Considerations for Going to the Hospital with Someone with Dementia

Blog, Health

Growing old includes visiting the hospital more often, but when dementia becomes part of the picture, the experience might get a little bit more difficult. Ironically, hospitals can be considered dangerous for people with dementia since they are not necessarily adapted to their particular needs, but it is a must for the family and caregivers to make this experience as least stressful as possible. This is what you need to consider:

 

Packing

Family members and caregivers have to be prepared for all circumstances. Make sure to pack important papers and documents such as the patient’s ID and health insurance cards, contact information, consent treatment wills, etc. Include lists of patient’s particular needs, medicines being taken, allergies, healthcare providers’ phone numbers, etc.

You can also pack snacks and bottles of water, cash, toiletries, extra clothing, objects to keep them distracted, etc.  Although many of these things could be found easily in hospitals, it is better to keep them on hand to make the visit more bearable, and so the patient never has to be left alone.

 

Emergency Room

The ER can be very scary for a person with dementia and can be very stressful for the person taking them there. One of the best things to do is to never go by yourself. Always ask someone else to accompany you. That way you could walk around the hospital and have the other person watching the patient.

The first thing to mention to the ER staff is that this a dementia patient. Be ready to explain how to approach them and what took you to the ER. Stay calm and be patient so you don’t become another stressful factor for the person with dementia.

 

Going to Hospital

Hospitalizations are common and might occur more than once with a person with dementia. It is good for them to have a private room so they can have their own space to feel calm, but it still is an unknown place without their familiar objects and commodities. Keep in mind that they are being exposed to an unfamiliar place, filled with people and strangers approaching to touch them with needles and other objects that could scare them.

It would be good to have a family member or someone they know and feel comfortable with to be with them at all times and to tell doctors and hospital staff how to talk to the patient or do it as little as possible. It would also be good to keep clothes and personal objects out of sight since they can remind them of their home and make them want to leave, which can cause distressed behavior.

 

Hospital staff

Although hospital staffs are used to working with people with different medical needs, it is better not to assume they are familiar with the specific ones for a person with dementia. It is likely that they know how to deal with people with dementia, but it is important that you provide specific details and information about the patient so they can address their requirements in the best way possible.

You can create an information sheet where you detail their routine, habits, signs of discomfort, if this person tends to wander too much, what upsets them, how to reduce and control distressed behavior without medications or control measures, and other details that might be helpful.

If you want to learn more about what to do when taking someone with dementia to the hospital, don’t forget to buy the book “10 Helpful hints for when a person with dementia has to go to the hospital.”

Understanding People with Dementia: The 3 Types of Delirium

Blog, Health

Like any other disease, dementia can become very complicated at certain moments, and it is important that caregivers and family members have knowledge and are well informed about what these situations could be like and what can they carry. Delirium is one of the most common but most stressing events a person with dementia can face.

Delirium is a state of mind in which the person suffering it loses all notion of reality.  It is characterized by illusions, confused thinking, changes in their behavior, and difficulty speaking and recognizing the environment. Symptoms could begin within a few hours or could take a few days to appear. They could be intermittent and generally get worse during the nights since objects are less recognizable in the dark.

There are three types of delirium, and they are all characterized by changes in the patient’s ability to stay focused and aware. Still, each of them has its own characteristics:

 

Hyperactive delirium

Also known as “confusional state with agitation,” it is the easiest to recognize. Patients could act restlessly and become more anxious, their mood could change rapidly and could often hallucinate. This type of delirium is often confused with dementia. It is important to know that dementia develops slowly over time, and delirium happens abruptly and unexpectedly. If it occurs that delirium is mistaken for dementia, it means that the patient loses an opportunity to address the episode with therapy.

 

Hypoactive delirium

Hypoactive delirium, as opposed to hyperactive, is characterized by inactivity and drowsiness. Patients seem to be hypnotized or sedated, move slowly, and barely respond to social interactions. This type of delirium is often mistaken for depression and tends to be ignored because of its calmed characteristics. It is important not to let this delirium go unnoticed since it brings worse consequences and is more difficult to recognize than hyperactive delirium.

 

Mixed delirium

Mixed delirium includes the symptoms of both hyperactive and hypoactive delirium, which show up intermittently, which means that episodes can come and go, or increase and decrease in intensity and severity.

