or using the toilet.

Half the trick is to get them this far. When they’re sitting on the toilet, you can apply their “leg cream” (non-rinse soap). Keep a change of clothes in the room so you can apply the non-rinse soap and change their socks, pants and undergarments quickly, smoothly and without resistance.

Unpredictable.

Sometimes routines are really helpful to those with dementia – but sometimes you just have to be watching for the window of opportunity and be ready to take it when it comes. Have everything ready pretty much all the time, so when they are ready you are too.

Alternative Bathing Options and Products

Sponge Bath

As simple as a warm washcloth in a sink or basin, a sponge bath can be a very effective way of removing old skin cells, bacteria, sweat and odor.

Use soapy water, being sure to rinse well with a clean washcloth afterward, or try using a non-rinse conditioning skin cleansing product for more ease and better skin health.

The general rule of thumb is to wash from cleanest to dirtiest body parts, using a clean washcloth for each body part.

Seven-day Bath

To avoid overwhelming the person, you can break up a sponge bath so that just a tiny portion is completed each day.

Break it up however works best for the person.

One example:

Monday: hands and forearms
Tuesday: elbows, upper arms and underarms
Wednesday: back
Thursday: front torso
Friday: feet and lower legs
Saturday: thighs
Sunday: perineal area and buttocks

Bed Bath

Essentially a sponge bath given in bed, the bed bath can be an effective way to get someone clean while keeping them warm, feeling secure and modest.

It can easily be disguised as a massage and be a very relaxing experience for the person with dementia.

It might be helpful to hire a professional bath aide to assist with this if you find it physically difficult.

Towel Bath

A towel bath is essentially a bed bath where the person is covered in warm wet towels.

The experience is even warmer and more relaxing than a traditional bed bath.

There is a lot of research to back up its effectiveness in maintaining hygiene and reducing anxiety and resistive behaviors in dementia.

Bag Bath

Commercially available bag baths come with 10 disposal cleansing wipes. Pop the whole bag in the microwave and follow the directions for a complete waterless bathing experience.

Bag baths have been proven to be one of the very best options for preventing spread of infections and are used frequently in hospitals, hospices and other organizations.

Non-rinse Soap

Non-rinse soaps often contain lotions or skin conditioners which offer added benefits to skin health.

Non-rinse Shampoo

Available as a powder or a shower cap, this can be a good way to clean hair without getting it wet.

How to Overcome Resistance to Bathing and Dementia

To overcome resistance to bathing in someone with dementia follow these steps:

1. Identify the causes for the resistance.
2. Reframe the goal. It’s not to get them to bathe, it’s to meet their hygiene needs.
3. Consult with the individual’s doctor, if needed, to determine an appropriate bathing frequency. 4. Consider their unique health status and feelings regarding bathing. 1-3 times per week is plenty for most elders.
5. Try a strategy. Try another.
6. Keep trying until something works.
7. Be flexible and keep adjusting the plan as the situation evolves.

Dementia and Traumatic Brain Injury (TBI)

Rok Krivec Blog, Causes February 28, 2021October 16, 2021dementia, tbi, traumatic-brain-injury

The potential between increased risk of dementia and traumatic brain injury has become a pressing issue as scientists try to find the link between the two.

This is mostly because the immediate effects of head injury can include symptoms that are similar to those of dementia.

These include signs such as memory loss, confusion, and changes in speech, personality, and vision.

Relationship Between Dementia and Traumatic Brain Injury

Depending on the severity of the head injury the symptoms can clear up fast, last a long time, or fail to go away altogether.

Keep in mind that symptoms a person experiences after an injury usually do not become worse over time which is usually the case with dementia.

Dementia affects about 47 million people worldwide and we expect the numbers to double in the next two decades.

Over 50 million people across the globe experience traumatic brain injury yearly.

Causes of TBI

This usually occurs when external forced disrupt the normal functions of the brain. Leading causes of TBI include falls, assaults, and motor vehicle accidents.

Research, however, notes that certain types of head injuries may increase the risk of someone developing different types of dementia.

Two primary factors seemingly affecting a person’s risk include the severity of the injury and the age when the injury happened.

Some studies suggest that more severe head injuries might increase the risk of developing Alzheimer’s disease (AD) which is one of the most common causes of dementia.

The risk also increases for persons who experience head injuries when they are older say 55 years and above.

Repeated mild injuries also increase the risk of having problems with reasoning and thinking in the future.

Brain injuries after 55 are risky

Check out essential details of a study that has been done to try and figure out the link between the risk of dementia and traumatic brain injury.

One of the larger studies reported that the risk of dementia as well as that of Alzheimer’s is significantly higher in persons who have experienced TBI than in those who have no history of traumatic brain injury.

The study that was conducted in Denmark observed almost 2.8 million participants and they began in 1977.

The large study population involved a 36-year follow-up where researchers gained access to a uniform healthcare system that tracks the severity and numbers of traumatic brain injuries.

