routines in dementia care

Daily Routines Help When Caring for Those with Dementia

March 26

Establishing a daily routine for those suffering from Alzheimer’s is a critical component of care, notes Jerome Bagaporo, RN, chief nursing officer at United Hebrew of New Rochelle’s skilled nursing facility, where he also oversees a secure dementia unit.

“Whether it’s a morning walk, afternoon tea, or listening to music in a cozy chair, familiar routines give people comfort,” he says Bagaporo.

And for those with memory loss, routines may also bring a feeling of control. That’s because the progressive damage to the brain cells of those diagnosed with dementia usually cause confusion and anxiety.

“So, providing structure for daily activities and keeping to a routine can reduce the agitation we often associate with dementia,” Bagaporo says.

For caregivers at home, Bagaporo suggests tailoring the day to their loved one’s individual interests and preferences, keeping in mind the conditions caused by the disease. For example, many people with dementia experience “sundowning,” or the time of day when symptoms worsen, in late afternoon or evening. For the one in five people sundowning affects, an activity such as listening to music is best at that time.

Here are Bagaporo’s tips for establishing routines when caring for someone with dementia:

  1. Establish a consistency of care: If you need help with caregiving at home, try to have consistent caregivers’ help when you need some time off. Perhaps another family member or the same home health aide can fill in for you on a daily schedule. Exposing your loved one to an array of different caregivers may cause agitation.
  2.  Stick to the same time for daily activities: Follow a schedule for mealtimes, bathing, medications, and recreation. If possible, build in time for fresh air and exercise, which improve mood and brain function.
  1. Follow the same steps when doing certain activities: For example, your loved one may find it soothing to follow a specific bedtime routine, i.e. first washing up, then changing into bed clothes, then listening to music before going to sleep. Find out their preferences and stick to them.
  1. Learn what used to be your loved one’s routine: For example, if your loved one left work every day at 5 p.m. and came home to prepare dinner for the family, you may find that around that time, she walks around the house looking for something to do. If possible, provide a task to do in the kitchen to help instill a sense of purpose.

“Repetition and routine are calming for folks with dementia. Even if they previously enjoyed more variety in their daily lives, sticking to a schedule now will help alleviate the symptoms caused by the disease,” Bagaporo advises.

At United Hebrew, the skilled nursing staff carefully establishes routines for those with dementia or Alzheimer’s – similar to what they experienced before they moved in, according to Bagaporo.

For example, one resident worked in a laundry shop years before coming to United Hebrew. She was engaged in the music, art, and other social activities offered by the staff. But, at times she would become restless. Remembering what she did on her former job, staff gave her linens to fold. This had an immediately calming effect. Other residents have found similar comfort in working on purposeful “tasks” with their caregivers. The strategies are “person-centered,” says Bagaporo, which ensures they are tailored to an individual’s personal circumstances.

“We establish a personal care plan after we learn from the family about their loved one’s life story, preferences, and abilities. We take the time that is needed to ensure they have purpose every day in their lives.”

For more information on dementia care at United Hebrew’s skilled nursing home or in its assisted living facilities, Willow Towers Assisted Living or Willow Gardens Memory Care, call 914-632-2804.