dementia - ReaDementia

12 Benefits of Occupational Therapy and Dementia

By understanding the close connection between occupational therapy and dementia, you know the support a patient gets from a professional is crucial.

Dementia is a condition that develops as a result of brain damage causing impaired cognition.

To date, there is still no cure for the progressive illness. People with dementia, however, may be put under other treatments that can help deal with the symptoms of the disease.

These allow one to be as comfortable and independent as possible even when battling dementia.

One of the helpful treatment options that a person with dementia can try is occupational therapy (OT).

Benefits of Occupational Therapy for Dementia

We can describe this as a client-centered health profession discipline that deals with promoting wellbeing and health through occupation.

Occupational therapy experts approach the illness as a condition that interrupts occupational performance.

They evaluate persons who have the illness to determine their level of impairments and strength as well as the performance areas where they need help. This has proved to be helpful in several areas.

Let’s take a look at some of the benefits that people with dementia get from occupational therapy.

1. Improving Safety

Studies show that occupational therapy can help increase the safety of people who have dementia. This is one of the reasons it is important to talk about occupational therapy and dementia.

A huge percentage of people with the illness are at high risk of falling that can result in quicker decline, hospitalization, not being able to care for themselves, or having to move out of the house, etc.

Working with a qualified therapist can help to prevent this.

The professionals assess home safety and the environment where the individual with dementia spends the most time in.

This allows them to make practical recommendations about the changes that need to happen to keep the person safe.

OT therapists can also recommend the equipment that a person needs to use daily to reduce injury incidents.

The therapists can also go a step further to offer guidance on how to make day to day activities more manageable.

These may include the installation of shower bars, removal of carpets, or use of wheelchairs where necessary.

2. Offering Support and Education to Caregivers

In as much as OT experts work with people who have dementia directly, they also offer assistance to caregivers.

They do this in several ways.

One of them is by setting up routines that make the work of looking after your loved ones a little bit easier.

Effective routines are essential.

They can make sure that the individual who has dementia is eating and drinking right, taking their medication at appropriate times, and has decreasing problem behaviors.

An OT can offer guidance in areas like:

Reducing distractions
Availing instructions that are easy to comprehend
The use of visual cues
Breaking down tasks to make them simpler

The therapists play a crucial role in relieving the burden on caregivers because their job primarily involves promoting independence.

Working with the OT experts also means that caregivers are not alone.

The collaboration between the professionals and relatives of friends enables the person who has dementia to continue participating and enjoying life.

3. Promoting Social Relationships

Many people who have dementia tend to exhibit some behaviors that can put a strain on their relationships.

This is where you will find they become socially withdrawn or other people do not want to spend time with them. This can lead to loneliness which is not good for any person.

An OT professional will study the behavioral problems that are affecting social interactions and close relations.

The expert will help the individuals with the illness and their caregivers identify the trigger in a bid to offer possible solutions.

This can help deal with communication problems, frequent outbursts, and how to positively respond to underlying emotions.

Here the person who has the condition may benefit from opportunities to engage in fulfilling tasks.

It can be something as simple as fun puzzles, folding laundry or sorting objects.

4. Enhancing Recollection of Memories

Communication skills are one of the key areas that occupational therapists handle when it comes to occupational therapy and dementia.

In line with this, the professionals can also guide an individual in showing them how to use reminiscence.

It is a move that can help one remember valuable memories that can either bring joy or tears.

By remembering things in the past, the person can feel more secure, confident, and at peace.

5. Access To Other Helpful Services

There are times when an OT therapist will not have all the answers. This does not mean that they will leave the person they are looking after in a limb.

The therapists usually offer services under a larger group of health and social care teams.

It implies that they can connect a person with dementia to the right professionals who will offer the services they need. It is important to note that people can talk to therapists about any aspect of their health.

Based on this, they will be able to direct an individual to the networks and organizations that will offer help.

6. Helps to Enhance Cognitive Function

Occupational therapists can work with people who have dementia to help them improve or maintain cognitive function. Cognitive function refers to several mental abilities.

These may include decision making, learning, attention, remembering, reasoning, thinking, and problem-solving.

One of the ways that professionals can offer assistance is by taking persons with dementia through activities that stimulate cognitive skills.

This is especially useful during the first stages of the illness because it can help to delay progression and prolong independence.

7. Improve Balance and Strength

The experts can also help with the restoration of physical skills which can include a range of motion, endurance, and strength.

This is where exercise comes into play when discussing occupational therapy and dementia.

OT professionals can pick the right type of exercises that a person with dementia can comfortably engage in depending on their ability.

This may result in improving the person’s strength and balance so that they can enjoy life more.

