What is Person-Centred Care?
Person-centred dementia care aims to enhance the wellbeing of persons living with dementia by meeting their psychological needs, which maintains personhood. Person-centred care (PCC) is a way of thinking about a person living with dementia and how to support them to enhance their quality of life. When caring for a person living with dementia, it is sometimes difficult to understand why a person behaves in the way they do, or make decisions related to the activities they should engage in.
Understanding the Four Pillars of Humanitude
Listen Min Read As dementia progresses, the needs of those living with the condition evolve, requiring caregivers to adapt and find new ways to connect and support their loved ones. This journey can be challenging but also rewarding, as it offers an opportunity to enhance the quality of life through caregiving. The Humanitude methodology provides […]
Responding to Behaviour Changes using the ABC approach
Listen Min Read Behavioural and Psychological Symptoms of Dementia (BPSD) often present significant challenges, impacting both the person with dementia and those providing care. This article delves into common manifestations of BPSD and introduces the ABC approach—a structured method to analyse and manage these symptoms effectively. Persons living with dementia may experience behavioural and psychological […]
Creating a Life Story for Persons with Dementia
Listen Min Read Discover the powerful impact of life story work in dementia care. This article explores how gathering and reflecting on personal narratives enriches identity, deepens empathy, and fosters meaningful connections for persons living with dementia and caregivers alike. What is a Life Story? Everyone has their own, unique life story. Our life experiences, […]
A Guide to Setting Up a Trust for Persons with Dementia
Learn how to safeguard finances for dementia care with a special needs trust and the Financial Care Planning (FCP) App
Books for Your Journey with Dementia
The personal stories of others can provide affirmation and perspective for our own lives. This article lists free books available on loan that can support you in your journey with dementia.
Tips for Managing Disinhibited Behaviours
Dementia self-advocates play an essential role in creating positive change in policies, researches, and initiatives that support the dementia community.
Meeting Centre Support Programme
Persons with dementia and caregivers living in the community meet weekly to socialise, and to receive practical information and social support.
When to Consider Moving into a Nursing Home
This article lists the important considerations for a caregiver when deciding on moving their loved one to a nursing home, information on how to apply and other living arrangement options.
Integrating Play into Dementia Treatment Plans
Listen Min Read Dementia, a progressive neurological disorder affecting millions globally, prompts a multidimensional approach to care. While pharmaceutical interventions are prevalent, the recognition of non-pharmacological strategies is on the rise. Play, seemingly incongruous with dementia, can also be incorporated into non-pharmacological treatments for dementia. This article provides an overview of the benefits, types […]
5 Effective Tea Blends for Caregivers’ Stress and Sleep Relief
This article offers a list of outdoor monitoring solutions and alternatives that may be helpful for caregivers to explore with their loved ones.
Book Recommendations for Dementia Caregivers
Caring for someone living with dementia may be a long and challenging journey. If your loved one has just been diagnosed with dementia, you may be feeling overwhelmed and unprepared for the changes dementia might bring. Reading can provide a form of resource to equip yourself.
Vascular Dementia
Location-tracking technology offers a way to empower a person living with dementia to remain active in the community while caregivers monitor safety from a distance.
Programmes and Services
Persons living with dementia and caregivers are supported by an integrated mental health network to help them live well in the community.
Location-tracking Technology in Dementia Caregiving
Location-tracking technology offers a way to empower a person living with dementia to remain active in the community while caregivers monitor safety from a distance.
10 Ideas for Outdoor Monitoring
This article offers a list of outdoor monitoring solutions and alternatives that may be helpful for caregivers to explore with their loved ones.
The Power of Self-advocates in Dementia
Dementia self-advocates play an essential role in creating positive change in policies, researches, and initiatives that support the dementia community.
How is Dementia Diagnosed?
How is dementia diagnosed? Learn about the variety of tests doctors use to find out whether someone has dementia.
Supporting Persons with Dementia to Vote
Learn how you can prepare your loved one who is living with dementia on voting essentials for the election and casting an informed vote.
Communication Approaches in Dementia Care
Reality orientation, validation and reminiscence are effective methods to facilitate communication with persons living with dementia. Find out how you can use these approaches to help people living with dementia.
Frontotemporal Dementia (FTD)
Frontotemporal dementia (FTD) is an uncommon type of dementia caused by changes in the brain’s frontal lobe (behind the forehead) and temporal lobe (next to the ear).
