Gradual decline in cognitive function is the hallmark of Alzheimer's disease with decline in memory, reasoning, calculation, language and decision making. This poses a challenge to both elders with dementia and caregivers as their day-to-day living, e.g. housework, cooking, managing money, and placing objects becomes more difficult. Most elders with dementia compensate for the deficit by following habitual routines that have been preserved in their long term memory. In the late stage, self-care ability is lost and they become fully dependent on caregivers. In addition to personal care in daily living, a structured daily routine, appropriate activities and a well designed home environment can promote safety and maintain residual skills to facilitate self care as far as possible.
A good environmental design can compensate for some of the cognitive impairment faced by elders with dementia. A familiar safe, supportive, and stimulating environment can facilitate the elder's engagement in daily activities, reduce task difficulty, enhance participation and delay further decline in daily living skills hence helping caregivers to ease stress as well. More support, encouragement and empathy from caregivers can promote wellness and dignity for elders' remaining days.
Online videos - Dementia: Environmental modification.
A familiar living environment for elders with dementia can provide a sense of security and comfort. It can help to stimulate memory and preserve residual function. Avoid changing furniture or home renovation unnecessarily.
Elders should develop the good habit of putting household objects such as clothes, shoes, wallets and keys in same designated place. This enables easy retrieval and reduces the chance of misplacing them.
Simple environmental improvements can significantly reduce the risk of domestic injuries. Examples include installing handrails in the bathroom, keeping the floor dry, using non-slip shower mat to prevent falls; reducing clutter and keeping hallway clean to reduce the risk of accidents etc. A well-lit and quiet environment avoids unnecessary distraction and enables the elder to pay attention.
Labeling cupboards and doors can assist elders with dementia to locate items and find their way. Such labels may use simple wordings, picture and distinctive color. Combination of colorful pictures and words can be used for easier understanding.
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A stimulating environment can reinforce elders' sense of identity and facilitate integration in daily living. Past photos, ornaments and other souvenirs can trigger reminiscence which would strengthen their old memories and stimulate interests in life, help to slow down the degeneration process.
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It is a challenge to provide quality care for elders with dementia. In order to provide a safe, fulfilling and stable living, caregivers should try to understand elder's needs and be ready to adapt to changes as their condition deteriorate. Love, acceptance and patience are the essence in care for elders with dementia. However, caregivers should not neglect their own needs. They should learn caring skills to understand the disease process, seek support from family and community services and expert input wherever necessary so as to reduce caregiver stress.