8. Assist In Maintaining a Healthy Lifestyle

Occupational therapists go beyond assisting persons who have dementia stay active. They also offer a hand in regards to maintain a daily lifestyle.

This is where the professionals help the persons to perform various functional activities that are vital to their lifestyles.

These include things that give the person under their care purpose in life or enjoyment.

The therapists play a huge role in ensuring that persons with dementia function to the best of their abilities.

This is whether they are out playing golf, gardening, playing with grandchildren, group activities, or performing tasks in the office.

9. Assist with De-stressing

OT also comes in to enhance the emotional well-being of a person who is suffering from the disease.

Many people who have dementia will become depressed because their functionality becomes limited in one way or another.

The professionals do their best to offer positive emotional support.

They will identify the things that make the person with dementia happy and the tasks they can complete without too many complications.

This can help an individual focus on the things that they can do.

Additionally, the experts can incorporate relaxation techniques and exercises in a person’s daily routine.

This has been known to reduce stress or anxiety as the seniors are able to regain some sense of independence and self-esteem something great for their mental health.

10. Help with Major Life Transitions

The topic of occupational therapy and dementia is quite vast and important for people who have the illness as well as their caregivers.

As aforementioned, dementia is a progressive disease. This means that as months or years go by, people with the illness may have to make some drastic changes in their lives.

These may including having to retire from work or even move from their home into an appropriate senior residence.

Naturally, most people will not have an easy time dealing with these changes.

Occupational therapists have the skill-set required to guide persons through these life transitions to make them as smooth as possible.

11. Helps to Keep other Diseases at Bay

When a person with dementia is going through occupational therapy, they lower the risk of getting other diseases.

For instance, the experts can offer advice on relevant modifications that need to happen around the workplace or at home.

These can help the elderly tackle illness like arthritis so that they can continue to perform tasks normally for the longest possible time.

If a person already has arthritis, the therapist can help them use their hands differently to reduce pain. The professionals can also guide on the best resting positions to increase comfort.

12. Assist with Vision Loss

It is also important to talk about vision loss when talking about occupational therapy and dementia.

If a person who has dementia is also suffering from vision loss issues like glaucoma, occupational therapists can work with them to promote visual awareness.

This is through helpful activities that help in reinforcing perceptual skills. The professionals may also suggest some changes at home that can help with the situation.

These may include more contrast and lighting, color-coded ID tags, and the use of equipment like magnifiers. Therapists can also suggest the removal of items that can post as tripping hazards.

10+ Best Incontinence Products for Dementia Patients

Laura Herman Blog, Prevention, Resources March 6, 2021September 5, 2023dementia, incontinence, incontinence products

There are numerous incontinence products for dementia patients, and each has dozens of variations.

Different combinations of products may be right for different individuals, and a person’s needs may evolve over time.

Incontinence Products for Dementia

	Product	Features
	Prevail Air plus Daily Brief	Soft & breathable Ultimate absorbency Pack of 4 (18 count) Night & day Skin smart Omni-odor guard
	Wellness Superio Series BriefsBrand: Unique Wellness	Fully Absorb up to 2.6L Wide absorbent core Resealable landing zone for easy adjustment White with a nylon based crinkle-free plastic Value for money Stays dry for 8+ hours Award winner/ Featured on Discovery Channel
	One Piece Waterproof Snap-on Diaper Cover BriefBrand: Salk	Lightweight Softness of cloth 100% waterproof Polyester/urethane outer Brushed polyester inner Super-absorbent pad 3-ply inner layer Waterproof outer layer Washable
	SOSecure Containment Swim BriefBrand: Discovery Trekking Outfitters	Discreet Swimming Undergarment Durable Polyurethane Fabric Fleece Lining Hook and Loop Closure (Easy) Elastic Waist & Legs Machine Washable Latex Free
	Prevail Overnight Bladder Control PadsBrand: First Quality	For Women Dri-Fit cotton enhanced QUICK WICK Layer and cotton Odor Guard
	Depend Men GuardsBrand: Kimberly Clark	Adhesive strips to hold guard in place Individually wrapped Discreet- pocket-sized pouch Easy carrying and disposal Contoured design Cup-shaped protection for men One size fits most
	Medline Incontinence Bed Pads	Underpads 50 count 36"X36" Heavy absorbancy Polypropylene backing (protects against leakage & resists melting) Ideal for overnight use
	Inspire Washable and Reusable Incontinence Chair or Bed Pads	Washable/reusable Solves incontinence problems Safely absorbs & lock in liquids Soft & comfortable Non-irritating
	Bariatric 2X-Large UnderwearBrand: Attends	Improved side panels (better comfort & fit) Acquisition layer Super absorbent polymer Tear-away sides (easy removal) Looks & feels like regular underwear Bag of 12
	Depend Mens Maximum Absorbency UnderwearBrand: Kimberly Clark	Outstanding protection Improved underwear-like fit Brief-like leg opening Heavy incontinence Soft, quiet, breathable material Conforms to the body
	AIRCUTE Washable Absorbent Urine Incontinence Underwear for Women	6 layers High waist Absorbent & leakproof Washable Breathable Comfortable
	Prevail Adult WashclothBrand: First Quality	Super strong & soft fabric (12" x 8") Stay-open & easy-close lid Press 'N' Pull lid Super strong soft fabric Aloe & lanolin Lid closes tightly

