Dementia Care During COVID-19

In the wake of the COVID-19 pandemic, family members are making hard decisions on caring for their loved ones with dementia. Without a doubt, COVID-19 has upended everyone’s routines, and older adults with Alzheimer’s disease and other forms of dementia rely on predictable activities to keep them focused.

Dementia is also considered a pandemic because it affects people around the world. According to Alzheimer’s Disease International, the number of people living with dementia globally is expected to triple from 50 million to 152 million by 2050. What’s more, one new case of dementia occurs every 3 seconds.

The coronavirus outbreak has forced families to develop new caregiving plans for older relatives who live independently. David Beerman, for example, started worrying about his mother around the time of the COVID-19 outbreak when she began asking him who he was or when she thought he was her brother.

As Patricia Beerman’s memory loss continued to worsen, David, who lives in Johnson City, Tennessee, and was concerned whether his mother, who lives near Charlotte, North Carolina, could continue taking care of herself and managing her daily routine. So, David made the difficult decision of placing his mother in a long-term care facility.

Tracey Wilson, regional director of Alzheimer’s Tennessee, said her organization has been fielding calls from families asking how to establish routines similar to ones that their loved one had before the pandemic.

Tips for Dementia Caregivers on Setting Up New Routines

Caregivers in a home-based setting not only had to create ways to engage older adults with social activities but also had to find ways of reducing their risk of exposure to COVID-19.

The Alzheimer’s Association sheds some light on how caregivers can establish routines that safeguard the health of seniors with dementia:

1. Schedule a regular hand-washing routine. According to the Centers for Disease Control and Prevention (CDC), thorough hand washing is the best way to remove germs and keep from getting sick. Caregivers can demonstrate thorough handwashing, per CDC guidelines. Caregivers can also post notes around the house to help people with dementia remember to wash their hands.

2. Ask the pharmacist or doctor about filling prescription medication for an extended number of days. Filling prescriptions for two or three months, instead of only 30 days, reduces the number of trips to the pharmacy.

3. Limit in-home visits on non-essential persons. While a person with dementia may want to see relatives and friends, caregivers must limit social visits.

4. Ask a home healthcare agency for its COVID-19 protocols. Some older adults receive in-home health services from a healthcare agency. During the COVID-19 pandemic, agencies have been providing clients with steps they take to ensure that their workers reduce the risk of exposing clients to the coronavirus. Even with this information, caregivers can still check the healthcare worker’s temperature prior to entering the house. Also, prior to the visit, the caregiver can:

Ask workers whether they have been exposed to anyone infected with COVID-19.
Ask workers if they have developed COVID-19-related symptoms.

5. Schedule telehealth visits with the older adult’s doctor. Some doctors are making routine phone calls and video visits with their patients so that seniors will not have to leave home. Contact the doctor if the person becomes more agitated or confused, which could be symptoms of illness for people with dementia.

Most importantly, make alternative plans for someone else to provide care should the primary caregiver becomes ill.

Residential Facilities and Dementia Care During COVID-19

Nursing homes and assisted living facilities with memory care units established additional routines due to COVID-19. Besides helping residents with bathing, dressing, grooming, and other daily living activities, some facilities:

Implemented a supervised hand-washing schedule to help prevent the virus from spreading.
Require residents, who can tolerate it, to use a cloth face-covering in common areas or when out of their rooms.
Have the same staff work in memory care units so residents will be familiar with the workers.
Provide structured activities so residents can remain active
Require residents to maintain a distance of six feet away from another person (per CDC guidelines) in common areas

Another important routine that caregivers have implemented is helping older adults stay connected with family members and friends. Due to COVID-19, long-term care facilities limited non-essential visitors, including residents’ family members, from entering the facility.

Staying in contact with family and friends goes a long way in helping adults with dementia navigate the many changes brought by COVID-19.

Dementia Care Remains Person-Centered

According to the Alzheimer’s Association, one of the most important ways of providing quality dementia care is to know the person living with dementia—particularly adults staying in long-term facilities.

While it may be difficult for temporary or new staff to get to know residents during a major outbreak liked COVID-19, the association recommends creating a profile of the older adult. For example, a nurse, social worker or other clinician can create a profile that complies with federal privacy laws, and includes:

The person’s preferred name, cultural background, religious or spiritual practices
Names of family and friends
What upsets the person
What calms the person down
Past hobbies and interests
The person’s sleeping habits
The person’s remaining abilities, motor skills, verbal processing, communication abilities and methods

Providing “personal-centered care,” as the Alzheimer’s Association calls it, helps caregivers—whether in-home or at a facility—notice and respond to dementia-related behaviors triggered by an illness or by the abrupt disruption of their routine.

More than any time in recent years, caregivers must adjust daily routines to ensure that people with dementia receive the physical, mental, and emotional support they need as the COVID-19 pandemic continues.

Links:

https://wcyb.com/news/local/safe-sound-dementia-care-during-covid-19
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30755-8/fulltext
https://www.alz.co.uk/research/WorldAlzheimerReport2019.pdf
https://www.alz.org/help-support/caregiving/coronavirus-(covid-19)-tips-for-dementia-care
https://www.alz.org/professionals/professional-providers/coronavirus-covid-19-tips-for-dementia-caregivers