Among the millions of participants, the research indicated that 4.7% have at least one diagnosis of traumatic brain injury.

With the first TBI diagnosis, 85% had been categorized as mild while the rest were characterized as a skull fracture or severe. 4.5% of the persons who were 50 years and above developed dementia from 1999 to 2013.

From this group, 5.3% had experienced at least one TBI when the scientists were conducting their observations.

The average age at first dementia diagnosis was recorded as 80.7 years. The findings of this research were published in The Lancet Psychiatry on 10th April.

Dementia risk is higher in those with TBI history

The experts in the study concluded that the overall dementia risk in people with a history of TBI was 24% higher than those who did not have a history of traumatic brain injury.

They reached this conclusion after accounting for other risk factors of the neurodegenerative disease.

Severe traumatic brain injuries accounted for an increased risk of 35% while mild TBI increased the risk by 17%.

Men also have a slightly higher increased risk of dementia development when compared to women with traumatic brain injury histories at 30% versus 19%.

Jesse Fann the lead author of the study and a professor of behavioral sciences and psychiatry at the University of Washington School of medicine said that the relationship between the risk of dementia and the number of brain injuries was very clear according to the research.

Men are more likely to develop dementia after TBI

The study also indicated that the risk of dementia also increased based on the number of traumatic brain injuries.

Five or more TBIs increased the risk by 183%, four TBIs increased dementia risk by 51%, while the risk increased by 33% for two or three TBIs.

Fann also explained that if someone had a brain injury in their 20’s chances of developing dementia increased by 60% in their 50s.

The researchers nonetheless clarified that the findings of the study do not suggest that everyone who sustains traumatic brain injury will end up developing dementia in his or her later years.

Fann hoped that the findings will help people with histories of TBI to change their behaviors towards other dementia risk factors.

This includes quitting or limiting the use of tobacco and alcohol consumption, taking part in regular physical exercise, treating illnesses like depression, diabetes, and hypertension, as well as avoiding obesity.

He also suggested that people who have suffered traumatic brain injury need to get an evaluation from medical doctors to get immediate treatment for any persisting issues.

Fann stated that some cognitive rehabilitation strategies might help decrease cognitive deficits that relate to brain injury.

Not everyone with traumatic brain injury will develop dementia

Co-author Jakob Christensen an associate professor of neurology at Aarhus University Hospital in Denmark stated that severe traumatic brain injury is more prevalent in young people.

He went ahead to explain that there is a concern that this also increases the risk of developing dementia in younger people.

Fann warned children and parents to be aware of the risks of traumatic brain injury that contact sports present.

The authors of the study recommended heightened efforts to prevent TBIs, especially for the younger generation.

They said that strategies need to be put in place to ameliorate the impact and risk of dementia relating to traumatic brain injury.

Conclusion

Many studies looking into the relationship between increased risk of dementia and traumatic brain injury are targeting participants of contact sports such as hockey, football, boxing, and soccer as well as military veterans.

These are people who end up experiencing traumatic brain injuries in their line of work.

The researchers acknowledged that more research is still needed to find out who is at the greatest risk of developing dementia as well as other factors that contribute to this risk.

Is There A Connection Between Dementia And Concussion?

Petra Boh Blog, Causes February 26, 2021October 16, 2021concussion, dementia, head injury

Dementia researchers for a long time have been fascinated by the potential link between the risk of developing dementia after a concussion.

Mayo Clinic defines a concussion as a traumatic brain injury that affects the functions of the brain.

Its effects are normally temporary and can include headaches as well as problems with memory, coordination, balance, and concentration.

Can a Concussion Make Dementia Worse?

Blows to the head or violently shaking the upper body and head are the main causes of concussions.

In short, any severe head injury can lead to a concussion.

There is a very high chance that people will experience a concussion after falling or a motor accident.

Concussions are also common for people who play sports like soccer or football, as well as boxing.

Alzheimer’s Association describes dementia as a general term for loss of memory, problem-solving, language, and other thinking abilities.

It ends up affecting an individual’s daily life.

Many people with concussions usually recover fully.

New research, however, shows that there may be a link between increased risk of dementia development for people who have experienced concussions.

Some Studies Support The Increased Risk After Concussion

Several studies are supporting the idea that the risk of dementia can be increased by concussions.

One of the studies published in JAMA Neurology in May 2018 suggests that having a concussion can lead to increased dementia risk even when the person did not experience loss of consciousness.

The study was conducted by a team at UCSF (University of California).

There were over 350,000 participants in the study whose average age was 49. The researchers followed the participants for about 4.2 years.

The researchers also discovered that concussion without loss of consciousness accounted for a 2.4 fold in dementia increased risk.

When the concussion resulted in a loss of consciousness the risk of dementia increased up to 2.5 times higher.

The risk was higher for persons who experienced a moderate-to-severe traumatic injury almost four times (3.77).

