Dementia Care Tips during the COVID-19 Pandemic

With Worldwide’s current circuit-breaker measures (e.g. closure of most eldercare services and facilities; disallowing dining-in at public eating places), many persons with dementia’s routines may be disrupted to a large extent. Those who have been going out actively within their communities may feel lost or frustrated, especially if they are unable to do what they have always been doing. Some may also not be able to retain information about COVID-19 and the current measures within the country.

As a caregiver, you may be feeling more stressed or helpless in extraordinary times like these. Thus, this info-kit is created to share some dementia care tips and resources. Remember, you are not alone in your caregiving journey!

1. Sharing COVID-19 information with persons with dementia

• Ensure that information is presented to your loved one in a clear and simple manner. Usage of visual aids such as videos may be used. Can refer more info at http://www.moh.gov.my/index.php/pages/view/2019-ncov-wuhan-infografik
• If he/she appears confused or distressed watching the television news or videos about COVID-19, respond to his/her feelings. Try to divert his/her attention away by introducing another activity or switch off the television. o Take time to listen to your loved one and his/her concern(s). Validate his/her feelings and provide reassurance

• Can refer to http://www.moh.gov.my/moh/resources/user_35/What_are_the_symptoms_of_infection.jpeg

• Ensure that your loved one maintains proper hand hygiene by reminding him/her to wash his/her hands regularly. There may be a need to help him/her to apply moisturiser to prevent his/her skin from becoming too dry.
• Ensure that your loved one washes his/her hands before mealtimes, after going to the toilet, coughing and blowing of nose
• If he/she is not keen to wash his/her hands with water and soap, an alternative is to use hand sanitiser. Additionally, increase the frequency of environmental disinfection.

• Ensure that your loved one showers regularly.
• If he/she is not keen to shower, here are some tips: •
• You can use a wet towel / body wipes and assist him/her to wipe his/her body. If they are able to care for themselves, give him/her the wet towel / wet wipes and encourage him/her to do it themselves.
• To encourage him/her to shower/wipe, you can use statements such as “It is a hot day”, or “It is a hot day, I feel so sticky, I am going for a shower now. It will be your turn next ok?”
• To allow him/her to choose his/her favourite set of clothes to wear after the shower.
• Does he/she have any favourite snack or sweet treat? You may like to use that as an encouragement as well. 
• Take note of the timings when his/her mood tends to be much calmer. Pick those particular timings for shower-time. 
• It is unavoidable that caregivers have to touch their loved ones during care provision (i.e. feeding, hygiene care). Remember to practise hand hygiene regularly. Also, try to minimise hugging your loved one.

5. Environmental hygiene

• Maintain home environmental hygiene by cleaning commonly used surfaces with a clean cloth and household cleaning spray or disinfectant.
• Ensure adequate air circulation within the house by opening the windows. o
• If there is anyone within the household who is not feeling well, if possible, try to arrange such that your loved one does not use the same toilet as that family member who is unwell. However, if it is not logistically possible, try to clean the toilet with disinfectant every time that family member finishes using the toilet.
• Do not share utensils during mealtimes.

6. Bringing person with dementia for medical follow-up

• Postpone non-urgent medical appointments to a later date.
• Opt for tele-consultations if possible.
• Ask your doctor or pharmacist about filling prescriptions for a longer period so as to reduce trips to the clinic or hospital.
• Opt for home delivery of medications if possible

7. Daily routine and Activity engagement

• Try to adhere to a routine if possible. For example, stick to the same waking up and sleeping timing.
• Ensure a balanced diet and sufficient water intake for your loved one.
• Encourage your loved one to stay at home and refrain from going out unnecessarily.
• Try to introduce some activities during the day if possible (refer to “Activity engagement” as our blog). This will help to alleviate your loved one’s boredom at home, and he/she may also have less responsive behaviours such as mood irritability or wanting to go out. This will also help to enhance his/her sleep quality at night.
• For persons with mild dementia who are still going out independently, try to educate and remind them about the current situation and the government’s advisory to stay at home.

8. Mood changes 

• Persons with dementia may be confused with the presence of more family members at home during the day (since many people are working-from-home now).
• Try to provide reassurance and check-in with your loved one on how he/she is feeling.
• Ask the other family members to stay in their rooms as much as possible to avoid overwhelming your loved one.
• For persons with moderate dementia, observe their non-verbal to see if there are any signs of anxiety, distress. E.g. is there more pacing, frowning, mood changes?
• When outside, persons with dementia may feel frightened or anxious when they see people wearing masks. Try to allay his/her anxiety by providing a supportive presence i.e. stay by his/her side.
• Persons with dementia’s mood changes may also be attributed to having to stay at home now (especially for those who have a routine of going out or used to a routine of going day care).
• Take note of any physical discomfort which your loved one may be having. E.g. dehydration, any constipation, any aches or swelling, any sleep cycle changes.
• There may be a need to contact your loved one’s primary doctor or nurse for discussion and recommendations.

Source: Alzheimer's Disease Association & Ministry of Health. For reference only.