Dementia

Dementia care options

Friends and family - having clear and regular communication from the outset can help. Some people find it helpful to hold family meetings at the beginning and as the individual’s needs change, so that support can be discussed and shared.

Community help - There are many different types of help available from various places. It’s good to start with contacting your local Alzheimer's NZ branch, Age Concern, Carers NZ or your local Bupa care home. Your GP or medical specialist is also a valuable source of information and help.

Types of help can include:

  • Home care workers to help with personal care such as washing, dressing and putting someone living with dementia to bed at night.
  • Day programmes may be available at a local care home.
  • Private care: you may be able to arrange private domestic or personal care support through a nursing or home care agency.
  • Respite care: a short break for the person living with dementia in a local care home.
  • Home care like help with household tasks like washing, ironing and vacuuming.

Community care assessment – Each District Health Board has a Needs Assessment and Services Coordination team (NASC) who provide in home care assessments. Your GP can refer you or you can content them directly.

Helpful equipment – If you are caring for someone living with dementia, one major cause of concern and stress you may have is the fear of them wandering and becoming injured. To help manage this, you can place discreet sensors at strategic points in the home. These will automatically raise an alert if activated, and can be a huge help for you to get a good night’s sleep. To find out more, visit our medical alarms section or phone us on 0800 60 80 99.

Considering a care home - We recommend you look at suitable care homes for someone living with dementia if:

  • It’s unsafe for them to be alone.
  • They need increased physical support from a carer.
  • They are needing more care than the carer is able to provide.
  • They’re becoming confused or frustrated to the point of being upset or distressed.

At our care homes, we provide personal care in a comfortable and safe setting. We give ample opportunity to take part in activities, make new friends and offer peace of mind for all. Usually, people prefer to be gradually introduced to a care home. Most Bupa care homes offer day programmes, respite or short-term stays. Here, you’ll find a map of our care homes that provide dementia care.

For more information, download the Understanding Dementia booklet for advice on everything from different types of dementia, through to tips on caring for someone living with dementia, thinking about a care home and taking care of yourself in your role as a care

Everyone’s experience of dementia will be different, so it can be quite unpredictable. It’s important to know that if you are looking after someone living with dementia you are not alone and that there are people and organisations who can offer support.

As the mental abilities of your loved one declines, they may begin to feel vulnerable and in need of reassurance and support. You can help by making sure that they retain their sense of identity and self-worth and keep them as fit and healthy as you can.

Below is some practical advice for day-to-day living on a variety of useful subjects. Remember, if you need more help you can talk directly with our experienced dementia nurses on 0800 DEMENTIA (0800 336 368).


Below you will find some information that may help in your day to day routine and activities. We have included some tips for the following: 

  1. Eating
  2. Dressing
  3. Grooming
  4. Washing
  5. Using the bathroom
  6. Relationships
  7. Body language
  8. Behaviour
  9. Keeping active
  10. Calm time
  11. TV and radio
  12. Help from family and friends
  13. Equipment that can help
  14. Other specialist equipment
  15. Community help
  16. Assessment for community care and assistance
  17. Memories matter
  18. Get to know the person in your care
  19. Collect your memories
  20. Coping as a carer
  21. Being a friend
  22. Considering a care home
  23. Dealing with guilt
  24. Care options
  25. Partners in care

Eating

As time passes, cooking will become increasingly difficult for your loved one. Managing appliances, remembering cooking times, recognising food and remembering when they’ve eaten are a few things that are affected by declining concentration, memory and judgement.

The main thing to focus on is that your loved one enjoys their food and eats a healthy, well-balanced diet.

Quick tips to help your loved one with dementia eat and drink:

  • Allow plenty of time; meals should be relaxed and unhurried.
  • Remove distractions like television or radio noise.
  • It’s better to concentrate on offering favourite foods your loved one will enjoy.
  • If a meal you prepared isn’t eaten, try not to get annoyed. Simply ask why, there may be a simple reason.
  • If your loved one is agitated or distressed, wait until they are calmer before offering food or drink.
  • Be mindful of hot drinks, they may not be able to judge temperature.
  • Serve small portions. You can always serve more if you need to.
  • Plain plates make it easier for your loved one to identify the food on it.
  • If there’s difficulty with cutlery, you can help with prompting by guiding their hand to their mouth.
  • Finger foods are great for when coordination becomes tough.
  • Describe the food you’re offering your loved one to help remind them of tastes and flavours.
  • Eat with your loved one. It may help them to copy your actions, like using a knife and fork.
  • Leave snacks such and fruits and biscuits around the house to eat.
  • A wipe-clean tablecloth makes any mess much easier to clean up.