Don’t call them diapers

Many people refer to incontinent products for dementia as “diapers,” but the term has a strong connotation with infants.

It is generally considered to be disrespectful, infantilizing and tactless.

It should not typically be used when referring to adult absorbent undergarments (unless the person themselves prefers that term).

Words like “pads” or “briefs” would be an appropriate way to refer to these products.

Products designed to be worn inside, or instead, of underpants

Pantiliners – a very thin pad that adheres to underpants for small leaks
Disposable pads – adhere to underpants, but are thicker and more absorbent than pantiliners
Pull up briefs / disposable underpants
Washable pads, liners or absorbent underpants
Reusable vinyl waterproof underpants covers
Wraparound tab briefs – similar to a traditional “diaper” design
Extended wear – Products designed for extended use keep urine away from the skin
Brief liners – designed specifically for use in a brief to boost absorbance or easily remove if damp
Insert – for use with special underpants designed with a pocket to hold a disposable or washable pad insert
Condom catheter or body-worn urinal – Designed to fit over a penis and collect urine in a bag

Products to protect furniture from wetness

Waterproof bed sheets
Washable bed pads
Disposable bed pads
Waterproof mattress pads

Other supportive equipment

Raised toilet seat with handles – this can make it easier to get on or off the toilet
Portable bedside commode
Urinal

When the Person with Dementia won’t Keep a Brief On

If someone with dementia keeps removing their brief, pay attention for clues to determine a likely reason.

Is the problem specific to briefs or are they pulling at other clothing too? Does it happen mainly at night or after bathing? Understanding the reason behind it is essential for finding a solution.

Common reasons for removing clothing or briefs can include:

Feeling too warm
Ill-fitting brief or pants
Wet, damp or soiled brief

Is the person new to wearing briefs (or wearing a new type or brand)?

Briefs can be bulky or uncomfortable, especially when they feel unfamiliar.

Start with the smallest, thinnest or most comfortable product that will meet their needs. This might mean changing them more frequently.

Be sure to minimize incontinence with a toileting plan.

Try a different style

It is worth experimenting with various brands and styles to find something more comfortable or successful.

Look for patterns

1. Do they remove the brief mainly at night? Try going without the brief if possible, using several bed pads for absorbance instead. It may help to tuck an additional bed pad up between the person’s legs.

2. Does it happen mainly when the brief is damp? It may help to use a brief liner, or alternate style of brief that pulls wetness away from the skin. Allow skin to dry fully after a shower or wash-up to ensure there is no lingering feeling of dampness.

3. Are they removing the brief when they need the restroom? It may be a non-verbal sign that the person needs to use the restroom.

4. Do they seem to have bored or restless hands? Giving them something interesting for their hands, such as super soft fuzzy gloves, or a dementia fidget lap blanket with lots of interesting textures and items for their hands to explore.

Is this a sudden change?

A sudden change probably indicates a problem other than the brief itself.

Look for signs that the person might be uncomfortable, especially in the abdomen or perineal area.

Possible conditions that could cause discomfort include:

Urinary tract infection
Constipation
Hemorrhoids
Dehydration
Rash
Pressure ulcer or skin breakdown

Special clothing for special situations

Although there are specialty clothing designed to prevent people from removing their own clothing – such as a jumpsuit with a zipper in the back – there are ethical concerns about restricting normal access to one’s body. They can cause distress in some cases.

In many places, these types of clothing are considered restraints.

What if the Person with Dementia won’t Change their Brief when Needed?

There are many potential complications of wearing a soiled brief too long. It greatly increases one’s risk of urinary tract infections, rashes, skin breakdown, and pressure sores.

Unfortunately, it’s an all-too-frequent problem in dementia care.

There are dozens, if not hundreds, of unique reasons – and as many potential solutions. A few examples include:

Set them up for independence

Keep pads and supplies easily within sight and reach from the toilet.

Catch them when they’re in the restroom

Getting them onto the toilet in the first place is often the biggest challenge. Once they’re there, it can be much easier to access the brief to change it.