My Loved One Refuses to Get a Diagnosis – What Can I Do?
If your loved one is displaying possible signs and symptoms of dementia, it is understandable that you would want them to get a diagnosis and seek treatment as early as possible. However, having a conversation with your loved one about the memory lapses and moments of confusion they have been experiencing may be difficult. Often, someone experiencing these symptoms may feel defensive, worried or be in denial.
Mind-Body Wellness Programmes
Mind-body wellness programmes provide the opportunity for multimodal intervention for persons living with mild to moderate dementia, and aim to maintain or improve the cognitive function and overall well-being of participants. Through 3-hour sessions, participants can enjoy activities such as physical exercises, cognitive training or stimulation and social engagement.
Dementia Care Training for Care Professionals
To build competency and capability of Care Professionals, the Agency for Integrated Care (AIC) developed the Dementia Care Competency Framework to align the training pathways. This alignment was made to improve the quality of care provided to persons living with dementia and support for their caregivers.
Behavioural & Psychological Symptoms of Dementia (BPSD)
Behavioural and Psychological Symptoms of Dementia (BPSD) is a term used to refer to a spectrum of non-cognitive symptoms and behaviours in persons living with dementia.
These changes in their mood and behaviour are often caused by a variety of factors such as the specific changes to the area of their brain affected by their condition, medical issues (i.e., pain and infection) as well as unmet needs.
Tips to Improve the Shower and Bath Experience
Dementia is a progressive condition, in which those living with moderate or advanced dementia will require support in carrying out activities of daily living (ADLs) such as bathing, dressing, grooming, toileting, walking, and eating. For many, bathing and showering are activities that are rather private and intimate. The same applies to persons living with dementia. Thus, it is understandable that they may feel uncomfortable receiving assistance and may find it difficult to adjust to this change.
Nutrition & Hydration Needs for Persons Living with Dementia
The type of food we eat will affect our health and quality of life. While there is no special diet required for persons living with dementia, the condition may bring about challenges to proper nutrition, hydration, and weight maintenance. Here are a few ways to ensure that your loved one has a well-balanced and nutritious diet, drinks sufficient amounts of liquid, and maintains physical and mental well-being.
Decommissioning of Dementia Friends App
The Agency of Integrated Care (AIC) has announced that the Dementia Friends App will be decommissioned from 31 December 2022. The Dementia Friends app was developed to empower caregivers with the knowledge, resources and support they need to better care for their loved ones living with dementia. The app also served as a platform for caregivers to alert the community, including members of public who have signed up as Dementia Friends, in the event that their loved one goes missing.
Museum Activities for Persons Living with Dementia
Museums serve as iconic cultural landmarks in Singapore and are considered community spaces for many art, history and science lovers in the country. This includes persons living with dementia and their caregivers. However, persons living with dementia may feel uneasy and experience difficulty navigating and engaging with artefacts owing to a number of reasons. These range from a museum’s layout to other dementia-specific factors like overstimulation and communication needs.
Tips for Communicating with Persons Living with Dementia
As the condition of a person living with dementia progresses, the way in which others communicate and interact with them should also change in order to tailor the interaction to their needs, and to make the most of each conversation or interaction.
Preparing for Doctor’s Visit
Being well-prepared for a doctor’s visit will be beneficial to you and your loved one living with dementia. Keep a symptom diary for your loved one A diary helps you keep track of signs and symptoms experienced by your loved one. Record the symptoms or behaviours exhibited – when and how they started and how frequently they happen – and use these records to communicate any concerns you may have when it comes to caring for your loved one. This will also help the doctor in keeping track and administering a more tailored treatment plan.
Brain Health and Reduction of Risks for Dementia
We are increasingly aware of the importance of brain health, which affects our physical well-being and daily functions. Having the capacity to manage ourselves well and take care of our loved ones has significant meaning to us. Our understanding of the brain and other parts of the nervous system, and how they control our complex behavior’s, has been the subject of intensive research for the past 4 to 5 decades, but has only gathered substantial momentum in the recent 1 – 2 decades.
Swallowing Difficulties and Soft Diets
In the later stages of dementia, a person living with dementia can develop severe difficulties with swallowing. Changes in parts of the brain that control swallowing may affect and weaken the muscles involved, affecting various parts of the eating process. As a result, the person living with dementia may not maintain sufficient fluid and nutritional intake for bodily sustenance. Difficulty in swallowing also increases the risk of food or drinks entering the lungs. This can lead to a serious lung infection.