Dressing

Keeping your loved one involved with getting dressed and undressed for as long as possible is a great help with their sense of identity and dignity. Once they do require assistance, do offer it tactfully and sensitively.

Quick tips to help support your loved one with dementia dress and undress:

  • Allow plenty of time so you’re not rushed.
  • Offer simple choices like, “Would you prefer your red jumper, or your blue jumper?” Too many options might be confusing.
  • Remember to keep mistakes in perspective; does it really matter that their buttons aren’t fastened correctly, or that their top doesn’t go with their skirt?
  • Lay clothes out in the order they should be put on.
  • If your loved one requires instructions on how to dress, keep them short and simple.
  • Try to maintain little memory triggers like jewellery they like to wear or if they keep a handkerchief in their pocket.
  • Changing fastenings from buttons and zips to Velcro and elastic makes things easier.
  • Label different drawers and cupboards with names and pictures of the clothes inside them.

Grooming

Appearance is important to us all, and is likely to still be important to you loved one. You can prompt them, for example by handing them a hairbrush to brush their own hair. Extra bits are important too; a woman may like to wear makeup, perfume, jewellery or have her nails painted and a man might like to use aftershave or a hair product.

A trip to the hairdresser or the barber is good as it could be something your loved one did regularly that they recognise and enjoy. As dementia progresses, you may want to organise for a hairdresser or manicurist to come to the house.

Quick tips to help your loved one with dementia groom themselves:

  • Explain to your loved one what you’re doing at each stage. Imagine how frightening it’d be if someone came toward you with scissors and no explanation.
  • It’s good to keep them involved with decisions. But offer simple options like choosing between two nail colours.
  • If your loved one is enjoying it, make the experience as pleasurable as possible by offering a scalp or hand massage.
  • Remember the toenails. Overly long or neglected toenails are painful and make it difficult to walk.
  • If your loved one is being looked after someone else, like a hairdresser, make sure you use the time to relax.

Washing

Your loved one has carried out their personal hygiene activities for years. Needing help can be embarrassing and awkward for you both. It’s important to keep their independence for as long as possible in this instance. Talking with your loved one about their feelings and preferences helps. Try to find out what they can still do themselves and exactly what they need help with.

Quick tips to help your loved one with dementia wash:

  • Encourage you loved one to continue with their routines for as long as possible.
  • Supporting them to do as much as they can, like drying, helps to preserve their dignity and independence.
  • It’s good to keep them involved with decisions. Ask your loved one if they’d like bubble bath or not.
  • Explain everything you’re doing. Imagine having your head unexpectedly doused in water.
  • If you’re washing hair, a hand-held showerhead may work best.
  • Check the bathroom floor isn’t slippery.
  • Make sure the room is warm before they undress.
  • Be mindful that the water temperature isn’t too hot or too cold.
  • Making light of any awkwardness may make you both feel better.
  • Thorough drying is crucial to prevent sores or chaffing. Allowing them to sit for a while in an absorbent towel or bathrobe can be helpful.
  • If your loved one spends a lot of time sitting or lying in bed, check for pressure sores or red areas while they’re undressed.
  • Be organised. Having everything you need on hand before you start avoids unnecessary stress.
  • As dementia progresses, washing becomes more about hygiene than appearance. So if your loved one doesn’t wash every day, it’s not the end of the world.

Here’s some equipment you might find useful:

  • Grab rails to help get in and out of the bath.
  • Handrails installed on the wall near the wash basin, shower or toilet.
  • Non-slip mats in the bathroom and shower.
  • Seats to go into the shower.
  • Raised toilet seats.

