Daily routines provide us with a sense of control over our hectic existences, and are even more potent for people suffering from dementia.
People suffering from memory loss “thrive on familiarity,” says Holly Hart, L.V.N., director of residential health services at Claremont Manor, a CCRC in Claremont, Calif. “Familiar faces, a familiar environment, even familiar food—anything they can use as a touchstone.”
This comforting sense of familiarity is so helpful because dementia gradually impairs a person’s ability to plan, initiate and complete an activity.
People with dementia experience greater difficulty when attempting to do new things, according to Jed Levine, executive vice-president and director of programs and services for the New York City Chapter of the Alzheimer’s Association.
But, a predictable routine can prevent a person with dementia from becoming distracted and forgetting what they were doing.
Even if there is little or no conscious awareness of time, routine helps ground them.
A daily agenda may even be able to help a person with Alzheimer’s cope with the short-term memory loss that is typically one of the first things to be affected by the disease.
Hart posits that establishing a predictable pattern of events can help transfer the schedule of a daily routine into the long-term memory portion of the brain, helping a person retain their ability to perform activities of daily life, such as brushing their teeth or fixing a snack.
Tips for starting (and sticking to) a routine
When coming up with a regular routine for someone with dementia, the overarching goal should be to tailor it as much to your loved one’s preferences and past activities as possible.
For example, Levine recounts the story of one caregiver who was forced to put her dementia-stricken mother in an assisted living community. Living in assisted living was extremely stressful and anxiety-producing for the older woman, until her daughter suggested the staff give her mother a New York Times newspaper on Sundays.
Though Alzheimer’s had diminished the older woman’s ability to understand the articles as she used to, the paper helped by giving her a benchmark with which she could establish a sense of time. “On some level, she was aware it was Sunday and, once she got the paper, she calmed down and enjoyed reading the various sections,” says Levine.
The more you can include activities that resonate with your loved one’s pre-dementia life, the better. Did they have a favorite television program that they liked to watch at a certain time? Did they enjoy listening to a particular radio talk show? Did they always meet up with their friends for a game of checkers on Sunday nights?
Levine offers suggestions of other, more generic, activities that are also important to include in a daily routine:
Medication administration
Meal times
Toileting
Bathing/showering
Brushing of teeth and hair
Leisure activities
Exercise
The more you can schedule, the easier you’ll make things for you and your family member with dementia.
Sticking to the plan while going with the flow
Once a daily procedure is established, Hart says it’s important to try and follow it as often as possible.
Disruptions in daily routines (such as those caused by holiday visits to other family members’ houses) can elevate your loved one’s anxiety and make it harder for them to get back to a normal schedule once the disturbance is over.
Of course schedules will change, depending on doctor’s appointments, unexpected illnesses, an elder’s changing mood, and the progression of their disease.
In these instances, Levine says caregivers should, “remain flexible and go with the flow, do not insist on routines if the person with dementia is resistant.” Try to learn how to recognize when your loved one is becoming agitated or stressed by a routine, and then modify the schedule to fit their changing needs.
Taking care of a loved one with dementia is a continual process of trial and error. One day, your loved one might enjoy going for a midday stroll in the park, the next day they may not even want to set one foot out of the door.
That’s why both Levine and Hart echo that cardinal rule of family caregiving: make sure you look after your own needs, not just the needs of your loved one.
“Caring for a relative with dementia is difficult and challenging, and most people are not prepared for it,” says Levine. “It’s critical that the caregiver learn how to care for themselves.”