Old age dementia, also known as Alzheimer's disease, has a subtle onset and progressive development. Early symptoms include memory loss, changes in personality, constantly forgetting things, inability to recall recent events, and sudden changes in temperament. Severe cases may even result in the inability to remember the names, ages, and titles of family members, as well as the inability to take care of personal hygiene. Patients with advanced dementia require assistance in their daily lives, and may wander aimlessly outdoors. Ultimately, they may develop infections, injuries, or malnutrition and die. Mild dementia does not greatly affect the patient's daily life, moderate dementia requires some supervision and care, and severe dementia requires dedicated caregivers. The suffering caused by dementia is not only experienced by the patients themselves, but also by their caregivers. Research has shown that more than 80% of caregivers experience varying degrees of emotional disorders, and some even develop depression and anxiety disorders.
How can we provide home care for elderly dementia patients? How can we alleviate the physical and mental exhaustion of family members who provide care? When it comes to caring for elderly patients, it is recommended to pay attention to diet, daily living, safety, psychological comfort, and general health protection.
Diet and Daily Living
Diet: Low-salt, low-fat, high-protein, high-calorie, and vitamin-rich diets are recommended. The food should be easy to chew and digest. Feeding should not be rushed to avoid choking or suffocation. For patients in the late stage who have difficulty swallowing, gently press their lips and remind them to swallow. After each swallow, encourage the patient to practice swallowing a few times to ensure that all the food is swallowed. In severe cases of swallowing difficulty, consider using a gastric tube or elevate the bed when using a nasogastric tube. Dementia patients may have an insatiable appetite, so it is important to pay attention to the amount of food consumed and avoid overeating or undereating.
Observation of bowel movements: Encourage patients to have regular bowel movements and keep a record. Prevent constipation and avoid patients defecating or urinating anywhere.
Care for daily living: Encourage patients to be as independent as possible in daily activities such as eating, dressing, brushing teeth, and washing face. Due to impaired temperature perception, adjust clothing according to weather changes. Pay attention to any physical discomfort, such as fever, cough, abnormal bowel movements, and monitor blood pressure and blood sugar levels to detect any discomfort early and seek medical attention. For long-term bedridden patients, it is necessary to check the skin and mucous membranes to prevent pressure ulcers.
Living environment: Avoid sudden changes in the environment or caregivers. Open windows for ventilation regularly. Encourage appropriate outdoor activities.
Safety Precautions
Living environment: Minimize the number of objects within the patient's range of movement. Use bed rails to prevent falls. Fix objects in place and ensure the floor is non-slip. Patients may exhibit aggressive behavior, so keep sharp, pointed, toxic items out of reach. Ensure the safety of water, electricity, and gas facilities to prevent self-harm or harm to others. Clean up garbage in a timely manner to prevent patients from rummaging through it.
Medication precautions: Dementia patients often forget to take medication, take the wrong medication or dose, or refuse to take medication. Caregivers need to ensure that patients take their medication. For those who are unwilling to take medication, check their oral cavity to prevent missed or accidental ingestion. If necessary, mix the medication with food. If swallowing pills is difficult, break them into smaller pieces or crush them and dissolve them in water. Observe the patient's reaction after taking medication.
Preventing wandering: Avoid allowing patients to go out alone. Place a card with the patient's name, illness, address, and contact number in their pocket, or use a tracking device.
Psychotherapy
Previous studies have shown that effective emotional support can significantly improve the symptoms of elderly dementia patients. Caregivers need to have sufficient patience, provide enough companionship and tolerance to patients, and try to meet their reasonable requests while minimizing complaints and criticism. Encourage participation in activities with family and friends, reminisce about past events, encourage patients to express themselves, and provide feedback. Within the bounds of safety, tolerate the patient's irrational behavior.
"Five Ones" for Health
One exercise: Take a brisk walk in the sunshine at least once a day (no less than 3000 meters or 5000 steps), or engage in other suitable exercises such as Tai Chi or Ba Duan Jin (for at least 30 minutes).
One Mediterranean-style diet: Have at least one Mediterranean-style meal a day (consume more vegetables, fruits, fish, seafood, legumes, and nuts, followed by grains, and use vegetable oil instead of animal oil when cooking).
One social interaction: Interact with family and friends at least once a day, and participate in social activities at least once a week. Engage in intellectual activities at least once a day.
One cup of tea: Drink at least one cup of fresh green tea a day (multiple times, approximately 1000 ml, but caution is advised for those with a cold stomach).
One acupressure massage: Regularly massage acupoints for health maintenance, promote blood circulation, nourish the kidneys, and enhance cognitive function. Recommended acupoints include Baihui, Sishencong, Zusanli, Taixi, Xuanzhong, Yongquan, Guanyuan, and Sanyinjiao. For those with sleep disorders, the Shenmen and Anmian acupoints can be selected. For those with constipation, the Zigou and Tianshu acupoints can be chosen.
Taking care of elderly dementia patients requires a great deal of physical and mental energy. Due to the long duration of caregiving, limited social circles, and lack of understanding and support, caregivers often experience physical and mental exhaustion. This is a common phenomenon, so there is no need for self-blame or guilt. Instead, it should be given attention. One can seek information through popular science campaigns, public accounts, or support groups to learn about caregiving knowledge and the development of the disease. Family members can form teams to share the responsibilities of caregiving and communicate about the challenges they face. It is also possible to seek help from communities or nursing homes with extensive caregiving experience. If caregivers experience anxiety or depression, it is important to seek guidance and assistance in a timely manner.