Most of us consider the bathroom a private place. It’s understandable that your loved one may be unwilling for you to undress or bathe them. You too may feel uncomfortable. Allowing a little privacy could help both of you. Try doing some of these things:

  • Leave the room while your loved one gets undressed or put them into a dressing gown as you walk with them to the bathroom.
  • Only uncover the part of the body that you’re washing to help overcome embarrassment.
  • Let your loved one step into the bath wrapped in a towel.
  • Install a thermostatic valve so they can run their own bath without scalding themselves.

Using the bathroom

Continence problems and needing assistance with using the toilet can be distressing for you and your loved one. Controlling these urges is something we learn to do from a very early age and losing that ability can feel like a dramatic loss of control and dignity.

Continence problems tend to arise if your loved one forgets where the toilet is, has mobility issues, depression, difficulty arranging clothes or mistaking other items, such as bins, for the toilet.

Quick tips to help your loved one with dementia use the toilet:

  • Leave the toilet door ajar so your loved one may see inside.
  • Remind them where the toilet is. A picture of a toilet on the door can be helpful.
  • Installing handrails makes getting on and off the toilet easier.
  • Make sure clothes are easy to undo. Velco makes a convenient replacement for zips and buttons.
  • Moist toilet tissues make wiping a lot easier.
  • Make sure the toilet is well lit and warm.
  • Regularly remind your loved one to go to the toilet.
  • Watch for signs that your loved one needs to use the toilet, like fidgeting or pulling at clothes.
  • Generally, a person needs to urinate every three to four hours. Encouraging your loved one to go more often than this can lead to bladder control problems.
  • Try to establish a routine of going to the toilet before getting dressed or going to bed.
  • Make sure your loved has plenty to drink during the day, but reduce fluids in the evening.
  • If the toilet is upstairs or difficult to get to, a commode as a last resort could be useful. 

Relationships

As time passes and the illness progresses your relationship with your loved one will change. You may experience a range of feelings, including bereavement; a sense of loss for the person that you once knew, for the relationship you once shared or for their companionship and understanding. At times you may feel overwhelmed by sadness or anger or you may feel unhappy or resentful for the impact on your own life.

Feelings like these are normal. If you experience them, remember that you could be under a huge amount of stress and in need of emotional support too.

Quick tips to help your relationship with your loved one with dementia:

  • Don’t bottle things up. Talk about your feelings to friends, family or even others dealing with the same experience. The Carers NZ website has an array of information, help and advice you may need.
  • Take time out. Having a quick chat or a cup of tea with a friend each day will help you cope.
  • If you’re feeling particularly low, make sure that you see your GP.

Changes to the way your loved one responds to you can also be difficult. They may not remember the things you do for them, or your last visit. They may say or do things that you find extremely hurtful. You should remember:

  • Try not to take it personally. They’re probably feeling confused and frightened.
  • Write down visits and outings that have happened and when the next ones are.
  • Use labelled photos of family members and regular visitors. Photos of people at younger ages may be easier for your loved one to recognise in the later stages of dementia.

The whole family can be affected by the challenging situations that dementia creates. While you may want to protect younger members from the situation, it’s important that you explain what’s going on. Approaching this honestly and reassuringly may help encourage them to talk about their own feelings.

 


Body language

As dementia progresses, your loved one may become increasingly confused and hardly able to speak at all. But language is only one form of communication.

Reading facial expressions and body language can hint toward how they’re feeling. Using angry gestures and being unwilling to do something or smiling and being calm may be their way of communicating.

Difficulties with communication can be upsetting and frustrating for your loved one and for those around them. There are lots of ways to help you understand each other.

Quick tips to help communicate with your loved one with dementia:

  • Listen carefully to them and get their full attention before you speak.
  • Use physical contact; hold their hand where appropriate.
  • Speak clearly, slowly and simply.
  • Don’t bombard them with lots of questions.
  • Show respect and patience, not frustration or annoyance.
  • Try to laugh with your loved one about misunderstandings.

Behaviour

Your loved one may experience changes in behaviour as dementia progresses, including a loss of self-control and inhibitions. Aggression, hurtful comments, threats, pinching or lashing out at people or objects are not uncommon and can be very distressing for both of you.