Dementia in Film
There has been a steady increase in the number of films on dementia and its profound impact on the person living with it as well as their loved ones. While this is a call for celebration, it is also important that films portray dementia in a way that is accurate and does not contribute to misconceptions and perpetuation of stigma. This is especially a concern because film and media have been found to be a powerful medium in influencing the attitudes and perceptions of the general public.1
Anticipatory Grief
Dementia may gradually change the personality of your loved one. Anticipatory grief occurs when someone questions whether this “stranger” who is living with dementia is the same person they know and love. The changing personality of the person living with dementia could be difficult to accept, especially if you have had a special bond with them.
CARA: A Pioneering Membership Programme
CARA replaces the existing Safe Return Card (SRC) initiative by the National Council of Social Service (NCSS) used by persons living with dementia. A pioneering membership programme by Dementia Singapore – formerly known as Alzheimer’s Disease Association (ADA) – the CARA membership will have the same safe return functions of the Safe Return Card, but with added features and benefits.
Applying the K.I.N.D Gesture & C.A.R.E Approach
We may encounter persons living with dementia in different situations depending on our social or work roles. Watch this prize-winning video produced by Vinn Bay and Tee Boon Leng as part of the Alzheimer’s Disease International (ADI) conference in March 2009. As you watch, take note of how some members of the public interact with the person living with dementia who is lost in her neighbourhood, and how she feels because of these interactions.
Dementia-Inclusive Design Principles
In recent years, there has been a growing pool of dementia-inclusive design guiding principles developed by subject matter experts, intended for laypersons, caregivers, and care professionals to address and enhance the different aspects of the physical environments that persons with dementia live in.
Undernutrition & Weight Loss
Undernutrition and weight loss are prevalent issues worldwide amongst persons living with dementia, often worsening as dementia progresses. 20 to 45% of persons living with dementia living in the community (outside institutions such as nursing homes) experience significant weight loss over a one-year period, while up to 50% of those residing in care homes have inadequate food intake.1
Reminiscence Arts
Caring for our loved ones living with dementia often involves seeking effective ways to ensure that they live a life that is enriched and meaningful, even as their dementia progresses. One way to do that is by means of Reminiscence Arts.
Living Independently with Dementia
There are many changes that come along with living independently with dementia. If you are staying on your own and currently living with early-stage dementia or mild cognitive impairment (MCI), here are some tips to cope with the changes to maintain your independence for as long as possible.
Why Do Behavioural Changes Happen?
Dementia is accompanied by behavioural changes, which affect your loved one living with dementia and all of you around him/her. Behavioural changes can be one of the aspects of dementia that are most difficult to address. Persons living with dementia who experience behavioural changes are often described as having a “completely different personality” from their “old self”.
Palliative Care
End-of-life care, or palliative care, aims to support a person in the later stages of a life-limiting condition to live as well as possible until they pass on. It also aims to support family and caregivers during this time and after the person passes on. End-of-life care may last for weeks, months, or occasionally years. It is often difficult to know exactly when a person living with dementia is approaching the end of their life.
Person-Centred Care in Dementia
The term “person-centred care”, as a frequently-used term and a developing area,1 does not have a single agreed definition. When loosely defined, it has been used to refer to philosophies of caring that include goals that range from an emphasis on the dignity of the person being cared for, treating this person as an individual, ensuring that care is organised around the person, to involving the person and their close kin in their own care planning.2
Reminiscence in Dementia Care
Reminiscence is a method in dementia care that focuses on facilitating recollection about past events and experiences with persons living with dementia. This recollection creates opportunities to improve the wellbeing of persons with dementia, and for family and caregivers to meaningfully connect with them.
Making a Will
Planning a will is important to carry on the wishes of a person after they pass on. The will should contain clear instructions about what one wants to do with their money and the assets they own. It will also ensure that their legacy and future generations are taken care of accordingly
Reminiscence Activities for Persons with Dementia
Reminiscence involves the discussion of activities, experiences and events from the past and should ideally provide multi–sensory stimulation for persons living with dementia. Apart from reminiscence therapy, persons living with dementia and their family members can participate in or create activities that incorporate elements of reminiscence. These can include looking through old photos, listening to old music or taking part in more tactile activities such as arts and crafts or painting to evoke positive memories from the past.