It is important that a medical evaluation is carried as soon as possible to reach an accurate diagnosis and know how to treat the patient. If you want to learn more about delirium, its causes, and consequences, ways to prevent it, or more details about delirium studies, don’t forget to buy our book “Delirium – 2nd edition.”

These are the 5 Rules Every Designer Must Know to Create Spaces for People with Dementia

Blog, Design

People with dementia have very specific needs, and their environments have to be adapted to fulfill them. Whether designing homes or facilities, or even gardens and outdoor spaces for people with dementia, there are certain rules that every designer must follow. These are five that we consider are vital:

 

1. Create spaces for community integration

It is healthy for people with dementia to be integrated into their neighborhood and relate to people. Encourage socialization by designing spaces to invite people over to interact and share moments together.

 

2. Make patients feel at home

Keeping a decorative style which people with dementia are used to is going to help them feel and recognized themselves. Their room’s or home’s furniture and decoration must be comfortable for the patient.

 

3. Encourage brain activity

Colors and objects are beneficial to stimulate the brain of a person with dementia. It helps them as guidance to know where they are or where to go, and as a reference to identify what things are or what they mean. Stimulating their brain will help decrease dementia symptoms and slow down the degenerative process.

Also, environments have to be calmed and easy to digest to make them feel stable and relaxed.

 

4. Create wide open spaces

It is important, both for the patient and the caregiver, to be able to see each other from anywhere in the room.

In order to feel comfortable, patients have to be able to process the whole environment that surrounds them. Large rooms with big windows connected to open hallways are going to give them visual access to important objects and spaces.

And for caregivers, it is essential always to know where their patients are and to be positioned comfortably to keep an eye on them.

 

5. Create places for distraction

Whether indoor or outdoor, it is important that people with dementia have a safe and unique space to distract themselves. A place where they can do simple activities like playing table games, sewing or knitting, or anything that they enjoy doing, but that they can identify and relate this particular places to a certain activity.

There are many more rules that need to be considered and applied when designing any type of space for a person with dementia, and there are also many helpful tools and resources of which designers could benefit a lot when taking part in a project. If you want to learn more about these tools, don’t forget to buy the book “Dementia Design Audit Tool” by the Dementia Service Development Center.

7 of the Best Books for Dementia Design you Must Read

Blog, Design

If you are interested in improving your knowledge about dementia design, these are the seven books that must be in your library:

 

Design features to assist patients with dementia in general hospitals and emergency departments

This book describes the design principles, key features, and particular challenges every designer, architect or anyone involved in dementia building design and construction must follow and overcome to ensure that hospitals and emergency departments are adapted to the needs of people with dementia.

It is part of a series of books published by the Dementia Services Development Centre.

 

Designing outdoor spaces for people with dementia

Supported by research, this book is meant to provide profound information about the design of outdoor spaces for people with dementia in different environments such as towns, cities, gardens, patios, and more.

It was edited by Pollock, A. and Marshall, M, and received 5 stars in a Nursing Times review.

 

Design for people with dementia: an overview of building design regulators – England edition

This book provides information about legislation, regulations, standards, inspection and enforcement powers of building design for people with dementia in England

 

Designing mental health units for older people: features to assist patients with dementia and delirium

This books details features of a dementia-friendly design as well as directions to how to create appropriate environments for the interventions that patients with dementia typically undergo. It also helps to understand the impairments and disabilities an elderly patient with dementia and delirium faces.

 

Designing balconies, roof terraces and roof gardens for people with dementia

This book is meant to advise how to create outside spaces that are not located on the ground or first floor of the building. It details practical ways to take advantage of these spaces and adapt them for people with dementia.

It is part of a series of books published by the Dementia Services Development Centre.

 

Designing interiors for people with dementia – 4th edition

This is an assisting tool for guiding designers and architects to create and accommodate spaces in order to take care efficiently of people with dementia in an appropriate environment, whether a care facility or at their own home. It details aspects of indoor architectural and design elements that have a significant impact on the patient.