Working out the cause of their behaviour is helpful. It’s unlikely to be the disease that’s causing your loved one to be difficult. Think about whether your loved one may be feeling:

  • Frustrated: do they want to do something and are unable to do it?
  • Anxious: could they be feeling insecure and worried?
  • Misunderstood: are they trying to follow habits of a lifetime even though the time and place may be inappropriate?
  • Annoyed at being unable to make themselves understood.
  • Feeling intruded upon in regards to private actions, such as going to the toilet or bathing.
  • Startled by a sudden approach.
  • Pain or discomfort.
  • Frightened or confused.

Quick tips to help deal with the behaviour of a loved one with dementia:

  • Don’t take it personally; consider what they’re thinking or experiencing.
  • Ask them questions to help you understand.
  • Don’t react, be aggressive or loud in return.
  • If it’s safe to do so, leave the room or give them space.
  • Don’t tell your loved one of their failings or mistakes because they will neither recall or believe.
  • Don’t dwell on the situation and don’t punish your loved one for their behaviour.
  • Provide lots of reassurance by talking, hand-holding or cuddling if appropriate.
  • Never engage in confrontation or contradiction.
  • Minimise using ‘should’, ‘must’ and ‘have to’ as these create pressure and conflict.

If you’re worried about your loved one’s behaviour, a referral to a specialist, such as a psychiatrist, community psychiatric nurse or psychologist specialising in older people who will provide advice and support.

 


Keeping active

Being active together is beneficial to both you and your loved one. It’s a great way of relieving stress, encouraging feelings of happiness and improving your overall wellbeing.

Quick tips on keeping active with your loved one with dementia:

  • Walking, even short ones are a great and adaptable way to exercise.
  • Swimming can be calming and soothing.
  • Local classes that you and your loved one can attend may be available.

It may be important to your loved one to continue with social and community activities they already enjoy. Perhaps they've always gone to church, liked going to the pub or attending a community group. Your loved one may feel quite daunted at the prospect of activities, but if it is what they've always done, you should encourage them to continue without being too forceful.

 


Calm time

You might find it helpful to include activities that allow you to spend calm, peaceful time together. Knitting, model making and painting are good examples, or you may prefer watching sports or movies together, listening to music or simply reliving old memories.

If your loved one finds it easier to talk about the past or there are items they enjoy reminiscing about, you could keep them together in a box to use when there’s a lull in conversation. Younger relatives or old friends might also enjoy doing this with them to give you a break.

Always remember, whatever you do it’s about just enjoying the activity together.

 


TV and radio

Your loved one may still enjoy watching television or listening to their favourite radio station. However, as they become less able to concentrate and their short-term memory deteriorates, they may find it confusing and distracting.

Your loved one could lose the ability to tell the difference between what is real and what is on screen, and can become distressed. Too much noise can also be confusing to your loved one.

Quick tips on using TV and radio around your loved one with dementia:

  • Try turning the TV and radio off, particularly when your loved one is doing other things.
  • Try different stations, such as finding old movies, history programmes, or a golden oldies radio station.
  • Try watching television together, choosing programmes with small sections of action or humour.
  • Try DVDs or CDs of programmes or music from their younger days.

Help from family and friends

It’s usually helpful to keep regular communication with family and close friends. This could be done through phone calls or by holding a get-together so issues can be discussed and shared. This can assist in sharing the burden and prevent feelings of guilt or resentment towards the people you're closest to.

Encourage family members to bring old photos or objects to prompt memories and shared reminiscences.

If your loved one finds it distressing to spend time with other family or friends they no longer recognise, they can still help in other ways such as shopping or cooking.

 


Equipment that can help

One major cause of concern and stress you may have is the fear of your loved one wandering and becoming injured. To help manage this, you can place discreet sensors at strategic points in the home. These will automatically raise an alert if activated, and can be a huge help for you to get a good night’s sleep. 

Bed occupancy sensor
This sensor is inconspicuous and goes underneath the mattress. It’s programmed to alert you if your loved one has left their bed and not returned in a pre-set amount of time (like 10 minutes for a bathroom visit), or hasn’t got out of bed after a certain time in the morning.

Pressure mat sensor
This can be placed in a range of locations, like at the front, back or bathroom door, in front of a favourite chair or beside the bed. Once pressure is detected, you’ll know if your loved one has entered or exited a particular area in the house.