How Effective are Dementia Medications
Medications, while with modest benefits, may be prescribed to relieve some symptoms and behaviour changes associated with dementia. However, ongoing debates over their effectiveness continue – the benefits and risks of the medications are discussed.
Caregiving Through the Stages of Dementia
Your role as a caregiver changes with the progression of your loved one’s condition. Below summarises the caregiving experience through the different stages of dementia:1-3
Person-Centred Care Planning in Dementia
In this topic, the importance of developing a person-centred care plan for persons living with dementia is emphasised. This page also summarises some of the best practices for a person-centred care planning process and the elements that a good care plan entails. Having these in place will assist care professionals to then deliver quality person-centred care for their clients or patients living with dementia.
Looking after Yourself
Always remember that part of your duty to your loved one is to take good care of yourself. Most caregivers feel that all their time, energy and care should be given to their loved ones. However, your loved one may suffer too if you do not look after yourself.
Caregiver Training and Courses
You may consider signing up for caregiving training to help you better care for your loved ones living with dementia. As caregiving also involves more than one caregiver, such as family members and employed migrant domestic workers (MDWs), you may also consider encouraging other caregivers to sign up for caregiving courses.
Dementia and Driving Safety
Driving can represent independence and freedom for a person. One of the first concerns caregivers have when a loved one is diagnosed with dementia is whether or not he or she should drive. While it may seem like an easy and automatic activity for frequent drivers, safe driving is a complex task which requires a range of cognitive abilities,1-4 such as:
Advance Care Planning
Advance Care Planning (ACP) is the process of planning for one’s future health and personal care. Having ACP conversations will allow your loved one with dementia to:
Share their personal values and beliefs with the family
Explore how his/her values and beliefs influence their healthcare preferences in difficult medical situations
Delegate a trusted member/relative to make healthcare decisions on their behalf, should he/she be unable to one day
Ideally, discussions about the person living with dementia should take place as early as possible, while your loved one with dementia still has the capacity to make informed choices and decisions.
Making Festive Celebrations Dementia-Friendly
Festivities are typically a time for joy and celebration across all cultures. However, it might present as a stressful time for both caregivers and persons with dementia due to a disruption in their usual routine. Here are some practical tips on how you can make the time an enjoyable one for all family members.
Deputyship
A deputy is appointed by the Court to make decisions on behalf of a person who lacks mental capacity when the person has not made a Lasting Power of Attorney (LPA) and has no donee to decide on their behalf in respect of those decisions. A deputy can be an individual or a licensed trust company under the Trust Companies Act (Cap.336), as prescribed by the Mental Capacity Regulations. Deputies must submit annual reports to the Office of the Public Guardian (OPG) to explain the decisions and expenses they made on the person’s behalf.
K.I.N.D. Gesture and C.A.R.E. Approach
There are many scenarios where persons living with dementia may face difficulties and require assistance. The K.I.N.D Gesture and C.A.R.E Approach can help us to remember what to do and be more confident when interacting and assisting persons living with dementia, especially in situations where they may appear to be lost.
Tips on Taking Public Transport for Persons with Dementia
Public transportation is a common mode of transport for people in Singapore. This does not change even with the onset of dementia. Having easy access to transportation enables persons living with dementia to stay connected to their friends, families, and community. It also provides access to healthcare service locations, such as the hospital.
Talking to Children about Dementia
A family member’s dementia impacts the entire family, including children. Parents might wish to shield young children from the reality of their loved one’s condition, but it is best to broach the topic with them soon after the diagnosis. Children are often able to sense tensions in family dynamics arising from your loved one’s diagnosis of dementia and may be able to adjust better to these changes if they are informed.
Providing Namaste Care at Home
As a person living with dementia increasingly faces challenges in communication as their condition advances, what can help us to better communicate and engage them in daily activities at home? Namaste Care might just be the answer to support them in everyday care.
Improving Eating Environment & Appetite
While it is essential to pay attention to the nutritional aspects of a meal by providing regular, healthy and balanced meals, another important aspect of meals for persons living with dementia is the eating environment. As eating is a social activity, creating a comfortable dining atmosphere can help boost the appetite of a person living with dementia.
Financial Schemes
Caring for a person living with dementia requires careful financial planning, and may sometimes require the family of the person living with dementia to tap on financial resources. There are a number of government financial schemes available.
