12 Steps to care for a person with dementia
Raising the elderly population is a global phenomenon. Today the third age represents approximately 10% of the world population, being able to reach in 2050, 22%. The fact that people are living longer also has consequences for the health of these individuals, who can manifest degenerative diseases, such as dementia.
The term "degenerative" refers to the loss of proper functioning of a particular organ and is not infection, inflammation or tumor. In dementia, the brain is the organ that has its functions compromised.
Faced with this scenario, people who present this picture may experience loss of memory, difficulty performing daily tasks, such as managing money, driving or eating, as well as having changes in behavior, such as insomnia, irritability and aggressiveness.
Alzheimer's disease and vascular dementia are the most common manifestations. In the case of dementia what occurs is a lack of blood in some brain regions, resulting in small infarcts on the site. As for Alzheimer's disease, a cause that proves the disease has not yet been detected.
Today the treatment for dementia seeks to provide a higher quality of life for the individual and also to reduce the progression of the disease. Therefore, a person who has difficulty dressing, but can still walk on his or her own, will receive a treatment focused on maintaining the ability to continue walking for as long as possible.
Living with a person presenting a picture Dementia requires specific care, attention and caring. Here are some tips to help an entity that is experiencing
1. Change the way you communicate
The patient with dementia may have difficulty remembering names of people and objects. In the same way you can forget or confuse words and present mental confusion.
Given this, verbal communication must be given in short and simple sentences, for example, when offering something it is better to specify: "do you want to read?", instead of asking, "Do you want to do something?" Give him time to understand what was said. If necessary repeat the sentence or use another expression with the same meaning. Always keep your voice calm, and when talking, have the patient look directly at you.
2. Establish routines
When a person becomes weak, they tend to be more insecure, in the case of a patient with dementia, the logic is the same. Therefore it is important that the people around you know changes in the environment the in the routine can trigger mental confusion in these patients.
A way to help you and establish routines, so that tasks - such as personal hygiene and food - are always performed at the same time. Tasks should be simplified, for example, when dressing, reduce clothing options in the closet. Avoid clothes with a zipper, buckles or buttons and leave the pieces of clothing separated in the same order.
This habit can contribute to the patient feeling more confident and comfortable with the situation. Stimulate independence: Do it with him and not BY him
It is important to note that people who manifest a dementia can continue to carry out activities independently. This will contribute to your self-esteem and will bring you more quality of life.
Anyone who lives with someone undergoing this situation can stimulate their autonomy. Therefore, encourage him to do activities that are within his routine alone, such as dressing, for example.
Initially let him try to do it on his own, if you realize that he could not complete the task himself, you can help you by providing some guidance. If he can not, assist him in the task.
Depending on the health condition, it can happen that the patient can not perform the task alone and need someone to perform that action for him. It is important that those around you are prepared to deal with the situation with patience and sensitivity.
The important thing is to observe the tasks that the patient can accomplish and to encourage it. Mobility also plays an important role in patient health because it reduces the risk of infection and venous thrombosis, as well as reducing the burden on the caregiver, so try to stimulate him or her to walk and move whenever possible.
4. Take care of his safety
As the body ages, vision and hearing problems begin to appear. In addition, the task of balancing is also a bit more difficult. It is therefore important to take some precautions to avoid falls and stimulate independence:
remove rugs and excess furniture from the house as they can facilitate the incidence of falls
- put non-slip floor and safety bars in the bathroom
- In addition, avoid leaving the house unlit as this can cause mental confusion. Ideally, always keep some sort of indirect lighting at night. At the doors, the locks should always be at the highest or the lowest.
Another important measure to avoid accidents is to keep the key of the house and the car in safe places, because in crises the patient can become agitated and try to leave the house.
5. Have some "rules" for food
Always try to offer meals in quiet places and at regular times, remember: the routine leaves the patient less confused.
So avoid distractions at this time, such as television, loud music or many people chatting at the same time. Some people may find it difficult to swallow. If this happens in your home, a more dense food will improve swallowing and will also prevent episodes of choking
Also try, if possible, to break the diet, so that the person has six meals a day, small quantities.
6. Watch out for hygiene
The bath should preferably be at the usual time in which it was taken before the onset of symptoms.
After evacuation, genitalia should be hy- drated from the urethra to the anus because it reduces the risk of fecal bacteria entering the urethra and triggering infection urinary tract infection.
7. Pay attention to signs on the skin
The elderly have a thinner and fragile skin, so it is easier to have lesions in areas of support of the body (sacral region and heel). For the patient who is bedridden, it is not recommended to always leave him in the same position, move him at least every two hours. One should make use of moisturizing cream on the skin and offer liquid during the day to avoid a possible dehydration. The diaper should be changed at least every three hours. In case of skin sores, seek medical advice from a healthcare team who will prescribe the dressing.
8. Photos and personal effects help reduce disorientation
Leaving pictures and personal objects around the house can bring greater recognition of the home. Place watches and calendars, preferably digital and large, at strategic locations.
9. Beware of preambulation
Preambulation is a state of restlessness that causes the person with a dementia case to walk from side to side without showing signs of fatigue.
Often it is only a symptom of the disease, however it can be triggered by pain, adverse reaction to medications or some infection. When it is only a symptom of the disease, the risks of fall or leak should be minimized (see item 4). It is important that the patient undergoes medical evaluation so that other possible causes are ruled out.
10. In incontinence, what should be done?
It can happen that the patient with dementia has incontinence (urinary or fecal) for several reasons: inability to contain diuresis, loss of the ability to recognize when to go to the bathroom, know or not remember where the toilet is and due to infections.
In these cases, the measure to minimize urinary incontinence is to take it regularly to the bathroom every one to two hours. At night you can choose to use the geriatric diaper. Fecal incontinence is less frequent, and it may be circumvented by observing the usual time the patient usually defecates and leading him to the bathroom in advance.
11. Understand behavior changes
A person with dementia may behave differently than he or she used to. Agitation, aggression and hallucinations are common factors. The patient may think he is being robbed, this is because he often does not remember where he placed a particular object and considers someone else to have stolen it.
Sometimes he feels persecuted, as he may not recognize some family members at home, passing to consider them strangers. It is important to reassure the patient at that time by helping him to look for the object and showing him that there are no strangers in the house.
Do not try to convince him that he was wrong, as it may increase his aggression or confusion. Nor should he be confronted when he does not recognize his own house. Offer personal belongings or show furniture or rooms that make you recognize the environment.
12. Maintain a sleep routine
The patient with dementia has several changes in sleep, with the most frequent being insomnia and switching from day to night (sleeping during the day and at night staying awake). To improve the quality of sleep, one should avoid daytime naps and keep it active during the day in domestic or leisure activities. Exposure to light in the morning also helps regulate sleep.
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If you need to go to an emergency room (dental or conventional), do not forget to leave there with all the documents and exams related to the care. "The dentist of confidence should continue the treatment or refer a specialist in cases that require surgery, canals, orthodontic appliance installation or something more specific, "says Sílvia Reis (CRO-MG 18894), a dentist specializing in orthodontics and dentofacial orthopedics.