The study also acknowledged that concussions in the general population were also risky for dementia and not for veterans alone. They draw the participants from two databases.

One of them has a list of all-era veterans who experienced concussions during military or civilian life.

The other has vets serving war zones meaning most of their injuries occurred in combat zones for example for shockwaves in blasts.

Concussions are risky for people with dementia

The findings were similar in both groups.

This indicated that concussions happening in combat areas are as likely linked to the development of dementia as those affecting the general population according to Deborah Barnes the first author Ph.D., MPH, professor in UCSF psychiatry, epidemiology and biostatistics department.

The experts advised people who experienced concussions to seek medical attention. Also, to allow time to heal as well as try and avoid other concussions.

Although the research did not examine the issue of repeat concussions directly, there is growing evidence that it may result in a cumulative effect.

Different research from Boston University Medical Centre also concludes that there is a link between concussions and Alzheimer’s disease (AD).

Note, AD is one of the most common causes of dementia.

The experts on the study concluded that concussions speed up cognitive decline and brain atrophy that relates to Alzheimer’s especially in persons who are at genetic risk for the medical condition. You can find these findings in the Brain journal.

The researchers observed 160 Afghanistan and Iraq war veterans.

Among them were participants who had suffered one or more concussions and others who had never had a concussion.

Concussions and genetics are crucial

The professionals used MRI imaging to study the thickness of the participant’s cerebral cortex in regions that first show atrophy in AD.

They found that those who experienced a concussion had lower cortical thickness in the regions of the brain that are first affected by Alzheimer’s.

Their results suggest that concussions when combined with genetic factors may play a role in accelerating memory decline and cortical thickness in AD’s relevant areas.

The experts on the study hope that other researchers will build-up on their findings to discover the concussion-related mechanisms that increase the development of neurodegenerative diseases like Alzheimer’s, Parkinson’s and others.

As a result, treatment may target the mechanisms which might lead to delaying the onset of neurodegenerative pathology.

Dementia and Concussion Closing Remarks

Currently, experts do not know the long-term effects that concussions cause.

More ‘dementia and concussion’ research is still necessary to determine whether concussions cause dementia development in later years.

Bright Light Therapy and Dementia

Rok Krivec Blog, Prevention February 26, 2021October 16, 2021bright light therapy, dementia

When looking into new treatments for persons with dementia, bright light therapy and dementia is one of the topics currently getting a lot of attention.

Standford Health Care explains that bright light therapy is one of the treatments used to manage circadian rhythm disorders.

What is Light Therapy for Dementia?

Originally, it was intended for persons who were suffering from SAD (seasonal affective disorder).

According to Sleep Education, the human body has an internal clock that signals it when it is time to be awake, and when it’s time to sleep.

We find the clock in the SCN, an area of brain above the section where nerves travel to the eyes.

This clock is responsible for controlling a person’s “circadian rhythm.” The rhythms include the daily cycle of numerous hormones, alertness, and temperature.

“Circadian” implies to occur in a 24-hour cycle.

Circadian rhythm sleep disorder is common with dementia

We should mention that circadian rhythms make a person alert or sleepy at regular times daily.

It is common for persons with dementia to experience circadian rhythm sleep disorder.

Dementia refers to a group of progressive neurological symptoms and conditions that are characterized by an ongoing decline in a person’s cognitive abilities including thinking, memory, behavior, and communication.

It usually ends up affecting a person’s abilities to participate in daily living activities.

This implies that they can benefit from light therapy that can help shift sleeping patterns into what is considered normal.

Check out some of the benefits of bright light therapy for persons with dementia below.

Benefits of Bright Light Therapy

In regards to bright light therapy and dementia, experts state that light therapy can help individuals with dementia.

The therapy aims to affect brain chemicals that are linked to sleep and mood.

Most people with dementia may experience sleep issues at some point in the illness.

This is because dementia can destroy the area of the brain that is responsible for the wake-sleep cycle.

A well-conducted but small study revealed promising effects on disturbed sleep as well as restlessness for individuals with dementia.

Another study showed that bright light therapy administered in the morning can help treat sleep disorders in persons with dementia.

According to this study, this is the time the therapy entertains circadian rhythm to reduce interference with the sleep-wake cycle.

Yet another research measuring the combination of walking and bright light therapy reported significant improvements in sleeping habits when bright light therapy and walking were practiced every day.

Combination of melatonin and dementia

Some researchers also looking into bright light therapy and dementia also studied the combination of the use of melatonin with bright light therapy.

The experts observed that all the participants who had dementia experienced better sleep cycles after exposure to bright light therapy.

Interestingly, the results were not similar after combining melatonin and bright light therapy.

A larger, well-conducted research review reported that bright light therapy can help reduce sleeping during the daytime and increase night-time sleeping.

Multiple other studies also showed that bright light therapy can be used to normalize the wake-sleep pattern.

Additionally, light therapy also has the potential to treat aggressive behavior in persons with dementia.