Avoid “taking” anything without giving something in return

Hand them a clean pad to hold while you swap out the soiled one for another.

Spare their pride

Present non-rinse soap, wetness barrier cream, or other appropriate skincare products as a medical treatment, for example, to “prevent infection” or to “protect your skin.”

Not only are these statements true, they also take the focus off of their incontinence, which can spare their pride – and their need to fight for it.

Incontinence can be Embarrassing, Inconvenient and Challenging

Successfully managing it can make a big difference in terms of quality of life, physical health and mental well-

At What Stage of Dementia Does Incontinence Occur?

Laura Herman Blog, Signs March 6, 2021August 13, 2023dementia, incontinence

It is essential to understand at what stage of dementia does incontinence occur to prepare accordingly (in advance).

Up to 70% of people with dementia develop incontinence (urinating or defecating involuntarily).

What Stage of Dementia is Incontinence?

It’s especially common in later stages of dementia due to an assortment of reasons.

Some are directly related to dementia, while others aren’t. Physical changes that occur with other conditions or with the aging process also can contribute.

Why do People with Dementia Become Incontinent?

People with dementia may become incontinent for a variety of reasons – and often, for several at once.

Stress Incontinence

Many older women experience “stress incontinence.”

When the weakened bladder muscles are “stressed” by a sneeze or a laugh, they may leak small amounts of urine.

Urge Incontinence

Urge incontinence is a common condition among elders, characterized by a sudden and intense need to urinate, followed by the loss of a large amount of urine.

Functional Incontinence

Mobility challenges can make it hard to get to the toilet on time.

Difficulty Managing Clothing

Unzipping or unbuttoning pants can become a challenge due to various reasons, including arthritis or cognitive changes.

Communication Deficits

People with dementia may be unable to communicate the need to use the restroom.

Cognitive Changes

A person may forget how to complete the sequence of events needed to successfully remove clothing and use the toilet.

The brain may become less able to recognize the signal from the body that it needs the bathroom.

Difficulty finding the bathroom, recognizing the toilet, or comprehending how to use it can present a major barrier.

Incontinence Products

	Product	Features
	Prevail Air plus Daily Brief	Soft & breathable Ultimate absorbency Pack of 4 (18 count) Night & day Skin smart Omni-odor guard
	Wellness Superio Series BriefsBrand: Unique Wellness	Fully Absorb up to 2.6L Wide absorbent core Resealable landing zone for easy adjustment White with a nylon based crinkle-free plastic Value for money Stays dry for 8+ hours Award winner/ Featured on Discovery Channel
	One Piece Waterproof Snap-on Diaper Cover BriefBrand: Salk	Lightweight Softness of cloth 100% waterproof Polyester/urethane outer Brushed polyester inner Super-absorbent pad 3-ply inner layer Waterproof outer layer Washable
	SOSecure Containment Swim BriefBrand: Discovery Trekking Outfitters	Discreet Swimming Undergarment Durable Polyurethane Fabric Fleece Lining Hook and Loop Closure (Easy) Elastic Waist & Legs Machine Washable Latex Free
	Prevail Overnight Bladder Control PadsBrand: First Quality	For Women Dri-Fit cotton enhanced QUICK WICK Layer and cotton Odor Guard
	Depend Men GuardsBrand: Kimberly Clark	Adhesive strips to hold guard in place Individually wrapped Discreet- pocket-sized pouch Easy carrying and disposal Contoured design Cup-shaped protection for men One size fits most
	Medline Incontinence Bed Pads	Underpads 50 count 36"X36" Heavy absorbancy Polypropylene backing (protects against leakage & resists melting) Ideal for overnight use
	Inspire Washable and Reusable Incontinence Chair or Bed Pads	Washable/reusable Solves incontinence problems Safely absorbs & lock in liquids Soft & comfortable Non-irritating
	Bariatric 2X-Large UnderwearBrand: Attends	Improved side panels (better comfort & fit) Acquisition layer Super absorbent polymer Tear-away sides (easy removal) Looks & feels like regular underwear Bag of 12
	Depend Mens Maximum Absorbency UnderwearBrand: Kimberly Clark	Outstanding protection Improved underwear-like fit Brief-like leg opening Heavy incontinence Soft, quiet, breathable material Conforms to the body
	AIRCUTE Washable Absorbent Urine Incontinence Underwear for Women	6 layers High waist Absorbent & leakproof Washable Breathable Comfortable
	Prevail Adult WashclothBrand: First Quality	Super strong & soft fabric (12" x 8") Stay-open & easy-close lid Press 'N' Pull lid Super strong soft fabric Aloe & lanolin Lid closes tightly

How to Minimize Urinary Incontinence

There are many ways to minimize urinary incontinence. The solution for each individual will depend on the cause, or causes, in their unique case.