Property exit sensor
Triggered by opening a door, this alerts you if your loved one is exiting a room or leaving the house.

To find out more, visit our medical alarms section or phone us on 0800 60 80 99.

 


Other specialist equipment

There’s a wide range of equipment available that you may find useful with daily living. The things you or your loved one will need will vary as the dementia progresses, but could include:

  • Memory joggers such as notice boards, large or talking clocks.
  • Mobility aids such as wheelchairs, walking frames, stair lifts or hand rails.
  • Continence aids such as raised toilet seats, bed pans, commodes and pads.
  • Washing aids such as walk-in or sit-in showers, bath seats or hoists.
  • Specialist cutlery, cups or crockery to help your loved one feed themselves for as long as possible.
  • Medication aids such as tablet boxes with sections for each day of the week and times of the day.
  • Devices to control the temperature of hot water and restricted flow taps.

Your Needs Assessor or GP can make a referral for these.

 


Community help

As dementia progresses, your loved one may not know what care they need or be resistant to community help. In which case, help may be accepted more easily if it's introduced in the earlier stages of dementia.

There are many different types of help available from various places. It’s good to start with contacting your local Alzheimer's NZ branch, Age Concern, Carers NZ or your local Bupa care home. Your GP or medical specialist is also a valuable assistant.

Types of help can include:

  • Home care workers to help with personal care such as getting your loved one up in the morning, washing, dressing and putting them to bed at night.
  • Day care may be available at a local care home.
  • Private care. You may be able to arrange private domestic or personal care support through a nursing or home care agency.
  • Respite care: a short break for your loved one in a local care home.
  • Home care like help with washing, ironing and vacuuming.

Assessment for community care and assistance

Each District Health Board has a community needs assessment team that is responsible for assessing the needs of people who may require care services. They approve publicly funded services and can help you to get assistance from private agencies and volunteer services.

Your GP can refer you for a needs assessment or you can <contact the service directly>. This assessment is carried out in your home so the needs assessor can see as much as you can. 

There is sometimes a charge for certain care services and to arrange for those services your loved one often has to have their finances assessed.

 


Memories matter

Your loved one’s memory will gradually deteriorate as dementia progresses. They’ll struggle to remember what’s new and what’s just happened. While their recent memories fade, those from the past will remain relatively well-preserved.

Resurrecting memories and reminiscing is an important way of communicating and bonding. Thinking now about how much you know about your loved one will help you to capture their memories and achievements.

 


Get to know the person in your care

Do you know what your loved one’s most cherished memory is, where they were born or what their nickname was at school?

The closer your relationship is with your loved one, the more you’re likely to know about them. Knowing their preferences and perceptions will become even more important as their dementia increases.

Do you know:

  • What food they like the most?
  • What their favourite song is?
  • What their favourite activity/hobby is?
  • What they consider their biggest achievement in life?
  • What they most value in people?
  • What annoys them most?
  • What their favourite childhood memory is?
  • What place in the world they would most like to visit?
  • What makes them laugh?

Collect your memories

To help your trip down memory lane, you may want to start collecting things by using a scrapbook or keepsake box to keep your loved one’s achievements and memories.

Here are some useful tips for compiling your loved one’s memories:

  • Do they have any certificates, trophies or medals that they’re proud of?
  • Are they a hoarder of keepsakes? Perhaps they have letters, concert programmes or birthday cards that are special to them.
  • Ask what they were good at when they were at school? Do they still have school reports or school work in their possession?
  • Ask them if they were ever a collector, or perhaps they still are? It could involve stamps, magazines or coins.
  • Ask to see family albums and copies of photographs that reflect your loved one’s life milestones, like a new house, a wedding or the arrival of a much-loved pet.

Some interesting facts about memory:

  • Research suggests that women have memories from earlier in their lives than men.
  • 60% of our top memories date from when we’re aged between 15 and 30 years-old. This is known as the ‘Reminiscence Bump’.
  • Memories triggered by scent have a stronger emotional connection and therefore appear more intense than others.