Some studies also state that bright light therapy can help reduce depression in people who have dementia.

Note that depression is one of the most common symptoms of dementia.

Other perks that persons with dementia can get from bright light therapy include:

Reduced Wandering

Some research indicates that bright light therapy in addition to enhancing the sleep-wake cycle also helps to reduce wandering for people with dementia at night.

Enhanced Cognition

Bright light therapy has also been associated with better scores on the Mini-Mental State Exam. This is one of the most common tests for measuring cognitive abilities.

Persons with vascular dementia or Alzheimer’s disease (AD) were subjected to bright light therapy and they ended up demonstrating improved scores on their cognitive abilities tests.

This was in comparison to no changes in the scores when the same group was exposed to dim light therapy.

A similar study reported better cognitive functioning after exposure to bright light therapy. However, this was for people with early-stage AD as opposed to those with middle or late-stage Alzheimer’s.

Improved Behavioral Functioning

One study reported participants with dementia showcased improvement in various challenging behaviors.

However, another study compared levels of agitation of individuals with dementia after exposure to light therapy and stated that there was no difference.

How is Bright Light Therapy Administered?

When it comes to bright light therapy and dementia, the person with the illness sits in front of a lightbox that offers around 5-30 times more light than what the average office light emits. In most cases, the lightbox will emit about 10,000 lux of light.

This happens for a set time daily.

Keep in mind that it is important to consult a physician before starting light therapy. This is because there are a few cases where the therapy may not be appropriate.

Incorporating Light Therapy into the Routine of a Person with Dementia

There are times when it may not be easy to incorporate light therapy into the routine of a person with dementia.

Below are a few case scenarios you may be presented with, in regards to using bright light therapy and dementia and how you can solve them.

When a person becomes agitated in front of the lightbox, you may want to use verbal reassurance. If this does not work end the session and gradually introduce it until they become used to it.
Sometimes, an individual with this progressive illness does not want to sit in front of the light. In this instance, you can try focusing their attention on you. Start a pleasant conversation and hold their hands so that they can feel comfortable during the session.
When a person is easily distracted try and schedule the therapy when they are having breakfast. This will help speed up the process of becoming part of their routine.

Closing Remarks

Although some studies confirm that bright light therapy is beneficial to some people with dementia more studies focusing on bright light therapy and dementia still need to be conducted.

This will help to offer more conclusive results so that medics, caregivers, and persons with the illness can know how light therapy will benefit them.

Why Do Dementia Patients Eat So Much?

Dr. Muhammad Usman Blog, Signs February 24, 2021October 16, 2021dementia, dementia and eating, food

A comprehensive answer to the frequently asked question, Why do dementia patients eat so much, is here, written by a doctor and nutritionist.

The differences in appetite between dementia patients vary. Some eat too little, yet others overeat. Some dementia patients may consume too much food in one sitting or eat too many meals in a day.

But why does that occur?

Patients with behavioral variant frontotemporal dementia generally tend to overeat more.

Also, such patients develop a liking for food with a strong smell or taste and tend to eat the same food repeatedly (1).

For instance, very spicy, salty or sugary foods.

It’s also common to observe excessive eating and other related eating behavioral changes in dementia patients as their dietary preferences change.

Some even develop a seemingly inexplicable obsession with certain foods.

Managing Overeating and Dementia

Diagnosed dementia patients will experience a decline in their memory, problem-solving, and other thinking-related skills.

Alzheimer’s disease is the most common type of dementia and patients’ appetites usually change as a result of this.

What Causes A Dementia Patient To Eat More? – Four Possible Factors

Globally the dementia statistics continue to rise. A predicted 75 million people are expected to be diagnosed with the disease by 2030.

One in three elderly people dies from Alzheimer’s or another form of dementia in the US alone.

Dementia affects each aspect of living and poses hurdles that are rather unusual and challenging. Research indicates three of the main reasons dementia patients eat so much include:

1: Diminishing Taste Buds

As people age, their taste buds diminish. As their disease worsens and their taste buds weaken, the insulin levels in their brains can decrease.

Some dementia patients, therefore, experience intense cravings for foods containing high calories. They may prefer heavy or flavor-filled foods such as sugary sweets.

2: Changing Appetite

Also, dementia patients’ appetites change which results in craving unhealthy foods. If a patient overeats, they may eat inappropriate foods. They may even try to consume things that aren’t food, such as a napkin or bar of soap.

This is because they might not recognize the item or understand its use, and therefore they confuse it for food.

3: Forgetting Recent Meals

Due to their declining memory, dementia patients may forget that they’ve recently eaten.

They may frequently ask or search for food. Also, they may be concerned about when their next meal will be. This leads them to eat more.

4: Changes in Mood Might Affect Food and Eating Preferences

It is not uncommon for people with dementia to suffer from co-existing mental health issues, such as depression and anxiety.

