A daily routine and dementia care go hand in hand, benefiting patients and caregivers alike. Whether it’s indulging in a morning cup of coffee, going for a midday walk, or doing the laundry on a certain day of the week, our personal routines provide us with a sense of comfort and control over our otherwise hectic lives.
Seniors with Alzheimer’s disease and other forms of dementia are no exception. They may have difficulty remembering things, but embracing and adapting long-standing habits can help keep them calm and focused.
Why a Daily Routine Is Helpful for People With Dementia
Holly Ryan, LVN, director of residential health services at Claremont Manor, a continuing care retirement community in Claremont, Calif., says that people experiencing memory loss thrive on familiarity.
“Familiar faces, a familiar environment, even familiar food—anything they can use as a touchstone helps,” she explains.
Dementia patients gradually lose the ability to plan, initiate and complete tasks, often resulting in confusion, embarrassment and increased dependence on others for assistance. Because of the way Alzheimer’s disease impacts memory, patients experience greater difficulty when attempting to do new things, notes Jed Levine, president and CEO of CaringKind, a public charity that provides support and resources for seniors and dementia caregivers in New York City.
Learning and short-term memory are typically the first cognitive processes affected by the disease, but habits and memories that are deeply engrained often fade away last. The repetition involved in adhering to these lifelong routines can help keep seniors oriented, preventing distraction, anxiety and frustration.
Setting a daily schedule for dementia patients not only helps them cope with the challenges of short-term memory loss but also benefits dementia caregivers. In the mild and moderate stages of the disease, less prompting, direction and supervision may be needed for an elder to follow their established routine. If it’s easier for a loved one to remember how and when to complete certain tasks, then it’s less likely that their caregiver will have to handle challenging dementia-related behaviors like agitation and outbursts that often stem from confusion and frustration.
Of course, as a dementia patient becomes more impaired, their routine will need to be adjusted to ensure their health and safety. Although their daily routine won’t look exactly the same as it did before they developed dementia, it is still beneficial to keep some core elements in place wherever possible.
“Even if there is little or no conscious awareness of time, even a loose routine helps ground them,” Levine confirms.
How to Incorporate a Daily Routine Into Your Dementia Care Plan
When coming up with a regular routine for someone with dementia, the overarching goal should be to tailor it to their preferences and past activities as much as possible. Preserving even small or seemingly mundane aspects of a loved one’s day-to-day schedule can have surprising results.
Levine recalls the story of one family caregiver who was forced to put her mother in an assisted living community. She had been diagnosed with Alzheimer’s disease and the move to an unfamiliar environment made her extremely anxious. One day, the daughter suggested that staff give her mother The New York Times newspaper each Sunday. Although dementia had affected her ability to understand the articles the way she used to, resuming this long-time habit brought comfort and gave her a point of reference from which she could better maintain her sense of time.
“On some level, she was aware it was Sunday,” Levine reflects. “Once she got the paper, she calmed down and enjoyed reading the various sections.”
The more you can include habits and activities from a senior’s pre-dementia life, the better. If you can, sit down and try to map out what a “normal” day or week used to look like for them. Leisure activities are typically an easy place to start. For example, did your loved one have a favorite television program that they liked to watch at a certain time each day? Perhaps encourage them to watch TV at this time while you see to other tasks.
Aim to incorporate enjoyable aspects of their personal routine between more challenging or mundane activities of daily living (ADLs), such as bathing, dressing, toileting and eating meals. This will help break up the day and make it more pleasant for both of you. If your loved one functions best at certain times of day, be sure to schedule the most demanding tasks during these windows and allow for plenty of time to rest afterwards.
Both Structure and Flexibility Play a Role in Dementia Care
Once you’ve established a “dementia routine,” Ryan says it’s important to try and follow it as closely as possible. However, it’s also important to be realistic.
Disruptions in daily routines are inevitable and happen frequently in dementia care. Doctor’s appointments, unexpected illnesses, an elder’s ever-changing mood, and fluctuations in their cognition can easily derail the most carefully laid plans. Unfamiliar people, places and activities can contribute to disorientation and anxiety. Depending on the severity of a disruption, it may be difficult for a dementia patient to fall back into their normal schedule.
In these instances, Levine encourages dementia caregivers to remain flexible and go with the flow.
“Do not insist on a strict routine if the person with dementia is resistant,” he warns.
Forcing the issue isn’t likely to be effective and will only cause you and your loved one unnecessary grief. Instead, learn how to recognize when they are becoming agitated or overwhelmed before an outburst occurs. Having plenty of back-up plans ready will help you easily modify your schedule or an activity to fit their changing needs. This might amount to a one-time adjustment, or plan b could wind up being an integral part of your new routine.
If Dad is used to watching TV each night but starts having trouble following newer programs, try playing reruns or recordings of his favorite old shows. If your wife has always bathed in the evenings when she got home from work, but now she’s too tired to do so, push shower time a little earlier in the day. On particularly busy or difficult days, schedule an afternoon nap before encouraging her to bathe, settle for a quick spot treatment with no-rinse wet wipes as a stopgap, or postpone bath day altogether.
The truth is that caring for a loved one with dementia is rooted in trial and error. Every patient is different, and something that works perfectly one day is never guaranteed to be effective the next. Family caregivers face the difficult task of incorporating familiarity in any way they can while also adapting to new and unexpected developments in their loved ones’ physical and mental health.
A well-structured care plan can be extremely useful, but in the grand scheme of things, keep in mind that your well-being and the dementia patient’s health and quality of life should always come first.