A multi-pronged approach, tailor-fit to their situation, will likely be most effective.

Locate the Toilet

Placing signs, or a trail of masking tape on the floor, to help the person find the toilet may help.

Sometimes pictures are easier for the person to understand than written words.

Keep the light on in the bathroom, or place a portable commode, or urinal, at the bedside to help someone who has trouble finding the bathroom during the night.

Replace Troublesome Clothing

Elastic waistbands can make toileting easier for those who have difficulty managing buttons or zippers.

Watch for Non-Verbal Clues

Pay attention to the person’s non-verbal communication. Even if they can’t always articulate that they need the bathroom, people often show outward behavioral signs.

Common signs of needing the restroom include:

Fidgeting with or removing clothing
Pacing, wandering or going in and out of different rooms
Peering around frantically

Toileting Plan

One of the best ways to minimize incontinence is to develop a personalized toileting plan based on the person’s needs.

Initially, the “plan” may be as simple and informal as reminding the person to use the bathroom before leaving the house.

Over time, the frequency and amount of oversight or assistance may increase.

Pay attention to when the person usually needs the restroom and try to anticipate it.

Remind or assist them regularly just before they are likely to need it.

Example:

Larry is a senior with middle-stage Alzheimer’s Disease. He has difficulty recognizing when he needs to urinate, and usually doesn’t get to the toilet on time. He wears incontinent briefs, which used to be wet almost every time he went to the bathroom.

His wife, Roberta, used to ask him if he needed the bathroom, but he would always tell her “no”. Now, however, she doesn’t ask him. Instead, she walks with him to the restroom regularly – when he wakes up, before each meal, after dinner and before bed.

She also wakes him up around midnight and again around 5:00 a.m. If she doesn’t wake him up he will usually wake up on his own around 1:00 and 6:00 in a rush to find the bathroom. Not only is this upsetting to him, it is unsafe because he won’t slow down enough to use his walker.

With this plan, Larry’s brief has rarely been wet at all over the past several months. However, last week he started taking a new diuretic medication to reduce the swelling in his legs, and he immediately started to have accidents again. When Larry went to the toilet before lunch his incontinent brief was soaked.

After a few days, Roberta was able to adjust the plan to the new needs. She started walking Larry to use the toilet after breakfast, and again around 10:30. Larry is back to enjoying accident-free days at this time.

The Importance of Sleep

It’s worth thinking twice about waking up someone with dementia to prevent overnight incontinence. Sleep deprivation can seriously impact both physical and mental health.

It can also worsen the symptoms of dementia.

Depending on the situation, it may be worth considering a quality night brief instead.

These special briefs are designed for extended wear and can absorb large amounts of urine, keeping it away from the person’s skin.

Regular briefs should not be worn if they are wet. Extremely damaging to skin, it also increases the risk of urinary tract infections and pressure ulcers.

Keep Drinking

Some elders avoid drinking fluids because they are afraid of having to urinate more or having an accident.

However, dehydration is a serious concern for elders. It can worsen confusion, contribute to falls, or lead to a medical emergency.

Elders with dementia tend to be at especially high risk for dehydration.

Caffeine and certain medications can cause an increase in urination, which can contribute to both incontinence and dehydration. In general, it’s a good idea to avoid caffeine and to take the diuretic medication in the early waking hours.

Always discuss medications, including what time they are taken, with the person’s doctor.

Talk to the Doctor

There are medications for “overactive bladder”, but beware: this is not the cause of most incontinence in dementia.

Furthermore, some of these medications can worsen dementia symptoms significantly.

There are also other potential treatments for incontinence depending on its cause. Discuss all medications and any concerns about incontinence with the person’s doctor.

Watch for Urinary Tract Infections

Sudden onset or increase in incontinence can be a sign of a medical condition, such as a urinary tract infection.

UTI’s can greatly impact the health and behavior of a person with dementia. Other signs that may indicate an infection could include:

Fever
Increased confusion
Changes in behavior
Dark or odorous urine
Discomfort with urination
Low back pain

If incontinence is new or sudden, talk with the person’s doctor.

Multi-Infarct Dementia: What Is It?

Petra Boh Blog, Types March 3, 2021October 16, 2021dementia, multi-infarct dementia, stroke, vascular dementia

A kind of dementia, multi-Infarct dementia (MID) is a type of vascular dementia that is caused by multiple strokes.

It is also considered to be the second-most common cause of dementia after Alzheimer’s disease.

The strokes interrupt blood flow to the brain, which ends up affecting how the organ functions.