One way they find comfort is by eating more or indulging in foods that give them a sense of comfort, which are often sweet and over-indulging (2).

How to Help a Dementia Patient Eat Less?

It can become problematic if a dementia patient eats too much.

It’s important to ensure they’re consuming nutritious food to stay healthy and avoid becoming overweight.

Some patients may refuse help when eating, and they also might not be able to adequately express this.

It’s better not to pressurize a dementia patient to eat or drink when they’re anxious.

Some ways to cater to changing eating habits in dementia patients are as follows:

1. Accept unusual food combinations: Strange mixing of food isn’t likely to cause patient harm, especially if the food is healthy and in appropriate portions. It’s better to acknowledge rather than challenge this.

2. Satisfy sweet cravings for healthier alternatives: If a patient likes sweet foods, try incorporating fruit or naturally sweet vegetables such as carrots or sweet potato into their meals.

How to monitor what patients with dementia eat?

Solutions to monitoring what a dementia patient eats include:

Cutting food into bite-sized pieces: This assists the patient and makes eating easier, especially if they aren’t able to use utensils by themselves.
Eating in company: By enjoying a meal together with a loved one, a patient is more likely to eat the healthy meal you’ve served them.
Fortifying the prefrontal cortex: This controls a patient’s dietary self-restraint. Help by ensuring they avoid alcoholic beverages, sleep sufficiently, and exercise if they’re able to.
Including plenty of protein: As far as possible, incorporate eggs, milk-based pudding, or protein powder in the patient’s meal.
Puréeing their vegetables: Patients are more likely to consume softer vegetables.

If a dementia patient is overeating and you’d like to help them to eat less, try the following approaches:

Generously serve salad and vegetables: Carbohydrates and starch should take up less than half of a plate.
Halve the original portion: Start by halving the patient’s original portion. Only offer them the second half should the patient request more food.
Keep them occupied: A patient will feel less bored or lonely if they have something to do and keep busy.
Offer healthy snacks: Make bite-sized cut pieces of fruit or other healthy nibbles easily accessible.
Replace a second helping with a drink: Rather than offering the patient more food, give them a “treat” drink such as hot chocolate or a milkshake.

Guidance for Good Nutrition

To ensure a dementia patient is eating correctly, a balanced diet including various foods is key.

Meals should contain fruit, lean protein foods, low-fat dairy products, vegetables, and whole grains.

It is recommended to serve small portions of high saturated fat and cholesterol in a meal.

While some fats are healthy, it’s best to use butter, fatty meat cutes, lard, and solid shortening sparingly.

Also, high-sodium foods should be restricted. Replace salt with herbs or spices instead to flavor meals.

To reduce refined sugars, avoid serving processed foods. Baked goods made with fruit or sweetened with fruit juice are better alternatives.

Honey is also an optional sweetener.

Conclusion

Although some dementia patients tend to overeat, it is possible to better monitor what they consume and how often they do so.

If a patient has a particularly strong preference for foods that aren’t healthy which leads to insufficient consumption of other food groups, it is advised to consult with a dietitian.

Professional assistance with an eating plan will ensure good health with nutritious food and avoid excess weight gain.

References:
1. Kyoko Kai, et al. Relationship between Eating Disturbance and Dementia Severity in Patients with Alzheimer’s Disease. PLoS One. 2015; 10(8): e0133666.
2. Chia-Chi Chang, et al. Prevalence and factors associated with food intake difficulties among residents with dementia. PLoS One. 2017; 12(2): e0171770.

Viewing Nature Improves Dementia [Proven]

Laura Herman Blog, Prevention February 23, 2021October 16, 2021alternative treatment, dementia, natural therapy, nature

Now, to be clear, viewing nature will not cure dementia. There are still no cures for most causes of dementia. But is there evidence that viewing nature improves dementia?

But what improves dementia’s symptoms improves dementia.

Science has proven time and again that viewing images of nature improves many factors that worsen dementia’s distressing symptoms.

Factors like pain, anxiety, depression and stress all impact dementia profoundly.

The Importance of Getting Outside, Nature & Dementia

These types of excess disabilities make it harder for people with dementia to function at their best. They can increase confusion, agitation, restlessness and impact sleep.

Unfortunately, when any one of these things falls out of balance it will often disrupt the others as well.

For example, if someone feels anxious it can impact their sleep.

When sleep is disturbed, fatigue increases.
As fatigue increases, the ability to think, function and process information decreases.
This can easily lead to an increase in anxiety, agitated behavior and/or restlessness.
Restlessness can contribute to falls, injuries and pain.
Pain can lead to more restlessness, sleep disturbance, medication, anxiety and greater fall risk.
Medication can lead to constipation which can lead to increased restlessness, sleep disturbance, agitation, anxiety and appetite loss.
Appetite loss can lead to weight loss, weakness, decreased functioning and falls.

Symptoms can quickly spiral out of control and it can be hard to untangle the causes from the effects.

