Caregiving

More to Dementia than Memory Loss
Dear Mary, The doctor says my mother has dementia. I understand that the dementia makes her forgetful, which is why I moved her in with me, my wife and children. But she is constantly trying to get out of the house and says she wants to go home. Even in the middle of the night, she wanders all over the house. Would it help to post signs up at the doors reminding her that she is home? More to Dementia than Memory Loss
Dear Reader, Memory loss is only one aspect of dementia. Wandering is very common and can be caused by many factors.
Individuals with dementia wander when in an unfamiliar setting or when the setting is overwhelming. Constant noise, such as from a television left on, can be overstimulating and individuals may search for a safe, quiet area.
Persons with dementia are often searching for something, although they may not remember what they are searching for. They may be looking for the bathroom or for something to eat. Oftentimes, they wander because they are bored or because they are reacting to old memories, such as going to work or to the grocery store.
Wandering in itself is not necessarily bad, as long as the individual is in a safe environment. Ensure there are no safety hazards in the house (scatter rugs and extension cords she could trip over) and make sure the house is well lit. If you have stairs, put a gate at the top to prevent falling.

Make sure that she is unable to unlock the doors to go outside; you may need to put a deadbolt toward the top of the door. You can also add door knob safety covers on outside doors. Sometimes a dark-colored floor mat in front of the door will deter someone with dementia from venturing out.
In addition to living with her dementia, the move to your home has added to her confusion. Wanting to go home is also a common expression and a desire for safety and familiarity. Instead of correcting her and trying to orient her to the current living situation, go “home” with her by asking about her memories. What kinds of flowers did she grow? What was her favorite room?
Dear Mary, My father-in-law moved in with us after his wife died. He had been diagnosed with dementia within the past year but had been functioning quite well when his wife was the caregiver. Now, however, he seems to have lost interest in doing anything for himself, including bathing. That has become a big issue. His body odor is terrible and he wears the same clothes for a week or more. My husband is uncomfortable with the whole situation, and I just don’t know how to deal with it.
Dear Reader, The loss of you father’s-in-law wife and his home may be contributing to depression, in addition to his diagnosis of dementia. Please let his physician know what behaviors you are noticing so a determination can be made if medication may help him through this tough time.
Bathing often becomes an issue of individuals living with dementia. While many physicians recommend older adults shower or bathe at least once a week to reduce the risk of infections, there are many different avenues we can use to provide hygiene care. In your father’s-in-law situation, it might be helpful for your husband to encourage his father to bathe with your assistance behind the scenes.
Rather than make an issue out of bathing, be matter-of-fact in the presentation — “It’s Friday, Dad. Let’s wash up before we go get pizza.” Make sure the bathroom is warm and is ready with towels, soap, and water already at the right temperature. Have his clean clothes ready. If your father-in-law is able to wash himself, allow for privacy. Follow up this routine with positive reinforcement.
I recently spoke with another caregiver who experienced a similar situation. She hired a home care worker who was able to get her father into a hygiene routine with very little resistance. If this is a situation that neither you nor your husband are comfortable to tackle, you may want to look into hiring some in-home assistance.
Mary Chaput at the Department of Aging and Disabilities in Annapolis, MD