A Complete Guide to Care for Dementia

Whether you’re new to caregiving or looking for additional support, this resource is here to help you create a positive, dignified, and supportive environment for those living with dementia. We aim to give comprehensive support and practical tips to family members and carers, to help you to navigate the complexities of dementia care. From understanding the basics to planning for the future, this blog covers all the key aspects of providing the best care possible for those living with dementia.

The most well-known form of dementia is Alzheimer’s disease which accounts for 60-80% of all cases. However, dementia encompasses several different types:

• Vascular Dementia: Caused by reduced blood flow to the brain, often following a stroke or other vascular issues. It may present with more abrupt changes in cognitive abilities compared to other forms.
• Lewy Body Dementia: Characterised by abnormal protein deposits in the brain, leading to symptoms such as hallucinations, movement problems, and fluctuations in cognitive function.
• Frontotemporal Dementia: Involves the degeneration of nerve cells in the frontal and temporal lobes of the brain, impacting personality, behaviour, and language.

Getting an accurate diagnosis is so important for effective dementia care, especially in the context of Alzheimer's disease research, diagnosis, and care strategies. The process typically involves a thorough review of an individual’s medical history and cognitive and neuropsychological testing. These assessments help gauge the extent of memory loss, language difficulties, and problem-solving challenges. Clinical trials play an important role in exploring treatment options and their effectiveness, providing additional resources and support for carers. During the early stages of dementia, having a support system, such as a family member or care provider, is so helpful.

Supporting Family Members with Decision Making

Family carers have to try to balance the person’s physical needs with emotional support, creating a nurturing environment that prioritises their well-being. This involves not only providing companionship and assistance with daily tasks but also advocating for their healthcare and personal needs.

The emotional challenges faced by family members in their caring role can be significant, which means that seeking help and taking advantage of all available resources to support both you and the person with dementia.

It’s equally important to acknowledge and respect the individual’s mental capacity. As dementia progresses, involving the person in decision-making helps maintain their sense of autonomy and dignity. Regular communication and a focus on what they can still do, rather than what they’ve lost, are fundamental. Having a conversation about potential next steps and care options at an early stage helps someone with dementia understand the options available to them and gives them access to the relevant information to plan their next steps.

Managing Dementia Progression

Dementia is a progressive condition, meaning that cognitive decline and the associated symptoms will gradually worsen over time. Memory loss becomes more pronounced, communication becomes more challenging, and problem-solving skills diminish. This progression often requires changes in the care approach, including increased support with everyday tasks like eating, dressing, and managing medications. It is crucial to monitor blood pressure when managing medications for individuals with dementia, especially those with pre-existing conditions.

As Dementia Progresses

Carers can help a person with dementia by developing a structured daily routine that provides comfort and reduces confusion for the person with dementia. Additionally, understanding and managing behavioural changes is crucial. This might include strategies to handle agitation, aggression, or wandering. In some cases, seeking professional help from a healthcare provider may be necessary to address more severe behavioural issues.

As dementia progresses, planning for future care becomes increasingly important. It is essential to address financial and legal issues when planning for the future care of individuals with dementia. Exploring options like respite or residential care can offer relief and support for caregivers while ensuring that the person with dementia continues to receive the best care possible. There are many positive aspects to moving a person with dementia into a care home, and as symptoms progress, such a move can better meet their increasing care needs.

Care Options and Planning

Choosing a care home or residential care facility for a loved one with dementia is one of the most challenging decisions families face. Participating in clinical trials for new treatments can provide additional resources and support, and has shown benefits in slowing cognitive decline. This decision often comes after a period of trying to manage care at home, and it typically arises when the person’s needs exceed what can be safely and comfortably provided within the family setting. Understanding the types of care homes available, the services they provide, and the factors to consider when selecting a facility can make this process more manageable.

A financial assessment following a needs assessment from social services is important when choosing care for individuals with dementia. The financial assessment determines how much individuals will need to contribute toward care costs, ensuring that the individual and their family are aware of potential funding and support options available based on their financial situation.

Care Homes and Residential Care

Care homes and residential care facilities come in various forms, each offering different levels of support tailored to the needs of individuals with dementia. These are the main types:

• Residential Care Homes: These facilities provide a supportive environment where individuals can receive help with daily tasks such as dressing, bathing, and eating. They offer communal living spaces, social activities, and 24-hour supervision to ensure residents’ safety and well-being. While not all residential care homes specialise in dementia care, many have staff trained to assist residents with cognitive impairments. The local council may set a personal budget based on the person's eligibility for funding, detailing the overall costs of care and what the council will cover. This budget can influence the choice of care providers and whether payments are made directly to the council or to the individual caregivers.
  
• Nursing Homes: Nursing homes, also known as skilled nursing facilities, provide a higher level of medical care for residents with more advanced dementia. They employ licensed nurses and other medical professionals who can manage complex health conditions, administer medications, and provide medical treatments on-site. This option is suitable for individuals who require intensive support with mobility, feeding, and other medical needs.
  
• Memory Care Units: These are specialised units within residential care homes or nursing homes dedicated solely to individuals with dementia. Memory care units are designed with the unique needs of dementia patients in mind. They typically feature secure environments to prevent wandering, offer structured daily routines to reduce anxiety, and have staff trained in dementia care. These units focus on creating a calm, supportive setting that fosters dignity and quality of life.
  