 

10 Helpful hints for dementia design at home

This is an easy-to-read book that provides guidance and design solutions to bring commodities and adapt the environment to the needs of a person with dementia, to let them have a little independence in their own home. It is destined for carers and family members that worry about having the right tools for taking care of their patients.

It received 4/5 in a Nursing Standard review.

Consider This When Designing Homes for People with Dementia

Blog, Design

One of the most important things to do when someone is diagnosed with dementia is to adapt their environment to their new needs. We may think that a better choice would be to transfer them to a special facility where they could be taken care for, but what we sometimes forget is that they would feel more comfortable in their own home. The solution is, then, to make the appropriate arrangements in their house

 

Start with the minimum

When a person is diagnosed with dementia, it is better not the remodel their home altogether, but instead, make the right arrangements to keep them safe and secure. Their home has to remain essentially the same, but include few changes that go unnoticed and do a lot.

 

Design with endurance and to last long

People with dementia can become emotionally unstable and sometimes react in unexpected ways that could harm them and damage objects around them. It is important that these objects are soft enough not to hurt anyone but also durable enough to be hard to break. Protective surfaces and impact resistant walls are features that could be included in any home.

 

Kitchens have to be safe and fun

The kitchen is one of the most important spaces of a house. The phrase “the kitchen is the heart of every home” is commonly heard in any country, and it speaks the truth. The kitchen is a space that allows people to share special moments while cooking, which can be a therapeutic activity. It can be a place for therapy and for creating homelike atmospheres that bring positive impacts on a patient’s brain.

A well-adapted kitchen for people with dementia has to be open to moving around comfortably. It has to have many places to sit comfortably, tools that should not be touched must be placed out of reach, and home appliances have to be easy to use.

 

Bathrooms have to provide independence

Bathrooms have to provide support and let them feel more independent. Since these are very private places, it might be possible that they don’t feel comfortable with someone assisting, so it would be better to accommodate the bathroom in a way that they could clean up on their own.

Showers cubicles have to be easy to get in and always have grab rails. They could also include additional lighting. The bathroom can feature a mirror, but it is important to consider a way of covering it or hiding to avoid a person with dementia who no longer recognizes their reflection to be confused and distressed.

 

Include assistive technology

Assistive technology is always helpful in any home. Wheelchairs and scooters can help taking a person from one place to another without much effort. Sensors and alarms can help to keep track of water, gas, lighting, and temperature of the house. Or even smaller things such as medication dispensers with alarms can help a person remember when to take medicine.

If you want to learn more and find amazing tips about home designing for people with dementia, don’t forget to buy the book “10 Helpful hints for dementia design at home” by the Dementia Services Development Centre.

3 Important Legal Issues that Must Be Addressed after Dementia Diagnosis

Blog, Legal

When someone is diagnosed with dementia, health issues take the spotlight. We worry a lot about our elders’ mental health that we forget to deal with fundamental legal issues that are just as vital as health and must be addressed with the same efficiency. Addressing these issues at the very first stages of the disease means getting ready for the future, and preparing for a moment in which this person will no longer think consciously nor be able to make legal decisions without support.

 

1. Consent to treatment

When facing a health issue, we as patients must be able to make medical decisions. The inability to make decisions by oneself is called impaired capacity, which is very common in patients with dementia. The law protects patients with impaired capacity and created a series of procedures and safeguards to let patients give consent to medical treatments or interventions on their own. However, as dementia worsens, it affects the mental capabilities of the patient, reaching a moment in which they can’t give valid consent. To be ready for this moment, it is important that patients designate an attorney or a guardian that makes all decisions on their behalf.

 

2. Advance care planning

Advance care planning is a way to make your health treatment decisions and preferences known in advance. It allows to stipulate what kind of treatments or interventions the patient feels comfortable with and which ones they don’t want to undergo, whether they want measures to extend life to be applied and for how long or to be let go smoothly, or if they would like to donate their organs after death. Patients can leave a written statement in which they declare how they want to be treated before they become unable to make decisions or pass away.

 

3. Wills

Wills are designed to decide in advance what is going to occur with personal assets, like belongings, money, and properties, after death. This is an excellent way to make sure a person’s wishes are fulfilled when they are gone, there are help guides for seniors to choosing their plans & wishes before the time comes, so family aren’t left planning and paying for everything. The patient can write it on its own, but it’s better if they receive help from a solicitor, who then will also sign it to make it legal.