A brain infarct or stroke happens due to the block or interruption of blood flow to any part of the brain.

Everything You Need To Know About Multi-Infarct Dementia

Blood transports oxygen and other essential nutrients to the brain. When the brain lacks oxygen, it causes the death of brain tissues.

Multi-Infract imply that multiple areas in the brain have been injured because of lack of blood from a series of small strokes.

There are times when blockages of the brain cause an infarction (stroke) without any stroke symptoms.

These are known as “silent” strokes which are known to increase an individual’s risk of getting vascular dementia.

If someone experiences a series of small strokes over time, they may end up developing infarct dementia.

Symptoms of Multi-Infarct Dementia

The type of symptoms a person gets often depends on the area of the brain that the stroke has damaged.

At times the symptoms appear suddenly after a stroke or they may appear slowly over time.

We can categorize MID warning signs into two major sections as seen below.

Early Dementia Symptoms

Loss of executive function
Getting lost in familiar places or wandering
Short-term memory loss or confusion
Losing bowel or bladder control
Walking with shuffling rapid steps
Crying or laughing inappropriately
Challenges performing routine tasks like paying bills
Personality changes
Losing interest in activities or things that were previously enjoyed

Late-Stage Symptoms

As the disease progresses, a person may also experience other symptoms such as:

Hallucinations/delusions
Problems with simple tasks like meal preparation and dressing
Changes in sleep patterns
Memory loss
Social withdrawal
Poor judgment
Depression

Some individuals may go through periods where they seem to improve and then decline after experiencing small strokes.

MID Risk Factors

Some of the risk factors that increase a person’s risk of getting this disease include:

Medical Conditions

Diabetes, heart failure, previous strokes, atrial fibrillation, high blood pressure, cognitive decline prior to the stroke, and hardening of the arteries are some of the medical conditions that increase the risk of MID.

Age

Increasing age is a common risk factor for all types of dementia including MID.

The disease mostly affects persons who are between the ages of 60-75. In some rare cases, some people get the illness before they celebrate their 60th birthday.

Research also shows that men are slightly more likely to develop the disease than women.

Lifestyle Risk Factors

These include alcohol consumption, smoking, little to no physical activity, poor diet, and low level of education.

Diagnosing Multi-Infarct Dementia

There is no single test that can determine whether a person has MID or not. Worth noting is that each MID case is not the same.

One person may experience severe memory impairment while another individual may only experience mild memory loss.

Diagnosis can also be difficult because it is possible for a person to have both Alzheimer’s disease and MID making it challenging for a doctor to diagnose either of the diseases.

Medics base diagnosis on a number of factors such as:

History of stepwise mental decline
Blood pressure reading
Neurological exam
Blood tests
Physical Exams: this is where the doctor will ask questions pertaining to diet, sleep patterns, medications, past strokes, personal habits, stressful events, recent illness, and other medical issues.
Ruling out other causes of dementia like depression, diabetes, anemia, high cholesterol, brain tumors, carotid stenosis, chronic infections, thyroid disease, drug intoxication, vitamin deficiency, and high blood pressure.
Radiological imaging tests such as X-rays, CT & MRI scans that detail tiny areas of tissue that died from lack of adequate blood supply, electroencephalograms that measure the electrical activity of the brain, and transcranial doppler that is used to measure the velocity of blood flow through the blood vessels in the brain

MID Treatment Options

Currently, there is no treatment for multi-infarct dementia.

Experts have not yet discovered how to reverse brain damage that occurs after a stroke. Treatment options mainly focus on preventing strokes from reoccurring in the future.

This is done by putting in place measures to avoid or control the medical conditions and diseases that put individuals at risk of experiencing strokes.

Stroke risk factors include diabetes, high blood pressure, cardiovascular disease, and high cholesterol.

Treatment is also tailored to a person’s individual and most of them will include:

Medications

Doctors may prescribe certain medications to help improve symptoms such as:

Folic acid
Memantine
Hydergine
Nimodipine
Angiotensin: these help to lower blood pressure by converting enzyme inhibitors
Calcium channel blockers that help with short-term cognitive function
Some serotonin reuptake inhibitors that are antidepressants which may help neurons grow in a bid to re-establish connections in the brain

Healthy Lifestyle Habits

Practicing healthy habits is also key when it comes to MID treatment and some of them include:

Maintaining a healthy weight
Not smoking
Moderately using alcohol
Exercising
Eating a healthy diet

Alternative Therapies

Herbal supplements are also common when it comes to treating MID. However, more studies are still necessary to prove their efficiency.

