One of the main things people fear when they receive a diagnosis of Alzheimer’s disease or another form of dementia is the inevitable loss of independence and control over their world. If you’re caring for a person with dementia, daily routine is one of the most useful tools you can use.
Why Routine is Important for Dementia
In the early stages of the disease, daily routines help people living with dementia navigate their world in a predictable way and add a sense of order to their days — something that becomes even more important as they lose awareness of time. Plus, since routines are stored in long-term memory and dementia usually affects short-term memory first, routines often remain accessible even into the middle stages of disease.
Because they struggle with short-term memory loss, people living with dementia find it difficult to learn new ways of doing things. They may struggle to remember instructions or to stay focused for more than a short time. Daily routines help people with dementia cope with these signs of short-term memory loss by engaging them in activities that are familiar. Since they know they’ll eventually lose the ability to do many everyday tasks, continuing to do these things for as long as possible becomes especially important. It reinforces a sense of independence, builds self-esteem, and can even help them retain skills longer.
Another significant advantage of daily routine for dementia patients is a reduction in anxiety. As the disease progresses, people living with dementia tend to become increasingly frustrated with their loss of cognitive and physical abilities. Routines can help them face the day with a greater sense of peace and security, which helps lessen agitation and troublesome behaviors.
No less important is the fact that establishing daily routines can help decrease stress for caregivers. By creating an environment and routine that are more predictable, days often go more smoothly. And when the person with dementia is less agitated, there are more opportunities for moments of joy and connection.
Tips for Developing a Daily Routine
Following are some helpful tips and strategies you can use to develop a daily routine when providing dementia care to someone you love.
- Tailor routines to their preferences. This is not the time to try to introduce significant changes in their world. Keep routines in line with what the person with dementia has done for most of their life. For example, if they always brush their teeth before breakfast or always have ice cream after dinner, maintain that routine.
- Stay flexible. Recognize that, as the disease progresses, abilities will change. It’s important to remain flexible and adjust the routine to accommodate these changes while also continuing to let your loved one do as much as they’re able to do. This may take more time than doing everything yourself, but patience is key and will help reinforce a sense of independence and accomplishment. Also, if they begin to seem bored or irritable, consider changing the activity or taking a break.
- Let them help. Involve the person with dementia in daily household tasks such as washing dishes or folding laundry to help them maintain cognitive and motor skills. Even if they don’t get the dishes completely clean or fold the laundry just right, let them do it without correction. Offer praise for their help to reinforce their sense of self-worth, then move on to the next part of the routine.
- Make mundane daily activities part of the routine. In addition to establishing consistent mealtimes, simple things such as always placing their medications next to their beverage at breakfast, whether they bathe in the morning or at night, when they get dressed and more, go a long way toward reinforcing a sense of order and purpose.
- Include physical exercise. This can be as simple as taking a walk at a certain time of day when the weather is nice or doing some chair yoga together when you can’t get outside. Physical exercise will benefit both of you.
- Include activities that help establish a sense of time. Even if the person with dementia is unaware of time on the clock, creating routines that provide cues as to the time of day or day of the week can help increase feelings of security. For example, do they always watch a favorite television show on a certain day or at a certain time? Do they enjoy a special afternoon meal on Sundays? Make those things part of the routine. You can also use cues such as opening the blinds in the morning and closing them at night, setting the table before dinner, and lowering the lights or turning back the bedcovers when it’s time to get ready for bed. These types of nonverbal cues will become even more important in later stages when your loved one has more difficulty processing words.
- Include activities they may find therapeutic. Do they enjoy arts and crafts or other visual challenges such as puzzles? Have they always had a garden or maintained an immaculate lawn? While they may not be able to till soil or operate a lawn mower, they may be able to plant seeds, water a garden or pull weeds. Choose activities that are safe and in keeping with their abilities so they can continue to enjoy things that always brought them pleasure.
- Add music to their day. According to Alzheimers.net, research has shown that music has multiple benefits for people with dementia, in part because musical appreciation and aptitude are two of the last abilities to be lost. Listening to music can evoke emotions and stir memories, and music associated with a certain activity can also help a person with dementia remember the activity. Dancing to music, if physically able, can help people with dementia share emotions, and the physical closeness of dancing with a partner can create a sense of security. Researchers also noted that “singing activated the left side of the brain, listening to music sparked activity in the right, and watching the [singing] class activated visual areas of the brain.”
- Consider their needs when planning a trip or vacation. If you want to take a person with dementia on a vacation with you, it will help to choose a location that is familiar to them. For example, has your family always visited the same beach each summer or the same mountain cabin in the fall? While familiar surroundings may be comforting to your loved one and even evoke memories, going to a completely new place may produce feelings of anxiety and create agitation.
It’s inevitable that some disruptions to the routine will occur — whether it’s a medical appointment for the person with dementia, an appointment of your own, or you become ill or simply need a few days off. Just remember that, when caring for a person with dementia, daily routine doesn’t have to be rigid; it’s just there to give structure to the day.
When it’s Time For Specialized Dementia Care
While it’s natural to want to care for your loved one as long as possible, the sad fact of dementia is that, at some point, doing so may become unsafe for both of you. If the person with dementia wanders from home or becomes lost, begins having issues with mobility or falling, begins to exhibit extreme agitation or aggression, or experiences any other change that causes you to worry about their safety or your own, a specialized memory care community may be the solution.
Specialized memory care offers staff who are specially trained in dementia care and an environment specifically designed to help people with dementia thrive.
Thankfully, if you’ve been maintaining daily routines for your loved one, your efforts will help them make a more successful transition when moving from their house to a memory care community or when moving between levels of care in a Life Plan Community. Typically, staff at the community will develop a personalized plan of care that honors the individual’s established routines and preferences, so they can continue to do the things they enjoy in a safe and secure environment that gives you both peace of mind.