To the extent possible, a key goal in dementia care is to reduce “causes” and minimize effects.

So, when science shows us that viewing plants and scenes of nature can alleviate pain, anxiety, depression and stress we can see how this will effectively improve the symptoms of dementia – although more accurately we’re reducing excess disabilities that worsen dementia’s symptoms thereby allowing the person to function closer to their true baseline capability.

Hospitals are great places to study pain, stress and anxiety

Hospital patients, with their detailed records and controlled experience, are great fodder for study.

Hospital stays and procedures are known to be stressful, and contribute to anxiety. This makes them a great way to study the effects of plants on health outcomes, and there is no shortage of such studies.

View Through a Window May Influence Recovery from Surgery

One of the most cited studies occurred in1984 when Roger Ulrich examined whether the view through the window made a difference to the recovery of post-surgical patients.

Some rooms in the hospital overlooked a grove of trees, while others overlooked a brick wall. The rooms were nearly identical other than the view.

Patients went through the same gallbladder surgery and were matched on multiple factors, including age, gender, and health status.

The findings showed a statistically significant difference in:

1. The frequency and strength of pain medication required

The tree-view group required significantly less, and less potent, pain medication than the control group.

2. Length of hospital stay

The tree-view group was able to leave the hospital an average of a full day earlier than the brick wall-view group.

3. Fewer “negative” experiences

Nurse notes were reviewed for all patients. The group with the brick wall-view had over 3 times as many negative notes (such as “upset and crying” or “needs much encouragement” than the tree-view group who had more positive notes (like “In good spirits” and “moving well”).

Since 1984, thousands of studies have built on and expanded Dr. Ulrich’s research into an enormous body of research.

Although it wouldn’t be possible to cover them all here, we can take a closer look at a sampling of key studies.

Measuring the Benefits of Indoor Plants and Flowers

Live plants enhance health outcomes of patients recovering from surgery

In 2009, this study showed that post-surgical patients in hospital rooms with plants and flowers had a significantly improved physiological recovery response and felt better about their rooms and the hospital staff caring for them.

90 patients recovering from the same hemorrhoid surgery were randomly assigned to similar rooms either with or without live plants.

Researchers measured patients’ vital signs, length of hospital stay, pain medication used, ratings of pain intensity, distress, anxiety and fatigue.

They found that patients in rooms with live plants showed significantly lower systolic blood pressure, and less pain, stress, anxiety and fatigue than the control group.

They also rated their room satisfaction higher and reported more positive impressions of the hospital care staff.

Live plants enhance recovery and mood; reduce pain, anxiety and fatigue

This study in 2016 shows multiple benefits of live plants to post-surgical patients’ mood and recovery.

Patients in rooms with plants reported less pain, anxiety and fatigue than those in the control group.

They also were noted to have increased mood, social activity, friendly behavior towards others, and positive feelings in general.

They described their rooms to be more calming, soothing and satisfying than the control group.

There are hundreds of more studies showing similar effects of plants and flowers on health, stress, anxiety, pain and mood.

A number of studies examine the effect of simply viewing fresh-cut flowers or live plants in a room.

Viewing fresh flowers invokes relaxation and improves mood

Researchers in 2014 confirmed physiological and psychological relaxing effects of cut fresh roses in a room.

This study from 2016 also confirmed that the presence of flowers can positively influence mood as well as perceptions of places and other people.

In another study in 2017 researchers measured a significant relaxation response after participants viewed fresh roses for three minutes. The control group viewed no stimulus.

The physiological and psychological relaxation response was determined by measuring participants’ oxyhemoglobin levels, heart rate and heart rate variability.

A mood profile and semantic differential were also used, which showed a significant elevation in mood and an increase in feeling ‘natural’, ‘comfortable’ and ‘relaxed ’.

And, in case you had any doubt: receiving flowers is actually scientifically proven to enhance mood! It also enhances both social behavior and memory.

Receiving flowers improves mood, social behavior and memory

A series of studies in 2005, showed that people benefit in multiple ways from receiving flowers. People were presented with either flowers or a non-flower gift such as pens, candles or fruit.

The control gifts all had the same economic value, a pleasant odor, similar color variation and were wrapped similarly for presentation.

The results showed that that both women and men, young and old, showed improved mood, positive social behaviors and episodic memory after receiving flowers.

The social behaviors that were measured included initiation of conversations, eye contact, and standing at a more familiar social proximity. Non-flower gifts elicited less or no improvement in these areas.

These improvements were measured both immediately and weeks later, demonstrating a lasting effect on mood, social behavior and memory.

Live plants induce relaxation

In 2016, researchers studied men performing the same task – transferring pots for three minutes – with and without plants present. When live plants were present, the participants relaxed.

This was determined by significant differences in key physiological and psychological measurements, such as prefrontal cortex activity, heart rate variability and mood profile.