Some of the herbal supplements that are being studied for use in MID treatment are:

Lemon Balm: A great alternative to restore memory
Wormwood: It enhances cognitive function
Water Hyssop: Used to improve intellectual function and memory

It is important to consult a doctor before taking any supplements to be on the safe side.

Other treatment options include rehabilitation therapy for mobility problems and cognitive training to help regain mental function.

Caregiver Support

Relatives and friends of persons with MID can help them cope with their physical and mental problems.

This can be done by encouraging regular physical and social activities as well as daily routines to help reinforce mental abilities.

Alarm clocks, calendars, and lists are useful when it comes to reminding the affected persons of important events and times.

MID Prognosis

The prognosis for persons with multi-infarct dementia is not clear.

This is mostly because the symptoms of the disease can appear all over sudden after each small stroke mostly in a step-wise pattern.

Some individuals with the disorder can appear to improve after some time and then decline after experiencing silent strokes.

The disease will spiral downwards with intermittent periods of fast deterioration. Some people may die after a MID diagnosis while others will survive many years.

Death may also occur from heart disease, stroke, pneumonia, or other infections.

Is Normal Pressure Hydrocephalus Reversible?

Petra Boh Blog, Prevention, Signs March 2, 2021October 16, 2021dementia, normal pressure hydrocephalus, nph

One of the questions that often comes up when looking into the reversible causes of dementia has got to be “is normal pressure hydrocephalus reversible?”

Before answering this query, it is important to discuss what normal pressure hydrocephalus (NHP) is.

What is Normal Pressure Hydrocephalus

The brain has chambers that are known as ventricles. These ventricles usually contain a fluid called cerebrospinal fluid (CSF) which protects and cushions the spinal cord and the brain.

It is also responsible for supplying them with nutrients and eliminating some waste products. The body typically makes enough CSF that it absorbs daily.

However, there are times when too much of the fluid builds up in the ventricles leading to NPH.

This can result in brain damage because the extra fluid can cause expansion of the ventricles which puts pressure on the brain tissues.

NPH mostly affects the parts of the brain that control the bladder, legs, and mental cognitive processes like reasoning, memory, speaking, and problem-solving.

Even though NPH can affect anyone, it is common among seniors who are in their 60s and 70s.

Appropriately 700,000 Americans are living with NPH according to Hydrocephalus Association. It is also known as “treatable dementia.”

This is because it is one of the dementia causes that can be reversed or controlled with treatment.

Causes of Normal Pressure Hydrocephalus

Several factors contribute to excess fluid build-up in the brain ventricles and these may include:

Brain surgery
Infection
Head injuries
Bleeding around the brain
Brain tumors
Stroke
Worth noting is that some people will develop NPH even in the absence of the factors above

Symptoms of Normal Pressure Hydrocephalus

Examples of NPH warning signs include:

Confusion
Mood Changes
Apathy
Loss of bladder or bowel control
Difficulties thinking
Depression
Challenges with responding to questions
Speech problems
Nausea
Headache
Problems with vision
Mild dementia that may involve loss in interest in day to day activities, challenges completing routine tasks as well as short-term memory loss and forgetfulness
Having trouble walking, falling, changes in the way a person walks, poor balance, and getting stuck or freezing when a person wants to walk

Diagnosing NPH

It is usually challenging to diagnose normal pressure hydrocephalus because its symptoms are similar to those of other diseases such as Parkinson’s disease, Alzheimer’s disease, and Creutzfeldt-Jakob disease.

Many cases go unnoticed because the disorder is usually misdiagnosed.

This means that it often goes untreated. Doctors may use several tests to rule out other conditions and diagnose NPH such as:

Brain scans (MRI or CT)
Cisternography: this is a test that highlights the absorption of CSF
Intracranial pressure monitoring: this is a diagnostic test that helps medics determine if there is low or high CSF pressure causing symptoms.
A Lumbar catheter or spinal tap: this is a procedure that measures CSF pressure. Doctors also use this to remove some of the fluid located close to the spinal cord for analysis to help them spot any abnormalities that may direct them to the problem
Medical interviews where doctors ask a person about the symptoms they are experiencing, past and current mental and medical problems, medications a person is taking, family medical problems, habits and lifestyle as well as travel and work experiences.
Detailed physical exams that may include testing mental status, neuropsychological tests, and lab tests that help to rule out other medical conditions with similar symptoms.

Treating NPH

You will be happy to learn that normal pressure hydrocephalus is reversible.

In most cases persons will NPH will go through surgery so that medics can place a shunt or tube in the brain to drain off any surplus fluid.

Medics will insert the shunt into a ventricle and then pass it under the skin from a person’s head to their abdomen through the neck and chest.

This way, the excess fluid will flow from the brain into the abdomen where the body will absorb it.