Coping as a carer

It’s really important that you care for yourself, whether it’s because you’re also leading your own life, wanting to provide the best possible care to your loved one or planning for the time when you no longer care for them primarily. You don't have to cope alone. There are many sources of help available. 

The simple things are important:

  • Getting enough rest.
  • Eating well.
  • Taking breaks from caring.
  • Fresh air and exercise.
  • Support from others to ease pressure, frustrations and general ability to cope.
  • Checking whether you’re entitled to benefits.

You’re entitled to a carer's assessment to identify ways you can be helped.

The Carers NZ website has an array of information, help and advice you may need.

 


Being a friend

Below are seven ways to be a great friend to a loved one with dementia:

  1. Respect and patience are hugely important
    By remembering that the disease isn't their fault, you may find it easier to be sympathetic and patient. Try to be positive and let them know how important they are to you.

    “It’s nice to be treated like everybody else and not feel separated.” 
    - John, living with dementia

  2. Be a good listener
    Make time to listen carefully and allow your loved one time to explain. Dementia makes it harder to process information and communicate. Often they just need a chance to express how they feel, rather than looking for practical solutions. 

    “You need to let the person think. The answers don’t come as quickly as they used to.” 
    - Leslie, living with dementia

  3. Communicate clearly and calmly
    Taking time and making eye contact can make a big difference to a conversation. Wait for signs that your loved one has understood you. Non-verbal communication is very important too, especially if they’re losing their language skills.

    “Because I forget quite quickly what people have said, I tend to get off track. I like it if the person brings me back.” 
    - John, living with dementia

  4. Little things mean a lot – stay in touch
    Losing touch with friends can have a huge impact. Keep in touch, even in a small way; it shows you care. If you can’t be there, a postcard, letter, email or text can still let someone know you’re thinking of them. Brief and frequent is better than a long letter twice a year.

  5. Offer practical help
    Helping your loved one tackle something on their “to do” list or running an errand could be useful. If they’re dependent on a carer at home, giving that carer some time out is good.

  6. Organise a treat
    We all like to be spoiled; it leaves us with a nice feeling and a welcome break from everyday routine.

  7. Help different family members in different ways
    Different family members will be affected in different ways, from emotional to practical impacts. A caring ear or helping hand can often be very welcome.

Considering a care home

We recommend you look at suitable care homes for your loved one if:

  • It’s unsafe for them to be alone.
  • They need increased physical support from you.
  • They’re becoming too much for you to look after.
  • They’re becoming confused or frustrated to the point of being upset or aggressive.

At our care homes, we’ll provide your loved one with personal care in a comfortable and safe setting. We also give ample opportunity to take part in activities, make new friends and offer peace of mind for all.

Here, you’ll find a map of our specialised dementia care homes.

 


Dealing with guilt

Thinking about moving your loved one into a care home is possibly one of the hardest, most distressing decisions you’ll ever have to make. At this point, you may be feeling a lot of emotions and just need time to come to terms with the decision.

It’s very common to feel guilty, anxious, relieved or worried. It’s important not to be too hard on yourself as this a completely natural reaction. You need to remember, what you’re doing for your loved one is what’s best for them right now. Talk to our carers, your GP, family and friends for moral support, but what you may need most is time to adjust to this transition.

 


Care options

Usually, people prefer to gradually introduce their loved one to a care home. Most of our care homes offer day care, respite or short-term stays. These options are great for giving you both a break. Respite can be anything from a few days to a few weeks.

If your loved one is in the later stages of their illness, our long-term residential care will provide them with the personal care, comfort and companionship that could improve their quality of life.

 


Partners in care

Our philosophy is person-centred care, which means we’ll get to know your loved one and find out their likes and dislikes so that we can provide individualised care and make them feel more at home.

You can help our carers a lot. Your personal knowledge coupled with our care experience makes for a great team to provide the best care for your loved one.

When your loved one moves to one of our care homes, bring along someone who knows them well. Also, let your loved one express their own views and feelings, even if they weren’t what you were expecting, and try not to contradict them. If necessary, you can share your personal understanding with our carers after the meeting or in a letter.

Together, we’ll sit down and write a personal care plan that includes your loved one’s needs, preferences and abilities. We’ll regularly review the care plan together as their needs change.



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