What matter the most is that people with dementia can exercise their rights, make plans and make decisions on their own before they can no longer do so, to make sure everything is carried according to their preferences. If you want to learn more about legal issues and the rights of people with dementia, don’t forget to but the book “10 questions about the law and dementia in Scotland” by the Dementia Services Development Centre.

Understanding People with Dementia: How to Respond to Distressed Behavior

Blog, Health

Confusion can lead anyone to act irrationally, and this occurs commonly in people with dementia. Distressed behavior is a typical characteristic of the condition and it is essential to know how to identify its causes and how to respond to it. Screaming, rudeness or any exalted attitude is a sign of distressed behavior, and they can be caused by frustrating situations, a scare, a problem of communication, depression and many other different causes. Whenever a person with dementia is acting this way, this is how you should respond:

 

Avoid arguing

Remember that people with dementia can no longer think logically nor rationally, so arguing with them can worsen the situation.  It is better to leave the room to relax and then come back.

 

Don’t take it personally

Again, people with dementia don’t think rationally. They might say things that seem personal or intentional, but the truth is that they are not thinking what they are saying nor notice if they are being rude or hurtful.

 

Encourage communication

The reason why this person is distressed might be that there is something they want to communicate but can’t find the way to do so. Maybe they are in pain or want to ask for something in particular, and they will try to express it through their behavior.

 

Have respect and empathy

Understanding is the only tool that is going to help anyone deal with a person with dementia. Understanding their emotions are going to help feel empathy towards them and respect them. It is important always to treat them right and the way they deserve, with support and love.

 

Consider drug treatments

Sometimes, levels of aggressiveness can reach high, and they can become dangerous for themselves and anyone around them. If nothing helps to calm down a person with dementia, then it is good to consider using medications, always prescribed by a doctor.

If you want to learn more about how to respond to distressed behavior in people with dementia, don’t forget to buy the book “Supporting people with dementia: understanding and responding to distressed behaviour.”

Image source: visual.ly

3 Tips to Make Interiors Comfortable for People with Dementia

Blog, Design

A care facility for people with dementia has to be adapted to its patients’ needs. Caregivers have to understand how people with dementia see the world and move on it to be able to offer the best help they can. These are a kind of patients that require a lot of attention and have particular necessities, so it is important that everything that surrounds them accommodates to them. Here are four tips to create comfortable spaces for residents of a dementia care facility:

 

1. Areas for wandering are a must

One of the biggest characteristics of dementia patients is that they tend to wander around quite often. As we cannot control them, wandering is a must in their lives, but it can put them in dangerous situations. It is important to accommodate the furniture in a way that it does not block their path and leads them back to where they started. Doors they should not pass can be painted the same color as the wall, so they don’t notice them.

 

2.  Use objects to make them feel comfortable

It has been proven that objects help triggering memories and make connections with important parts of their lives. Personalize their space with familiar objects to make them feel at home. This will also help them stay calmed and relaxed.

Also, objects can help them make connections with simple actions and give them a sense of stability and order. Particular and identifiable objects like statues, big clocks, pianos, bookshelves, etc., can help them recognize where they are and what to do there. For example, a picture that attracts their attention located in a dining room can help them understand that that is the place for eating. They establish a connection between the picture and eating.

 

3. Avoid confusing and contrasting objects, walls and floors

The brain of a person with dementia understands things literally, so it is important to avoid mixed signals in anything that surrounds them. If wallpaper looks like a sky but when they approach it there isn’t more space in front of them, and instead it feels hard – because it is a wall- they can feel stressed and confused.

Floors have to be the least contrasting in their environment. It is better to keep the same flooring type all over the place and avoid having different patterns in hallways and rooms since these changes could make it hard for them to step into new places.

If you want to learn more about how to design interiors for people with dementia, don’t forget to buy the book “Designing interiors for people with dementia – 4th edition” by Liz Fuggle.

Understanding People with Dementia: 5 Tips for Caregivers

Blog, Health

Dealing with dementia is hard either for the person suffering it and everyone who surrounds them. It is important that caregivers and family members learn to deal with specific situations typical of the disease. Understanding this fact is key to making the caring process more bearable. Here are five tips for anyone that carries this task.