At this point, the ventricles in the brain can go back to their original size.

The shunt can remain in position as long as the brain has too much CSF.

Regular follow-ups by a professional physician are essential because it helps to identify if there are any subtle changes that can show if there is a problem with the shunt.

When implanted properly, the shunt is usually not obvious to other persons and it remains in place for an indefinite period.

Most people will enjoy full recovery after treatment and continue to enjoy a good, quality life.

However, not everyone will benefit from implanting a shunt because the method does not work for a small percentage of individuals.

Although normal pressure hydrocephalus is reversible, its symptoms will become worse when it is left untreated.

It is advisable to get an early diagnosis and prompt treatment because this may increase the chances of good results.

Currently, no other medical treatment or drug has been known to help reverse normal pressure hydrocephalus.

Post-Stroke Dementia and Cognitive Impairment

Rok Krivec Blog, Types March 2, 2021October 16, 2021dementia, post-stroke dementia, stroke

After suffering a stroke, many people will end up with post-stroke dementia (PSD).

This can be any type of dementia from Alzheimer’s disease, vascular dementia, degenerative dementia, mixed dementia or stroke-related dementia.

Post-Stroke Dementia Review

PSD is a common occurrence after a stroke covering for about 6%-32% of the cases.

However, not everyone who has suffered a stroke will end up with dementia.

Others will experience a degree of cognitive impairment that is not severe enough to be categorized as PSD.

ResearchGate reveals that many people will experience mild cognitive impairment after a stroke which may or may not progress to dementia.

Cognitive Impairments

Cognitive impairments are generally divided into several domains that include:

Attention

This can generally be defined as shifting, focusing, sustaining, or dividing attention on a particular task or stimulus.

Executive Function

This has a lot to do with abstract thinking, planning, conflict monitoring, inhibition, and organization of thoughts.

Memory

This mostly affects a person’s ability to recognize or recall verbal or visual information.

Language

It primarily affects an individual’s ability to be receptive or express themselves through language i.e. reading and writing comprehension.

Social Cognition

This defines the recognition of a person’s or other people’s emotional state as well as an understanding of the mind’s theory.

Perception and Praxis

For the most part, it primarily affects visuospatial abilities, apraxia, prosopagnosia, and agnosia.

Post-stroke cognitive impairment (PSCI) can be described as a failure in the cognitive domain that happens after a stroke.

Cognitive impairment is a threat to post-stroke recovery for persons of all ages. It can compromise a person’s ability to continue working hence the need to be dependent on others at an early stage.

Unlike physical disability that is caused by stroke, cognitive function normally becomes worse over time.

While cognitive problems usually become worse during the first months after a stroke, there is a chance they can become better as the brain starts to become more active in trying to repair itself.

It is a complicated process because recovery can start to slow down after six months.

Even when cognitive problems do not go away completely, they normally get easier to live with.

This is especially the case when cognitive issues do not lead to dementia.

What Causes Cognitive Impairment

Cognitive issues occur because of the damages that happen to the brain.

Different brain sections are responsible for controlling different aspects.

If one of the areas that control cognition is damaged by stroke, this can affect the way a person does certain things.

Cognitive challenges are quite common after a person experiences post-stroke dementia.

Risk Factors for Post-Stroke Cognitive Impairment

After a stroke, the risk factors for cognitive impairment are usually associated with an overlap of dementia and frequent cerebrovascular diseases.

Some of them include:

1. Age: this is a risk factor for both cognitive decline and dementia. The prevalence of cognitive decline increases significantly after the age of 65 according to research by the American Stroke Association.

2. Vascular risk factors like diabetes, smoking, hypertension, and atrial fibrillation increase the risk of cognitive impairment.

3. Recurring strokes are also documented as a risk factor for cognitive impairment.

4. Education level: this is a conflicting risk factor with some studies suggesting that higher education is related to better cognitive performance.

Diagnosing Cognitive Impairment after Stroke

A neuropsychological examination is one of the methods that is used to assess cognition after a person suffers from a stroke.

In clinical practices, this is conducted from one week to a month after the stroke.

It is different when it comes to research because the examination is performed three months after a stroke.

In some cases, it may not be possible to conduct a neuropsychological examination for persons who have had a stroke because they may be too fatigued or disabled to go through with it.

Shorter screening tests are done as an alternative in such cases for both research and clinical purposes.

Early detection of cognitive impairment is critical because it may help reduce the chances of progressing to post-stroke dementia.

Treatment and Management Options

When it comes to treating cognitive impairment caused by post-stroke dementia, the main options include strategies that range from preventing white matter changes, new strokes, to treating underlying vascular risk factors hypertension.

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.