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    Dementia Symptoms & Caregiver Strategies: The Importance of Consistency When Caring for Someone with Memory Loss

    Memory loss is one of the most challenging issues for caregivers to deal with because of its ever-changing, sometimes unpredictable nature from person to person. Research is ongoing about the best ways to enrich the lives of individuals with cognitive impairment and one thing that has been shown is that consistency in the environment seems to be associated with a higher level of comfort.

    Keeping the physical environment recognizable and unchanging, be it living rooms, dining areas or bathrooms, encourages and supports a feeling of independence for individuals with memory loss. It is also helpful to maintain consistent cues for people to help them find their way around and avoid confusion —such things as familiar photos, paintings on the wall or wall colors, and furniture that remains unmoved.

    Caregivers should also strive to maintain a consistent schedule of when a person gets up, how they wish to be bathed, when they like their meals, when they enjoy activities, and when it’s time to go to bed.

    Developing day-to-day routines

    Having a daily routine helps caregiving run smoothly. These routines won’t be set in stone, but they give a sense of comfort, which is beneficial to the cognitively impaired person even if he or she can’t communicate it.
    While every family will have their own unique routine, you can get some great ideas from your medical team or a memory loss support group, especially regarding establishing routines to handle the most challenging times of day, such as evenings.

    The To-Do’s

    • Keep a sense of structure and familiarity. Try to keep consistent daily times for activities such as waking up, mealtimes, bathing, dressing, receiving visitors, and bedtime. Keeping these activities at the same place and time helps orient the person.
    • Continue the same medication schedule as advised by the treating physician(s).
    • Let your loved one know in advance what to expect throughout the day and right before a change of activity even if you are not sure that he or she completely understands what will be happening. You can also use cues to establish the different times of day. For example, in the morning you can open the curtains to let sunlight in. In the evening, you can put on quiet music to indicate that it’s bedtime.
    • You may think that doing everything on your own might be easier, but try to involve the person in daily activities as much as they are able. For example, a person may no longer be able to tie their shoes, but they may be able to put their clothes in the hamper. Clipping plants outside may not be safe, but they still may be able to weed, plant, or water. Use your best judgment as to what is safe and what the person can handle.

    Planning activities and visitors

    As you develop routines for the day, it’s important to include activities and visitors. Visitors can be a rich part of the day for a person with cognitive impairment. They can also provide an opportunity for the caregiver to socialize or take a break if necessary. Invite visitors at a time of day when your loved is usually alert and not irritable. What the individual can handle will change over time, so stay flexible in your planning. You’ll want to make sure that your loved one is getting sensory experiences and socialization, but not to the point of getting over-stimulated which may sometimes cause unnecessary agitation.

    Visitors can be briefed on communication tips if they are uncertain. They can also bring memorabilia your loved one may like, such as a favorite old song or book. Family and social events may also be appropriate for a person with memory loss to attend. Focus on events that won’t overwhelm the person; excessive activity or stimulation at the wrong time of day might be too much for them to handle.

    Here are some suggestions for activities:
    • Start with the person’s interests. Ask other family members and friends for memories of interests that the person used to have. You’ll want to tailor the interests to the current level of ability so they don’t get frustrated.
    • Vary activities to stimulate the different senses of sight, smell, hearing, and touch. For example, you can try singing songs, telling stories, movement such as simple dance steps, walking, or swimming, tactile activities such as painting, working with clay, gardening, or interacting with pets.
    • Planning time outdoors can be very therapeutic. You can go for a drive, visit a park, or take a short walk. Even sitting on a balcony or in the backyard can be relaxing.
    • Consider outside group activities designed for those with memory loss. Senior centers or community centers may host these types of activities. You can also look into adult day care programs, which are partial or full days at a facility catering to older adults.
    We all want our loved ones to enjoy the best quality of life, and consistency and engaging activities are key to helping make this happen.

    Cognitive Impairment can have many causes. The patient’s doctor should be consulted to determine a specific diagnosis and treatment options. But whatever the cause, the symptoms are often alike, and the Caregiver Strategies are often similar.

    The information in the resources listed above was compiled by the Ray Dolby Brain Health Center through clinical experience and commonly available published materials. For information on additional Caregiver Strategies, go to: