Caring for Loved Ones with Dementia: Understanding the Role of Senior Care

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By : Suvarna Sheth

Caring for a loved one past a certain age can be a difficult task, whether you are the person’s spouse, adult-child, or in-law.

Care for seniors is often complicated due to common ailments such as diabetes and cognitive impairment, which can include short term memory loss, mild cognitive impairment, Alzheimer’s disease, and dementia.

Recent studies find a correlation between diabetes and dementia, although the exact mechanisms are not known.

We speak to the director of Nightingale Senior Care, Pramod Patel, based in Orange County, Calif., to learn more about senior care, and what role caretakers may have in caring for patients with diabetes and dementia in particular.

Do you see a correlation with patients who have both diabetes and dementia?

We do take care of clients afflicted with dementia that also have dietary restrictions due to diabetes.  This is not a 1 to 1 correlation, however, as we do care for dementia patients who do not have diabetes and other dietary issues.

What’s the difference between senior care and a nursing home?

In-home care is designed to provide the senior with a sense of comfort in an environment that they control, as opposed to being in a nursing home where the senior has to follow the rules of the facility, which oftentimes make the senior feel like they are confined to specific rules.

A senior-care service like Nightingale facilitates the care of clients by working with the family and the client to devise a “plan of care,” that maximizes the enjoyment of daily life while ensuring a safe environment at the client’s home.

How does senior care take care of someone with dementia?

Dementia expresses itself differently in each person, so the experience of caring for someone with dementia will vary significantly.

Once dementia progresses to mid-stage, caring for that person will increase in difficulty. For example, incontinence issues will arise and can be incredibly messy.

Also, showering will become a challenge as a senior with dementia may often refuse showers because they have lost track of time.

Taking care of a parent or grandparent in this situation can be overwhelming to the senses. In spite of the difficulty, caregivers are able to persist in order to provide healthy living for the senior.

Caring for some seniors with dementia may be more challenging than others, depending on what type of personality they exhibit.
Either way, caring for dementia does require extreme patience as it very challenging.

What are some good practices in caring for a loved one with dementia?

There are some good practices look for when it comes to taking care of a loved one with dementia.  An important one is to avoid contradicting a person with dementia.

This means it’s important to avoid saying things like: ‘no, you’re wrong, don’t do that, stop it,’ etc.

Instead, you want to re-direct them to a different topic or activity.  For example, if they are fixated on playing with an object, instead of saying ‘stop playing with that’ you would introduce another object to them in hopes that this new shiny object distracts them from what they were just playing with.

Once they have let the original object go in favor of the new object you can clandestinely remove the original object from their field of vision.

In general, you cannot reason with a senior with dementia as their faculty to keep the focus on a single thought is greatly diminished.

Contradicting a dementia patient will only lead to increased agitation which leads to an incredibly unpleasant experience for both parties.

What are some day-to-day tasks for dementia patients?

Day-to-day tasks for dementia patients start out as just standby assistance when the dementia is in an early stage.

As dementia progresses, every ADL (Activity of Daily Living) will need to be a hands-on-assist.  Meal preparation, medication reminders, and driving are commonly the first ADLs that need to be managed by the caregiver.

As time progresses, toileting and bathing will become hands-on assistance as well.  Toileting and showering are typically the most challenging due to the fact the dementia patient will not know when they need to toilet and will refuse showers.

Thus, there will days that the dementia patient is soiled and refusing showers.  This will not only be unpleasant but also hazardous to the senior’s health.

It is not uncommon for seniors with dementia to refuse showers for 2 weeks or more.

How is care complicated for seniors with both dementia and diabetes?

The challenges multiply as dementia does hamper the ability of the senior to cooperate with specialized diets.

Since dementia has diminished the critical thinking ability in the senior, they may refuse a diabetic friendly diet and demand unhealthy food while not understanding why they are being denied.

Most likely, they will not be able to properly express their wish for non-diabetic food, so they will likely refuse to eat and be agitated.  This could lead to daily conflict which will lead to greater tension with the caregiver to the frustration of both parties.

What kind of toll does caring for a loved one take on the family?

The toll that is taken on a family can be extremely high.  We’ve seen many adult children and spouses have their own quality of life deteriorate to due to the additional strain of caring for a parent that has age-related maladies.

These adult children often have their own, work, business and children to manage, so the time for their exercise and self-care is taken away.

This can lead to developing their own health and mental wellness issues.  It’s wise to involve another family member in the tasks and responsibilities required by the aging parent.

Another option is to hire an agency to provide and manage professional caregivers to help with the care for Mom and/or Dad.

We have seen many situations where not the just the aging parent benefit, but everybody in the family feels better and enjoys a better quality of life when caregiving duties are spread out and/or delegated to managed caregivers.

Resentment builds up when caregiving responsibilities fall upon one adult child when there are other adult children in the picture that are not contributing time or effort on par with the main family caregiver.

This can lead to relationship strains, which are best to avoid.  It’s better to spend money on professionally managed agency caregivers than to have family bickering.

What things should someone look for when looking for senior care?

When sourcing a caregiver, it is important to make sure they are skilled in the ADLs that the aging parent needs help with.

Aside from the obvious personal care skills, the number one factor in choosing the right caregiver is to find the right personality fit.

There will be a lot of downtime during a shift when a caregiver is at the house to help Mom and/or Dad.  Mom and/or Dad will have to like the caregiver and embrace the help they will offer.

Thus, a good agency should go out of their way to meet the aging parent and the family to match caregivers just as much on personality and temperament as they do on the actual caregiving skills needed.

This means that, in general, calm, pleasant people are the types of caregivers that work best.

Aside from a pleasant and friendly personality, an equally important trait is patience.  The elderly, especially those are that physically frail and/or cognitively impaired are going to extremely slow to accomplish the simplest of tasks.

Patient caregivers work at the pace of the aging parent and not vice versa.  Patience isn’t a virtue in caregiving, it is a must.

dLife thanks Nightingale Senior Care for their insight on this important topic facing many adult children of seniors.


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