Techniques for Living with Someone with Alzheimer's Disease

Content provided by the Faculty of the Harvard Medical School
Excerpted from a Harvard Special Health Report

Communication

  • Use simple phrasing and short sentences, but be careful to avoid talking to the person as if he or she is a child.

  • To get the person's attention, begin by using his or her name.

  • Be patient. Give someone with Alzheimer's time to complete a sentence or thought, and try not to interrupt.

Bathing

  • Follow the person's old routines as much as possible.

  • Prepare everything in advance.

  • Lay out towels, soap, shampoo, and clothes. Have the water ready and at the right temperature before bringing him or her into the bathroom.

  • Avoid discussing whether a bath is needed. If the person refuses to get into the tub or shower, be flexible and suggest an alternative. If all else fails, try again later.

  • Be calm, gentle, and reassuring. If the person seems disturbed at this invasion of privacy, cover portions of his or her body with a towel.

  • Encourage him or her to do as much as possible without hands-on help. Talk through each step.

  • Check the skin for rashes and sores. Use powder, cornstarch, or body lotion on dry skin.

  • Safety tips: Use rubber tub mats, tub seats, grab bars, nonslip bathmats, etc. Do not use bath oil or products that make the tub slippery. Put razors and electrical appliances out of reach. Take the lock off bathroom doors.

Dental care

  • Prepare the toothbrush and demonstrate how to brush.

  • If the person will not brush and refuses assistance, try a foam applicator or a cloth moistened with mouthwash.

Dressing and grooming

  • Consider the person's past grooming habits, but keep grooming simple to avoid frustration.

  • Avoid forcing the person to choose what to wear. Remove clothes that are out of season or seldom worn.

  • Try to establish a routine in which you help the person dress at the same time each day.

  • Select simple clothing the person can manage easily without assistance. Avoid buttons, hooks, snaps, and ties.

  • Lay out clothing in the order that it should be put on.

  • Safety tips: Avoid shoes with slippery soles, pants or dresses that are too long or full, and long or full sleeves that may catch on doorknobs or furniture.

Mealtimes

  • Playing with food may be a signal that the person has too many choices. Put one utensil on the table and one food on the plate at a time.

  • Reduce sensory confusion at meals: Make sure the area is well lit. Use a plate color that contrasts with the food. Remove condiments from the table.

  • Eliminate distractions. Make sure the person is comfortably seated and doesn't need to use the bathroom.

  • Cut food into small pieces. If he or she chokes easily, switch to soft foods. Curved spoons, divided plates, and straws can make self-feeding more manageable.

  • Serve foods containing fiber to help prevent constipation.

  • Safety tips: Don't serve food or drink that is too hot. Remind the person to eat slowly and chew each bite thoroughly. If eating nonfood items becomes a problem, keep things like dog biscuits and flower bulbs out of sight.

Toileting

  • Put a colorful sign or reflective tape on the bathroom door to make it easy to find.

  • Buy slacks and pants with elastic waists, which are easier to manage than snaps and buttons.

  • Keep a diary of when the person urinates and has bowel movements, and remind him or her to use the bathroom at these intervals. Restlessness or agitation may indicate bladder or rectal fullness.

  • Help the person get into a comfortable position on the toilet.

  • If the person has trouble urinating, have him or her blow bubbles through a straw in a glass of water.

  • Restrict fluids two hours before bedtime. A portable commode or urinal bottle at the bedside may be helpful.

  • Use incontinence aids such as disposable briefs, pads to protect furniture, and condom catheters for men.

  • Try to be calm and understanding when accidents occur.

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More than 5.3 million people in the United States are living with Alzheimer's disease, with a new person developing the disease every 70 seconds. Americans ages 65 and older with Alzheimer's and dementia pay three times as much in health care costs.