• Supported Living with Dementia Care: Some warden-maintained supported living facilities provide specialised dementia care within a more independent living environment. Residents have their own living spaces but receive help with daily activities and medication management. Assisted living may be appropriate for individuals in the earlier stages of dementia who still enjoy a level of independence but need some support.

Tips on choosing a care home

A really important factor to consider when selecting a care home should be the latest report by the Care Inspectorate. The CI regulates all care facilities in Scotland. The report will tell you what care homes can do. When visiting a nursing home, take time to look at other people's homes. You can bring friends or relatives for comparison after visiting the hotel. Make a list before a visit to a care home. This guide could make it better.

Services Offered in Dementia Care Homes

A good care home provides a comprehensive range of services tailored to meet the needs of individuals with dementia. These services go beyond basic personal care, addressing the emotional, social, and medical aspects of living with dementia.

Each resident will have a personalised care plan that outlines their daily routines, preferences, and care needs. This plan helps staff provide consistent, tailored support that respects the individual’s unique circumstances. It is so helpful when a carer can share essential personal information about the individual being cared for with hospital staff, including how the person prefers to be addressed, their likes and dislikes, and the specific support they need, to ensure tailored care and minimise distress.

To ensure safety, care homes provide around-the-clock supervision and secure environments designed to prevent wandering and disorientation. Many memory care units incorporate calming design elements, such as colour-coded hallways, to help residents navigate the space more easily. Care homes also offer activities tailored to dementia patients, such as music therapy, art classes, reminiscence sessions, and gentle exercise programs. These activities can help maintain cognitive function, reduce anxiety, and enhance the resident’s quality of life.

Nursing homes and some residential care homes offer medical services, including medication management, routine health checks, and access to specialists. This is especially beneficial for residents with complex health needs or advanced dementia. Staff in dementia care homes are trained to provide emotional support, using techniques like validation therapy to help residents feel understood and valued. They often receive ongoing training to handle behavioural changes, such as agitation or aggression, in a compassionate manner.

Factors to Consider When Choosing a Care Home

Selecting the right care home for a loved one with dementia involves careful consideration of various factors. To make an informed decision, it’s essential to research thoroughly, visit potential facilities, and ask the right questions. Here are some critical factors to keep in mind:

• Specialisation in Dementia Care: Look for facilities that specialise in dementia care or have dedicated memory care units. Staff in these homes are typically more experienced and trained to manage the specific challenges of dementia, providing a higher level of support.
  
• Staff-to-Resident Ratio: A low staff-to-resident ratio is crucial in dementia care, as residents often need frequent assistance and monitoring. Inquire about the number of caregivers available per shift and whether there are medical professionals on staff around the clock.
  
• Facility Environment: A dementia-friendly environment is designed to be secure yet comfortable, featuring features like enclosed outdoor spaces, clear signage, and calming interior designs. During visits, observe how the layout supports residents’ independence and safety. Spend time during visits to thoroughly evaluate the environment. Engage with staff and residents, and assess the care home's conditions, which is crucial in making an informed decision.
  
• Personalised Care and Activities: Ask about the types of activities and therapies offered to residents. The best care homes provide tailored programs that cater to different stages of dementia, focusing on maintaining cognitive function, physical health, and social engagement.
  
• Involvement of Family: Many care homes encourage family involvement in the care plan and offer regular communication updates about the resident’s well-being. Some also provide support groups or resources for family caregivers to help them cope with the transition and ongoing care.
  
• Costs and Financial Planning: Understanding the costs is a crucial step. Care home fees can vary widely depending on the level of care required, the services provided, and the location of the facility. It’s essential to review the fee structure, including any additional charges for specialised services, and to explore potential financial support options such as government benefits or long-term care insurance.

Involving the Person with Dementia in the Decision-Making Process

Whenever possible, involve the person with dementia in choosing their care home. Including them in visits, discussions, and decisions helps maintain their sense of control and dignity. This involvement is particularly valuable in the earlier stages of dementia, when they may still be able to express preferences and participate in decision-making.

Transitioning to a Care Home: Making It Easier

The move to a care home can be an emotional and difficult adjustment for both the individual with dementia and their family. If possible, consider introducing the care home environment gradually. Some facilities offer short-term respite care or day programs that allow the person with dementia to become familiar with the surroundings and staff.

Bringing personal items, such as photographs, blankets, or favourite pieces of furniture, can help create a sense of familiarity and comfort in the new environment. Work with the care home staff to maintain aspects of the person’s daily routine, such as meal times, hobbies, and sleep patterns. Consistency can reduce anxiety and help the individual adapt more smoothly.

Additional Resources and Support

Accessing support services can significantly improve the quality of life for people with dementia and their caregivers. National dementia centres, local support groups, and community resources offer a wealth of information and assistance. These may include educational programs, social activities, and mental health support services, designed to help both individuals with dementia and their families.

At Manor Grange Care Home, we have organised a new peer support group where relatives can meet each other in a relaxed area of the home and share hints, tips, and ideas with each other on how they cope with loved ones living with dementia. If you'd like to know more about how we support residents with dementia at Manor Grange Care Home please get in touch.