Making Your Home Dementia-Friendly
Persons living with dementia may face challenges navigating the physical environment, due to loss of orientation, sensory acuity, visual-spatial awareness, and mobility. Changes in their sensory system may reduce their tolerance towards environmental stimuli, such as sound levels, lighting, activity and people. For some persons living with dementia, the lack of sensory stimulation and occupational deprivation results in ill-being, leading to loss of self-worth and self-identity.
What Is a Dementia-Inclusive Environment?
Why Is a Dementia-Inclusive Environment Important? While dementia already presents a set of challenges for persons living with dementia and their families, stigma and discrimination worsen the psychological, social, emotional and financial impacts on them, such as social rejection, financial insecurity, internalized shame, and isolation.2 Similarly, with the rising prevalence of dementia in Singapore, where one in 10 people aged 60 and above is diagnosed with dementia, these ramifications are relevant and of growing concern for the nation with an aging population.
Doll Therapy & Dementia
Doll therapy is a psychosocial intervention that aims to meet psychological needs of persons living with dementia. What is Doll Therapy? Doll therapy is a non-pharmacological intervention that aims to reduce the behavioral and psychological symptoms of dementia (BPSD) that a person may experience.
Psychosocial Interventions in Dementia Care
Psychosocial interventions is an umbrella term for a wide range of non-pharmacological interventions, activities, therapies, strategies, etc. that aim to promote the psychological and social well-being of individuals. People may be introduced to psychosocial interventions to cope with the challenges of living with disabilities, mental health conditions, etc., or when they need that support to get their lives back on an even keel. There are many types of psychosocial interventions, which include all psychological therapies, psychoeducation programmes, support groups, etc.¹
Cognitive Stimulation Therapy
Cognitive Stimulation Therapy, or in short, CST is an evidence-based, non-pharmacological intervention (NPT) for persons living with mild to moderate dementia.1,2 It was developed by Dr Aimee Spector, a clinical psychologist, in 1998, by reviewing the common non-pharmacological therapies for dementia, such as reality orientation and reminiscence therapy. The most effective elements of the different therapies were then combined to create the CST.
Creative Dance
Dancing can be a form of expression for persons living with dementia too, as they connect and interact with others through dance. Read on to learn about Creative Dance, another potential psychosocial activity to support the well-being of persons living with dementia. To complement the modest benefits of pharmacological treatment on cognitive decline in dementia, arts-based programmes have been increasingly used as a non-pharmacological approach to delay the effects of dementia.1,2
Interest-based Activities for Caregivers
What if we could combine caregiver support activities with their interest to acquire new skills? Dementia Singapore has done just that! The Caregiver Support & Network (CSN) is a refreshing and new programme launched in December 2020 to better support a caregiver’s needs and well-being.
Employment for Persons with Young-onset Dementia
Work plays a central role in our lives, providing us with a sense of fulfilment, personal development, and income. There are many decisions to make about employment for persons with young-onset dementia, including whether or not to tell your employer, what changes could be made to the workplace and how long to continue working.
Advance Medical Directive
An Advance Medical Directive (AMD) is a legal document signed by a person in advance, informing their doctor that they do not want any extraordinary life-sustaining treatment to be used in the event that they become terminally ill and unconscious.
Lasting Power of Attorney (LPA)
What Is the Lasting Power of Attorney?
As dementia progresses, persons with this condition will have increasing difficulty with judgment and problem solving. You may notice that they might be less able to make sound financial and healthcare decisions. The Lasting Power of Attorney (LPA) is a legal document that allows a person (a donor) to appoint one or more persons as donee(s). Donees are persons who have the authority to make decisions and act on the donor’s behalf should this person lose their mental capacity. The donor must be at least 21 years of age and have the mental capacity to voluntarily make this appointment, should he/she lose the capacity to make his/her own decisions.
Experience Dementia in Singapore (EDIS)
What is in a Day of a Person Living With Dementia? Step into the shoes of persons living with dementia using the Virtual Reality (VR) application Experience Dementia in Singapore (EDIS). Dementia is a degenerative condition where symptoms worsen over time. By creating an enabling environment and adopting a person-centred approach in managing the condition, the lived experience of a person living with dementia can be greatly improved. EDIS presents the following scenarios to illustrate the challenges of a person living with dementia, and suggests how you, families, and communities can support their enablement.
