Minimizing Confusion in the Dementia PatientMinimizing confusion in the dementia patient can make the caregiver's job much easier. Confusion in the dementia patient is common. Someone suffering from dementia forgets many things including where they are, why they are there, and who they are with. Confusion is a natural emotion to feel in this situation. Unfortunately, the dementia patient doesn’t have the ability to help themselves to work through this emotion. They will often panic and become afraid which makes helping them very difficult. There are ways to minimize confusion so that your loved one can remain more in control of their surroundings and of their emotions, but realize that the confusion that is very much a part of the dementia patient’s world will make even familiar things hard to remember. While there may come a time in your loved one’s life that you must take control of their living arrangements and routines, every little thing you can do to minimize the confusion before that time comes will help. Keep in mind, though, that no matter what you do, you can only minimize the confusion in the dementia patient. It will not go away. You will still have to deal with the memory loss and other emotions, including confusion, which your loved one may experience. Changes to Their EnvironmentIf at all possible keep the dementia patient in their own home. At home they know their way around. They know where the bathroom is, where their room is, and where to find the bed linen. They may temporarily forget these things at times, but deep-seated habit can often compensate for the memory loss.Our Mom was able to stay in her own home until a month before her death when she had to be admitted to the hospital. At home she knew where her chair was, which side of the bed was hers, and where to find her clothes. She couldn’t always remember what to do with each of these items, but just knowing that the surroundings were familiar helped her to remain more calm. When she would be in a public place she often became agitated and anxious. Even when visiting my (Paula’s) house, which she was very familiar with, she was always “ready to go home.” It may become necessary to move the dementia patient to your home or to the home of another family member. If so, move as many of their belongings with them as possible. Even putting your own things in storage for a while and moving their furniture to your home can help them to feel more comfortable and less confused. If many of their personal things are suddenly missing the dementia patient may accuse you of stealing them. They may even think that you have kidnapped them and are holding them hostage. Having their own furniture, family pictures, artwork, and knickknacks around them can minimize this confusion. It is a good idea to not rearrange the furniture in a dementia patient’s home. They rely heavily on habit when getting around and suddenly having a sofa in their usual path could cause them to have an accident. One change to the environment that may help them, though, is to remove clutter. Our Mom was a pack rat. She loved stuff! At one time her bathroom counter had several tubes of toothpaste, bottles of lotion, pieces of jewelry, brushes, combs, and many other items that didn’t even belong in the bathroom. We cleared out the clutter and left just her toothbrush, toothpaste, and brush. This helped her to focus on what needed to be done while she was doing her daily grooming. Minimizing Confusion When Changing Their RoutineWe all develop habits in our life. We get up, make the bed, brush our teeth, fix the coffee, scramble a couple of eggs, make some toast, read the paper, and on and on it goes. The dementia patient is no different. They may have done the same thing every morning for the past 30 years. It’s their routine.But if filling the coffee pot and using the stove are now too dangerous for them they will need to change their routine. Or should we say their routine will need to be changed for them. As much as possible let them do what they are used to doing and only make changes when there is a safety issue. An easy way to effect these changes is to do the job for them before they have a chance to do it themselves. If they come out of their bedroom and find a plate of eggs and toast and a cup of coffee waiting for them then they will probably not fuss about not being able to make the food themselves. This, of course, will require you to get up earlier than they do. Trying to explain to a dementia patient that they can no longer safely cook or take a walk or any number of other activities by themselves can lead to much frustration. Do not try to reason with a dementia patient. They will not understand and will often become defensive and possibly angry. The best way to minimize confusion while changing their routine is to actively participate in the changes. Your actions will produce the desired results (a plate of food, safety while walking down the street, etc.), while gently transitioning that area of independence away from the dementia patient. If it is necessary for your loved one to move into your home try to accommodate their routine instead of forcing them to immediately fit into your routine. It will be confusing enough for them to live in unfamiliar surroundings without also suddenly having to change everything about their lives. Changes to Lifestyle May Cause ConfusionBut as much as you can help them to keep parts of their familiar past, there will be changes that must take place that may not happen easily. Driving and the freedom to go outside alone are two big challenges that must be dealt with.As confusing and difficult as these changes in lifestyle may be they are necessary for the safety and well-being of your loved one. Driving can present obvious safety issues. The confusion and lessened muscle tone that are symptoms of dementia can make reaction times slow. And, of course, there is the added danger of getting lost. Our Mom had a prior back injury that caused her to need some powerful pain medication. She couldn’t drive while taking the medication so getting her to stop driving was an easy transition, but that may not be the case if your Mom has to give up her driver’s license. The ability to drive signifies a lot of things: freedom, independence, the ability to make your own decisions. Paula had a teenager who was just getting his license about the same time our Mom was giving up hers. Jeremiah was rejoicing in his newfound freedom while Mom was learning how to depend on friends and family members to take her where she needed to go. Not an easy thing to do! There are many factors that need to be considered when ending a loved one’s driving privileges and we will cover them on another page of this site. If your loved one loves the outdoors they may insist on going outside. But they may go out the front door and down the sidewalk and not remember how to return to the house or even remember that this is their house. For a dementia victim to wander away from home is especially dangerous because they can get very confused and disoriented and get very lost. Because they are an adult a stranger may not approach them to see if they are okay as someone normally would with a child who is lost. And the dementia patient may not have the ability to communicate that they are lost or even to remember their own name. One way to minimize the confusion of them not being able to go outside by themselves is to install a second door knob high up on the door and keep it locked. Disable the original doorknob, but leave it in place. The dementia patient will try the doorknob and when it doesn’t work they will often assume it is broken and walk away from it. This tactic can help, but if they ever do get outside it is imperative that they have proper identification on them identifying them as a dementia patient. Registering with the Alzheimer’s Association Safe Return program is one way to provide this identification. If being outdoors is important to your loved one be sure to provide time for this activity in your daily or weekly routine. Walking around a lake, feeding the ducks at the park, and strolling down the street are all good ways to enjoy the fresh air and sunshine as well as provide some much needed exercise for both of you. Minimizing Confusion at MealtimesMealtimes can become challenging. Our Mom only wanted to eat corn! If she was given a plate of food she would often dump the whole thing all over the table or into her lap. It was hard for her to balance food on her fork and bring it all the way to her mouth. For these reasons it is often easier to serve finger foods at mealtimes.Keep the table cleared of clutter and use solid colored plates. Creating a place setting of a solid colored place mat and plate that contrast with each other and contrast with the color of the table will make it easier to identify their own plate. And serving food that contrasts with the plate color will help them to distinguish the food from the plate. Turn off the radio and the television and, if possible, keep the number of people at the table to a minimum. A large, noisy crowd can become distracting and cause the dementia patient to either not eat or to make a mess at their place. It also helps to have a mealtime routine. Serve meals at the same times and the same place each day. Have the food prepared before the dementia patient arrives at the table. In the early and middle stages of Alzheimer’s the patient may still be able to serve themselves from the serving platter, but if this becomes a problem then have all the plates prepared before they arrive at the table and leave the serving dishes in the kitchen. Avoid giving choices that require the dementia patient to do abstract thinking. Say “Would you like a piece of toast?” instead of “would you like toast or a muffin?” Simple yes or no questions are much easier to answer. It is important to find a balance between simplifying things and also respecting the emotions of the dementia patient. Help them to remain as independent as possible for as long as possible. This web page is far from complete. There are many other tips and techniques to use to help minimize the confusion in a dementia patient’s life. We will be adding to this page or adding additional pages to this site with even more information on minimizing confusion. Get a FREE Copy of Our Ebook!
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