MindSG
Explore our suite of self-care tools and resources to help you better understand and manage your mental health.
- Understanding dementia
- The basics of dementia and its misconceptions
- How does dementia affect our elderly parents?
- Common types of dementia
- How can we provide support?
- How will their behaviour change?
- How can we manage their behavioural changes?
- How to help them from day-to-day
- How do we communicate with them better?
- Managing stress and emotions while caregiving
- Useful resources on community support
- Self-help tools for dementia
- Mental health services
Caring for
someone
living
with dementia
Our elderly parents may have
retired (or may be retiring) from working life. Unfortunately, it is also at this
stage that we may notice them becoming more forgetful, misplacing things, struggling
to find words to express themselves, or experiencing mood changes.
These
may be signs of dementia — a condition that can affect a person’s day-to-day life.
Let’s read on to find out how we can support them through
this difficult journey.
What is dementia?
As our parents age, subtle changes in
memory may occur naturally. Simple forgetfulness and a delay in recalling names,
dates and events can be part of the normal process of ageing. In other words,
becoming forgetful does not necessarily mean someone has
dementia.
Let’s
learn about the common misconceptions about dementia:
- Pursue daily activities and function independently, despite occasional memory lapses
- Make decisions
- Recall and describe significant events
- Engage in conversations with others
- Staying physically active and exercising regularly
- Keeping blood pressure at a healthy level
- Monitoring blood glucose if someone has diabetes
- Eating a balanced diet
- Quitting smoking
- Going for regular health screening
- Refraining from heavy alcohol intake
- Being socially engaged
- Staying mentally engaged by playing strategy games and puzzles
- Learning something new such as taking up a new hobby, practising a musical instrument, reading a good book
- Breaking old habits such as eating with a non-dominant hand or taking a new route home
- Sleeping well
How does dementia affect our elderly parent?
Dementia is the name for a group of brain disorders
that results in the loss of cognitive abilities such as memory and reasoning.
Dementia can affect adults of any age. Based on the Well-being of
the Singapore Elderly (WiSE) nationwide study by the Institute of Mental Health
(IMH), 1 in every 10 people aged 60 years and above has dementia.
A person with dementia may gradually find the following abilities challenging:
Thinking and reasoning
Problem-solving and making
judgements or
reasoning
Remembering new information
or recalling recent
events
Learning new
information and
skills
Recognising familiar
faces and items
Finding the right words
to communicate
There are different types of dementia, some common ones include:
Supporting someone with dementia
Caring for someone with dementia can be intensive and challenging. To support our elderly parents living with dementia:
Dementia has several stages ranging from mild to severe. It is important for us to understand what stage our parents are in before deciding which supports to use. The more we understand dementia, the better we can support them.
Caregiving through the stages:
At this stage, our elderly parents can most likely be independent in most daily activities. However, they may need reminders to help with memory.
- Maximise their independence in daily activities as much as possible. Discuss with them about the things they can do on their own, and those that they need support with.
- Talk to them about their emotions. It is not easy to find out that one has dementia. Discussing their feelings with them can help them through these difficult times.
- Encourage them to remain physically and mentally active through exercises and social interactions with family and friends.
At this stage, our elderly parents will likely show changes in behaviour, mood, and personality, and will require additional support in daily activities.
- Establish daily routines for them. Routines can help provide a form of structure during the many changes they are going through.
- It is also good to remain flexible in these routines and adjust them as our parents' dementia progresses.
At this stage, our elderly parents will likely be totally dependent on us for daily living. Changes are they will require intensive physical care round-the-clock and along with additional support and assistance at home.
- Engage and stimulate them through their senses as they still can experience sights, sounds, smells, tastes, and touch vividly.
- Gather family members and caregivers to discuss alternative care arrangements for them to ensure they get the appropriate care that they need.
By identifying what might
trigger challenging behaviours in people living with
dementia, it may be slightly easier to figure out
ways to prevent or minimise the behaviour from
happening again.
Some examples of
triggers and ways to cope with them can include the
following:
Possible triggers:
-
Fatigue
-
Hunger or thirst
-
Sleep deprivation
-
Physical discomfort such as pain or fever
-
Impaired vision or hearing causing misinterpreted sight and sounds
-
Illness
-
Boredom
-
Trying to express emotions
-
Needing to urinate or constipation
-
Excessive noise such as TV, radio or too many people talking at the same time
Some tips to overcome sources of triggers can include:
Encouraging short periods of rest to minimise fatigue
Serving snacks and fluids in between meals
Looking out for non-verbal cues of pain and/or discomfort (e.g. frowning)
Promoting regular toileting and monitoring bowel habits
Increasing comfort by doing frequent check or change of diapers
Lowering the volume of the TV or radio to minimise noise which can trigger agitation
Not forcing them to do something they dislike
Reducing clutter to give them space to move around
Improving communication e.g. speak slowly and in short sentences especially to those with hearing impairment
Managing personality behavioural changes
Often, families may find it difficult to accept the
personality change that comes with dementia. As the disease
causes changes in the brain, the person they once used to know
may seem to have become a different person. It is important to
understand that the change is not
deliberate.
Depression can also be more
common among people living with dementia which might make any
changes in their personality/behaviour worse. Learn more about
depression here.
- Showing physical aggression
- Buying the same things repeatedly
- Getting upset more easily
- Wandering away from home
- Imagining things that are non-existent
- Displaying inappropriate social behaviour such as spitting in public
Tips to overcome some of the changes
We can practise these tips to overcome some of the changes:
Reassuring them that they are safe
Being genuine and sincere when approaching them
Having a daily routine and structured activities
Using music, songs, or other activities they used to enjoy to soothe and comfort them when they are upset
Holding and comforting them when they appear anxious or afraid as a gentle touch or hug can help convey we care
Learning communication skills such as keeping things simple by saying one thing at a time, avoid arguing or trying to reason with them even if they end up making a few wrong accusations
Here are some things we can do:
If they get aggressive and/or agitated
Remain calm. Displaying our fear, anger, or anxiety can make the situation worse.
Be patient and listen to what they are saying.
Validate their feelings. This means reassuring them and acknowledging how they are feeling.
Being clear in communicating with them.
- Explain our actions in short, simple sentences to help them understand our intentions, such as “I am here to help you.”
- Ask them specific questions like “What do you need now?”
Help them in
managing their emotions and needs.
If they are
feeling particularly aggressive or
agitated, we can give them time and
space to calm down and return
afterwards to try
again.
If
possible, identify the signs or
behaviours of agitation or
aggression. Before their anger
surfaces, we can redirect their
attention towards other activities
that can soothe them (e.g. listening
to calming music or showing them
photos to reminisce with
them).
As much as
possible, their basic needs (hunger,
thirst, and sufficient sleep) must
be met in a timely manner. The lack
of these needs could sometimes be
the cause of their agitation or
aggression.
Finding
out and eliminating their physical
discomfort such as a wound, infection,
and/or physical aches, can help suppress
their aggression and agitation.
If they get physically abusive
A one arm-length should be maintained between us and them to protect ourselves from getting injured.
Their anger should not be restrained or restricted unless they are causing harm to others.
We can also help ensure the environment is free from dangerous objects such as scissors or knives.
We can get help from other family members, neighbours, or friends if needed.
If they experience sundowning
Sundowning occurs when there are changes in their behaviour during the evening. These can include being aggressive, agitated, confused and/or restless.
To manage sundowning, we can:
- Provide them with a consistent daily routine
- Occupy them with a familiar activity
- Reduce sources of discomfort such as loud noises and bright lights
Watch this video to understand how to manage changes in the behaviour of people living with dementia.
Supporting someone with dementia on a day-to-day basis:
Design a daily routine with activities to engage our elderly parents
Mealtime behaviours
Address safety issues
Prevent them from wandering
Taking public transport
Make their home dementia-friendly
Be with our elderly parents in their help-seeking journey
Medication management
Obtain some inspiration and gain helpful tips by watching this video on how to manage the daily activities of someone living with dementia.