Namaste Care Programme
Nature & Background
Namaste Care programme is a structured intervention for persons living with advanced dementia, which incorporates sensory intervention, social contact and environmental modification. It aims to respect the individual person for his or her unique personhood, nurture the individual spirit with meaningful activities using a loving touch approach, within a calm and home-like environment.
Participatory Arts
Participatory arts involve persons living with dementia and caregivers in their development, creation, and evaluation processes. Introduction Persons living with dementia gradually experience a decline in mental processes, including memory, orientation to space and time, and abstract thinking. The decline in cognitive skills may lead to social withdrawal and difficulties in communication.
Tools for Dementia Practice and Research
With the rising incidence and prevalence of dementia worldwide that is projected to continue, more efforts have been invested to address the needs of persons living with dementia and individuals around them. One such effort is the development of assessment tools and instruments in the field of dementia care.
Encouraging My Loved One to Accept Their Condition
It can be difficult to accept a dementia diagnosis, and understanding the reason behind the denial is important to coming up with strategies to help your loved one. Receiving a dementia diagnosis can be harrowing—it’s normal for the person who has been diagnosed to feel a range of negative emotions, from sadness to frustration, or even outright denial.
Encouraging My Client to Accept Their Condition
It can be difficult to accept a dementia diagnosis, and understanding the reason behind the denial is important to coming up with strategies to help your client. Receiving a dementia diagnosis can be harrowing—it’s normal for the person who has been diagnosed to feel a range of negative emotions, from sadness to frustration, or even outright denial.
What is Young-Onset Dementia?
Young-onset dementia refers to any type of dementia that develops in persons below the age of 65. Symptoms of dementia may present themselves differently in a younger person, as compared to dementia in older adults. It is a myth that dementia affects only older adults. Over 50 million people worldwide live with dementia in 2020, and this number is expected to increase to 82 million in 2030 and 152 million in 2050.1 Approximately 5% to 6% of the number is young-onset dementia, amounting to around 3.9 million people living with young-onset dementia as of 2021.2
Tips to Manage Dementia Medications
Most persons living with dementia are able to manage their own medication in the early stages of their condition, but may find it more difficult to do so as their dementia progresses. Consuming the wrong combination, dosage or forgetting to take their medicine on time may put them at serious risk. It is, thus, important that both persons living with dementia as well as their caregivers are equipped with the basic skills for effective medication management.
Pharmacological Management of Dementia
Though non-drug measures are usually the first-line approach to address the symptoms of dementia, medications are still important in the treatment of dementia. Presently, there is no cure for dementia. Although slight improvements or stabilisation of symptoms can at times be seen, these ultimately do not cure or prevent the disease or restore mental health. There are, however, drugs that may help improve mental function, mood or behaviour and slow down the symptomatic progression of the disease.
Treatments for Dementia
Caring for a person living with dementia involves many things. These include the use of both medications and psychosocial interventions (such as engagement and environmental changes to suit the person). Care plans should integrate both these kinds of treatments when addressing the factors that affect the condition of a person living with dementia. These include biological, psychological, and social factors. Though non-drug measures are usually the first-line approach to address the symptoms of dementia, medications are still important in the treatment of dementia.
Recreational Activities
What Are Recreational Activities?
Recreational activities are activities that people participate in for leisure. These are activities that are meant to engage persons living with dementia and are not specifically intended to meet therapeutic outcomes. Recreational activities differ from activities done for the purpose of therapeutic outcomes, such as activities done as therapeutic activities or psychosocial interventions. These non-recreational activities aim to meet therapeutic goals, such as the improvement of cognitive or emotional conditions, and tend to be more structured.
Physical Exercises
Physical exercise has positive effects on the wellbeing of persons living with dementia, whether the exercise is done for recreation or as therapy. It can be done as the main focus of an activity, or as part of other activities that involve a heightened level of physical movement, such as gardening or dance.
Managing Urinary Incontinence
Urinary incontinence is a common problem in dementia. As the disease progresses, your loved one may become less aware of their toileting needs and urinate unconsciously. Deterioration may lead to urinary tract infection, an enlarged prostate gland, drinking too much caffeinated beverages, impaired mobility, and constipation.
Managing Constipation
Constipation is common in persons living with dementia given their reduced awareness, and especially those who are older persons who may be relatively immobile. Poor food, fibre and fluid intake may also cause constipation. Constipation is a source of discomfort, and can worsen confusion and agitation. It also makes passing urine more difficult and can cause urinary retention.