Images of Nature on Screens are also Effective

Viewing nature imagery on a screens induces relaxation and positive emotional response

In 2007, researchers found that individuals felt significantly less stressed, more friendly, playful and elated, and less fearful after viewing slide images of nature rather than urban scenes.

In 2018, researchers found significant evidence that viewing forest imagery induces physiological and psychological relaxation. Participants viewed images of either a forest landscape or a cityscape on a high definition television set.

After viewing forest imagery, participants’ oxyhemoglobin levels were decreased and they reported feeling much more “comfortable”, “relaxed” and “natural”.

Awe-inspiring images of nature can be especially potent

In 2014, researchers investigated whether there was any effect, or difference in effect, on people viewing mundane pictures of nature versus awe-inspiring scenes.

Images were shown on a computer screen and were grouped into three categories: awesome nature (such as grand mountain scenes or powerful storms), mundane nature (like grass, foliage or trees) and a control group (featuring objects like buckets, ladders or chairs).

Both types of nature images invoked significantly more feelings of being connected to others, feeling more caring and more spiritual than the control condition.

Both groups of nature images invoked an improved mood, more marked in the awesome images. The awesome images also lead to participants making more prosocial choices.

Photographs and Paintings of Nature can Reduce Stress and Improve Attention

Exposure to natural landscape art reduces anger and stress in males

A study in 2008 showed a significant reduction in anger and stress in males (but not females) when nature landscape art posters were displayed versus abstract art posters.

Participants were asked to perform frustrating tasks on a computer and then report their anger and stress levels.

In the natural landscape settings, the males in the experiment reported less stress and anger – the more natural landscapes were present, the less stress and anger was reported.

Viewing plants, or pictures of plants, reduces stress

In 2012, researchers found that people who viewed real plants and those who viewed images of plants experienced a reduction in stress as compared to the control group, which viewed none.

Viewing pictures of nature improves attention

In 2013, this study showed that viewing pictures of nature significantly improved executive attention in both older and younger adults, as opposed to pictures of urban scenes.

Viewing photos of natural scenery reduces impulsivity

In 2014, researchers concluded that exposure to photographs depicting natural scenery decreased impulsive decision making as compared to viewing photos of a cityscape.

Other Interesting Studies

Virtual reality nature experiences offer relaxation and stress relief

In 2019, researchers studied the effects of seven different simulated forest environments on stress relief and relaxation.

All the virtual reality environments proved to offer relaxing and stress-relieving effects.

The environment which included a prominent water feature was noted to be an especially powerful stress reliever.

Ceilings with sky images may support healthier dreaming and circadian rhythm

This 2014 study examined which differences in brain activity as measured by magnetic resonance imaging would be noted in hospital rooms with traditional ceilings and identical rooms which had sky images painted on the ceilings.

The rooms with sky compositions activated regions of the brain associated with spatial cognition, circadian rhythm, perceived motion and dreaming.

The plain-ceiling rooms activated regions related to facial processing and potential visual hallucinations.

Nature and Daylight Improves Mood and Reduces Stress

This 2018 study established positive effects of exposure to nature and daylight throughout everyday life on one’s mood and level of stress.

Viewing natural scenery promotes relaxation and enhances mood

In 2015, this study added to the body of evidence that seeing a natural forest landscape in person produced physiological and psychological relaxation and enhanced mood as compared to viewing an urban landscape.

Looking at a garden relieves stress and improves verbalization and memory in dementia

In 2018, researchers found that simply seeing a garden relieved physiological stress and improved verbalization and memory in people with advanced dementia.

The Conclusions are Clear: Viewing Images of Nature Improves Dementia

Study after study has added to the body of evidence: seeing plants or images of nature offers substantial benefits to people with dementia.

Whether it’s a photograph, a television program, a view through a window or seeing it live and in person, viewing nature is an effective way to enhance the quality of life for people with dementia.

It can reduce pain, anxiety and stress, promote relaxation, improve mood and enhance mental functioning in many ways.

Adding live plants or images of nature into the environment for someone with dementia is an effective, and low-cost way to help them function at their best.

Dementia And Spicy Foods: Are They Related?

Dr. Muhammad Usman Blog, Signs February 23, 2021October 16, 2021dementia, dementia and eating, food, spicy foods

With the progression of dementia, taste buds weaken, making patients develop strange food cravings, even for extremely spicy foods. But is dementia and spicy foods linked increasing dementia risk?

Are Dementia And Spicy Foods Linked?

The prevalence of dementia is on the rise and numbers are expected to double every 20 years.

It appears when your brain suffers from neurological problems leading to loss of memory and poor judgment.

The decline in memory deteriorates the quality of life in the elderly and, in the long term, reduces cognitive function.

The effects of dementia, and problems happening concurrently with it, are extensive. Moreover, they do not affect the brain only.

Scientists have observed significant alterations in dietary behaviors of people suffering from dementia.

These range from the changes in appetite to unusual food cravings.

How Does Dementia Affect Eating Habits?