 

1. Accept their reality and go along with it

The main thing to understand is that people with dementia have a brain disorder which they cannot control or change, so the only solution is to go along with it. As we cannot change their inside world, the only thing left is to adapt the external world to their needs and their reality. Someone with dementia might think they have to do something they don’t have to like maybe they have an appointment with a doctor. It is better to ask them about the appointment, who the doctor is, and let the conversation flow.

 

2. Arguing doesn’t help

The person might begin saying things that are not true and making up stories. This can be very frustrating and our natural instinct is to correct them or argue with them, but it is simply impossible to convince someone with dementia that they are wrong, and arguing can lead to more stressful situations. People with dementia can no longer think logically, so it’s better to remain calmed and, as we mentioned before, go along with it.

 

3. Be affectionate

Dementia can make someone feel confused and anxious. It is very easy for them not to know the difference between what is real and what is in their head. When this happens, it is important to evaluate what feelings they are demonstrating and respond with affection and support.

 

4. Do some brain exercises

Though it does not cure dementia, doing brain exercises can slow down the deterioration of the brain and reduce its symptoms. With this kind of diseases, brain health becomes a top priority. Also, physical exercises and engaging in stimulating activities can also be beneficial.

 

5. Study their behavior

Every action is triggered by something and has a purpose. This means that their behavior happens for a reason and is trying to fulfill a need. Changes in their conduct can be caused by changes in their environment or something someone did or said, and then, their following actions would be directed towards responding to a particular need. It is important to observe what caused that behavior and what need they are trying to meet, so we can adapt their environment and make them feel comfortable.

If you want to learn more about taking care of people with dementia, don’t forget to buy the book “10 Helpful Hints for Carers: practical solutions for carers living with people with dementia,” edited by Professor June Andrews and Professor Allan House.

Image source: dailycaring.com

Consider these Facts about Heating and Lighting and How They Affect People with Dementia

Blog, Health

Heat and light can be key factors that affect the health of someone suffering dementia. As we are dealing with elders, they are more prone to develop sight loss and become more sensitive to temperatures. Here are some considerations to take into account when exposing people with dementia to heat and light.

 

Regarding heating…

 

Elders might not feel the heat

When aging, the body no longer transpires nor regulates the body temperature, meaning that they don’t notice if they are overheating, and sometimes they overdress. It becomes more problematic when it comes to someone with dementia and non-verbal because, even if they do feel the heat, it will be very complicated for them to communicate it. It is important to pay attention to this and make sure they dress with fresh clothing and wear natural fibers.

 

They can dehydrate easily

Temperatures can rise suddenly and unnoticed, and exposure to exteriors raises the chances of being affected by those changes. People with dementia can easily dehydrate or suffer heat stress, which worsens dementia symptoms and could lead to a deadly stroke. It is better to avoid going outside during the hottest hours of the day or having long walks under the sun.

 

Some medications might interfere

Consider that some medications like antipsychotics that are often given to dementia patients can cause the body lose control over heat regulation. In these cases, it is good to encourage people to drink more water and avoid strong fluids like tea or coffee.

 

Regarding lighting…

 

Light compensates poor eyesight

As we age, we begin to lose our sight, so it is important that everything around is adequately illuminated to compensate for the eyesight loss. Specially, people with dementia need it to find things around them easier.

 

Natural light is a better option

Our eyes are designed to use natural light, which explains why this is the best option for people with dementia and sight loss. Natural light reaches more areas than artificial light and exposes color and contrast that make objects more distinguishable. It is important to take as much advantage of natural light as possible in every part of the home.

 

Artificial lighting has to be intense and uniform

Natural lighting is ideal but, sadly, it doesn’t last the 24 hours. So the goal with artificial lighting is to imitate natural one as much as possible. The intensity of the light can vary depending on the person’s preferences but interiors have to be able to reflect it and let it reach every corner. However, it does have to be uniform in every room of the house since people with sight loss have harder times adapting to changes in illumination.

If you want to find out more about how heating and lighting affects people with dementia, and also learn to implement improvements in their care, don’t forget to buy the book “10 Helpful hints on heating and lighting for people with dementia and their carers.”