Additional Resources for Other Behaviour Changes
1. Talking Point | CNA Insider
Looking after a loved one living with dementia can be frustrating. In this episode of Talking Point, it provides you with some tips on what to do when you face the following 3 scenarios – when your loved one living with dementia:
Refuses to bathe
Forgets that he/ she has eaten and keeps demanding for food
Accuses you or others of stealing
Dementia-Friendly Neighbourhoods
This article lists some examples of neighbourhoods in Singapore, where adjustments have been made to address the needs of persons impacted by dementia. These examples feature the adaptation of different aspects of the environment, including the physical and social environments, to aid wayfinding and support the wellbeing of persons living with dementia.
Managing Wandering Behaviour
Many persons living with dementia feel the urge to walk about and in some cases leave their homes. Though it is sometimes termed as “wandering”, it is rarely ever aimless. Persons living with dementia may simply not remember where they had set out to go, or what they had intended to do.
Managing Sundowning
What Is Sundowning?
Your loved one living with dementia may display behaviour changes particularly in the evening which include agitation, aggression, confusion and restlessness. This is known as sundowning and often occurs in the moderate to severe stages of dementia.
Mealtime Behaviours
Persons living with dementia may sometimes refuse to eat. They may become angry, agitated, or challenging to feed during mealtimes. This can happen for a variety of reasons:
Disliking the food
Feeling rushed
Feeling uncomfortable with people or the environment
Feeling frustrated with the difficulties they are having
It can be challenging to identify what the actual problem is, particularly if they have difficulties communicating. It is important to remember that these reactions are not deliberate.
Managing Agitation & Aggression
At some point, your loved one living with dementia may behave aggressively, display an outburst of emotions, or act angrily towards individuals around them. Find tips to managing these behaviours.
Helping a Person with Dementia Who Lives Alone
Persons living with dementia, especially in the earlier stages of dementia, may choose to live alone to maintain their independence for as long as possible, or to remain in a familiar neighbourhood. As the dementia progresses to moderate and advanced stages, it is likely that alternate living arrangements have to be made. Here are some tips for you if you are a care professional working with persons with dementia who live alone.
Helping Your Loved One Who Lives Alone
Persons living with dementia, especially in the earlier stages of dementia, may choose to live alone to maintain their independence for as long as possible, or to remain in a familiar neighbourhood. As the dementia progresses to moderate and advanced stages, it is likely that alternate living arrangements have to be made. Here are some tips for you, as a caregiver, on how you can offer care to your loved one with dementia who lives alone.
Supporting Activities of Daily Living
As the condition of persons living with dementia progresses, their abilities to perform Activities of Daily Living (ADLs) deteriorate as well. ADLs refer to routine activities which most persons have learned to perform from young and usually do on a daily basis without any assistance.1 However, due to dementia, individuals gradually become unable to perform these daily routines.
Designing a Daily Routine
Persons living with dementia often feel confused and disoriented, especially when their memories begin to blur and their functions start to deteriorate. Your loved one living with dementia may have difficulties in performing his/ her usual tasks as their condition progresses. Designing a daily routine is a good way to provide them with some structure. Planning activities they enjoy can be helpful in reducing agitation and improving their mood.
Sharing Caregiving Responsibilities: Gathering the Family
A family discussion on sharing caregiving responsibilities can be very helpful when your loved one has been diagnosed with dementia. Some families may think it is taboo to discuss concerns revolving around dementia, but it is important for family members to be clear that the family discussion is about honouring your loved one’s preferences and wishes.
Dementia Progression & Behaviour Changes
The progression of dementia comes along with changes in persons living with dementia:
Abilities in Activities of Daily Living (ADLs)
Behaviours
Cognitive Function
Orientation to People, Places and Time
Dementia progression and its corresponding behaviour changes require the appropriate response from caregivers.
With the necessary information and resources at hand, you will be better equipped to respond to these changes while providing care for persons living with dementia.
Apply CAUSEd to Understand Behaviour Changes
The CAUSEd problem-solving tool is designed to encourage caregivers and care professionals to understand the behaviours of persons living with dementia as a form of communication with their social and physical environments. In turn, caregivers and care professionals can identify the possible triggers for the behaviours, and minimize the impact of behaviours by developing and implementing support strategies.