Dementia leads to various metabolic and psychological changes in the body. These, coupled with the weakened taste buds, change dietary preferences.

During a research study conducted by the Medical research council, the caregivers of dementia sufferers pointed out a preference for foods that are strong and savory in flavor.

Some of the eating patterns in people with dementia are:

Over-eating
Binge-eating
Decreased appetite
Changes in food choices
Pica (craving for inappropriate foods)
Pica (craving for non-food items e.g. mud)
High consumption of sugary and spicy foods

Do People With Dementia Crave Spicy Foods?

The unusual food cravings vary from person to person. Some people crave sweet foods while others incline towards spicy or salty foods.

The reason why the elderly with dementia crave spicy foods are as follows:

1. Dementia Weakens The Taste Buds

The craving is due to the disappearance of taste buds with the progression of the disease.

Humans can identify salty, sweet, sour, bitter, and umami taste.

However, dementia sufferers lose this ability with time. Dementia makes them unable to identify a particular taste as well as differentiate between two different flavors.

This is due to the loss of nerve endings in the tongue.

Since dementia appears with morbid brain conditions, it diminishes the neurological sense responsible for taste.

The elderly cannot feel the tanginess of food so, they ask for a stronger flavor. The same is true for salty foods.

2. Capsaicin Releases Endorphins

Ever wonder why spicy food burns tongue? It is due to the active ingredient present in chili, called capsaicin.

Capsaicin instigates pain receptors in the mouth and tongue, causing a burning sensation.

Due to the activation of these receptors, the brain translates it as a painful experience and floods the body with endorphins.

These are responsible for elevating mood and reducing the painful sensation.

Additionally, dopamine is released which is involved in the reward system of the brain. The result is a euphoric state called “runner’s high”.

Since such neurotransmitters are low in quantity in dementia patients, the body creates a compensatory mechanism.

It generates cravings for foods that cause endorphins to rush.

Is There Any Cultural Relation To Cravings of Spicy Foods?

Food choices vary immensely throughout the world.

This is also true for the condiments used to prepare local cuisine.

Predictably, the taste buds of natives of each region are adapted to the flavors of their local food seasonings.

Asians consume far more chili and spicy herbs in their meals as compared to westerns.

Therefore, experts think dementia sufferers from the Asian region are more likely to indulge in binge-eating spicy foods.

In such regions, the population develops a habit of using strong spices.

So, they misunderstand their lack of sense of taste in dementia as a bland and flavorless meal.

This results in an excessive intake of chili among the old age population.

Although it is more prominent in areas where spicy cuisine is widespread, westerns are also prone to such cravings.

Their chili usage is minimal but hot sauces and other herbs are still popular in Caucasians and western ethnicities. The proportion may be far lesser but they often enjoy pickles and jalapenos.

A study done in the UK showed that 15% of participants reported a likeness for spicy foods frequently after the onset of dementia.

Do Spicy Foods Increase The Incidence Of Dementia?

High spicy food intake may not be as harmful as excessive use of sweets, but it has a deeper relationship with the cause.

Scientists think that chili consumption is linked with an increased risk of dementia.

In Asia, chili is the most frequently used spice. In some regions of China, one in every three adults consumes chili daily.

It has many beneficial impacts on obesity and hypertension due to the presence of capsaicin in it. But there is more to the story.

Considering these properties, capsaicin should reduce the oxidative burden of the brain and enhance cognitive function but evidence proves the opposite.

People who consume more than 50g of chili per day experience a reduction in cognitive function.

The findings also suggested:

Twice the risk of self-reported poor memory
56% increase in the incidence of memory decline
The low global cognitive score for cognitive function
A decline in memory co-efficient with each 10g increase in chili intake
Both males and females are equally vulnerable
Less marked in overweight individuals
Those with normal or low BMI are more prone to dementia due to chili

Apart from these, spicy foods can upset the stomach and lead to long-term gastrointestinal problems.

Considering these findings, it is essential to cut back spicy food consumption in seniors in order to slow the progression of dementia.

How to Manage Spicy Food Cravings in Dementia?

1. Salty foods can replace spicy foods but they should be used with care as they increase the risk of hypertension in the elderly.

2. The senses of smell and taste are intertwined. So, preparing food with seasoning that can create a delicious aroma helps in managing cravings of spicy food without actually having a spicy meal.

3. Spices, other than chili, and herbs should be incorporated to increase the flavor of the meal.

4. Some naturally occurring spicy foods like jalapenos and pickles used as a seasoning.

Conclusion

The sense of taste diminishes and endorphin production reduces with the progression of dementia.

To overcome these troubles, the elderly often crave spicy foods. They can cause an upset stomach and even worsen dementia with time.

The decline in memory function due to chili is higher in the underweight population. To reduce this possibility, chili should be replaced with better spices and herbs.

Salty meals can be used in a controlled amount but some naturally occurring spicy products like jalapenos and pickles are better substitutes.