Show #347 Airing Sunday, 7/2/06
Can there truly be an “independence” day for people with dementia? How can a care giver balance the desire for independence with safety at home? And is it possible to find an assisted living environment that is both safe and supportive? Here to answer those important questions is Kate Nederostek, executive director of Arden Courts of Bath.
Question: If you are the caregiver of a person with dementia who is living at home, what can you do to allow them to have some independence, and to feel productive, yet be safe?
Answer: Adapt the home's environment so that it's not confusing for someone with dementia. Look at your rooms as if you're seeing them for the first time-how would you describe where to locate things?
Put up signs around the house. You don't want to overdo labeling, which can cause confusion, but say, for example, the person with dementia enjoys setting the table. Mark with signs (both text and photo of the object) where to find the forks, spoons, etc.
Eliminate confusing decorating choices. For example, an all white bathroom might look nice, but a white sink and a white toilet and white walls might all look the same confusing the person with dementia.
Reduce clutter, make walkways clear, take precautions that are similar to childproofing a house. But make sure the area is still inviting and not too cold that the person will not want to enter.
If you are afraid of your loved one going down the basement, or into a workroom with potentially dangerous tools, lock the door. You may be able to find high locks they may not notice. Try putting a stop sign on the door-years of driving rules will deter them. Or paint the door the color of the wall/put a cloth over it.
Question: Is it hard to balance the desire to give your loved one independence with their need for safety?
Answer: The natural instinct as a caregiver is to close in and protect the loved one. But if someone with dementia feels too claustrophobic, that can lead to falling, agitation, and great upset.
Conversely, we also see family members who want to sacrifice safety so their loved one can retain some independence. For example, people will say that they know their parent shouldn't still be driving, but it allows them freedom. Someone cannot be independent if they are not safe first. You don't want to wait until a catastrophic event occurs to make a change.
Question: What happens when a person needs to move into an assisted living facility? What can you look for to make sure that the facility is safe, yet fosters and supports independence for those with dementia?
Answer: When choosing a facility, you want to look for an environment that supports someone with dementia. A facility that's too large, with lots of elevators and floors, can be very confusing to a resident. However, an area that too small-one hallway, for example-will be terribly cramped and can cause agitation in your loved one. Look for a happy medium. At Arden Courts, there is plenty of room to walk around indoors and also an enclosed, secure outdoor courtyard for residents to enjoy.
Many times, family members are looking at the aesthetics of the facility instead of what's best for the person with dementia. Too many decorations, patterned wallpaper, or patterned carpet can overwhelm a resident with dementia and cause them to stay isolated in their room. Look for a place that's inviting put not overwhelming. At Arden Courts, we even make sure that our lighting is not too bright or too dim, and we have walls and ceilings that absorb sound to keep confusion at a minimum.
Finally, look for the visual cues from earlier. Can someone with dementia navigate the facility's environment. For example, is there a shadowbox of family pictures outside of their rooms so that they can identify it? It would be embarrassing for them to have to ask where their room is-environmental cues can help avoid such a situation.
Question: I understand you're offering an opportunity to learn more.
Answer: Yes. On July 13th we're offering a free seminar at Arden Courts of Bath where we'll take a more in-depth look at why independence is so important to those with dementia, and how to balance that with safety needs.
Safety and independence are vitally important for those with dementia. Putting them together-that's the challenge. For a free fact sheet, or to attend a free seminar on this topic on July 13th, give Arden Courts of Bath a call at the number that's next. My thanks to Kate Nederostek.