Learn communication tips
When communicating with our parents with dementia, it is useful to take note of the following:
Avoid testing their memory
Due to their dementia, they
are likely unable to remember many
things. When encouraging them to recall
certain things, it is best not to test
their memory by asking them what they
remember as this can make them feel
frustrated due to the difficulty they
may face in
remembering.
Instead,
we can use memory aids such as notes,
diaries, clocks or calendars to help jog
their
memory.
Be mindful of our tone and volume
Speak slowly and clearly.
The tone of our voice should be gentle
and calming. We should also avoid
speaking loudly and/or with a
high-pitched voice as that might be
distressing for
them.
If they
have trouble hearing, we can consider
getting them hearing aids or making use
of visual aids to facilitate
conversations.
Use different forms of communication besides verbal ones
If we do not understand what they mean, we can ask them to point or gesture. Visual cues can be useful in helping them convey what they want. Alternatively, we can try writing notes too.
Simplify what we say
We should avoid lengthy
conversations that require complex
thinking. We can break down tasks with
clear, step-by-step instructions.
Speaking slowly and in short
sentences can be helpful as well. Asking
close-ended questions that can be
answered with a “yes” or “no” can also
be helpful.
Avoid arguing with them
They may not be able to understand what others are saying or convey what they want clearly. Arguing about that will not help us understand each other better.
Be patient
Taking time to listen to
their feelings, thoughts, or needs can
be helpful. We can give them the space
and time to respond and express what is
on their
mind.
Sometimes,
the only way to get someone with
dementia to stop repeating themselves is
to distract them with something they
enjoy. For example, we can offer them
their favourite snack or beverage or
have them do their favourite
activity.
Be supportive
Offering comfort and reassurance can encourage them to open up their thoughts to us. We can look out for the intentions behind words or sounds and observe their body language.
Treat them with respect
This means maintaining eye contact as much as possible and acknowledging what they are trying to convey. We should avoid excluding them from conversations involving others.
Engage in conversation and activities together
Watch this video on how to communicate with someone living with dementia.
Learn some tips and guides from dementia.org.sg and download the language guideline resource kit that were developed and localised in the four languages to remind yourself on the use of appropriate language.
Self-care matters too
Caring for people living with dementia can
be tiring, frustrating, and upsetting at times. We may need some time to
recharge ourselves; otherwise, it could take a toll on our physical and
mental well-being.
Practising
and prioritising self-care will put us in a ready state to provide them
with the support they’ll need. Hence, there isn’t a need to feel guilty
to rest or attend to our needs as it’ll help us take better care of them.
Some ways of taking care of ourselves include:
Taking breaks and enjoying what we do
This can mean heading out for a short walk or for a bike ride, losing ourselves in books, movies, spending time with those we care for, or simply taking a relaxing nap.
Exercising
Exercise keeps us fit and
releases endorphins and serotonin. These are known
as ‘happy hormones’.
We can start small, like a short
10-minute walk or dance video; or go bigger and make
it a group affair with a family hike or a cycling
outing. We can stay active with free workout classes
or by signing up for the National
Steps ChallengeTM and start
clocking our steps.
Getting enough rest
Getting at least 7 hours of sleep can help us handle stress better. Find out how we can sleep well and/or manage our stress.
Managing our emotions
This means learning how to
identify our emotions and not brushing them aside.
The feelings
tracker is a good tool in helping us
identify how we are
feeling.
Managing our
emotions also means accepting our emotions as
something natural and finding out how they were elicited.
Most importantly, managing our emotions
means that we can talk to people about how we feel
anytime. We need not wait for problems to be big or
our emotions to be overwhelming before we speak to
someone. A trusted friend, family,
or colleague can be someone we
can confide in when we need
someone to
talk to.
Find out how else we can manage our
emotions here.
