Key strategies when caring for a loved one with dementia

November 26, 2018

(HealthDay)—People caring for a loved one with Alzheimer's or other types of dementia should focus on four main safety issues, an expert says.

Nearly 6 million Americans have Alzheimer's disease, according to the Alzheimer's Association. About 16.1 million Americans provide unpaid care for people with Alzheimer's or other dementias.

"When approaching dementia families, I follow the safe and sane rule," said Dr. Andrew Duxbury, a geriatrician in the Division of Gerontology, Geriatrics and Palliative Care at University of Alabama at Birmingham.

"Everything we do needs to make the patient safe and the sane. In terms of safety, it boils down into the big four: meals, wheels, bills and pills," he explained in a university news release.

In terms of meals, need to consider whether the person is capable of preparing food, eating healthy and appropriate amounts of food, and has the awareness that they need to eat, Duxbury said. "If any link in that chain breaks, the person may not eat," he said.

When it comes to kitchen safety, the "biggest issue is leaving things on the stove and forgetting to turn the oven off; but if cooking is part of someone's routine, let them cook on their own while monitoring what they are doing from another room," he said.

"Think about it this way: Would you let your 12-year-old make dinner? You may, but you would definitely be in the next room listening for anything that could go wrong," Duxbury said.

Other suggestions include planning meals that require minimal preparation or can be made in the microwave; removing scissors and knives from the countertop and drawers; putting labels on kitchen cabinets; and disguising the garbage disposal switch to prevent someone from turning it on accidentally.

It's not safe for patients with late-stage dementia to prepare on the stove or in the oven, Duxbury said.

When it comes to getting out of the house, the loss of independence caused by having to give up driving can be difficult for dementia patients.

"A lot of times, an older man may just want to have the car keys, feel them in his pocket and see the car in the driveway," Duxbury said. "You can let him have the keys, just not the key to the actual car. Give him the keys to a different car or remove the car key from his set of keys. This way, he has the keys, hears them jingle in his pocket and sees his car, but can't go anywhere."

If a person can no longer drive, caregivers need to ensure there is another source of transportation, especially for medical appointments. Arrange to have medications, groceries or delivered.

Evaluate and monitor the person's finances to make sure he or she has enough money to pay bills and is not being taken advantage of or scammed, Duxbury advised.

Many seniors take multiple medications. Those with dementia often forget to take their pills or take pills together that can cause harmful side effects. Caregivers need to ensure their loved one is correctly managing their medications and going to medical appointments. It's also important to keep an eye on the person's other health issues.

To help your loved one, set up a pillbox with a week's worth of pills, sorted by day. Some pillboxes have timers and locks you can set to prevent him or her from taking the wrong day's dose.

Duxbury said most people with dementia think they're fine.

"Families need to remember that a person with dementia does not live in the same reality that we live in," he said. "They live in a reality of their brain's . These individuals may have completely different perceptions of the world around them and what it means. … We have to accept their reality for what it is."

Explore further: How to help care for someone with Alzheimer's or dementia

More information: The U.S. National Institute on Aging has more about Alzheimer's caregiving.

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