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Palliative and Hospice Care for Seniors with Dementia

Written By: William Rivers
Reviewed By: William Rivers
Published: May 4, 2023
Last updated: October 9, 2024

Care for those suffering with dementia can be challenging. Senior citizens who are dementia patients usually demonstrate a range of conditions that affect the brain, and unfortunately, with no cure or treatment, it worsens over time. 

Palliative care and hospice are types of care for dementia patients. It can also be helpful to know the different types of dementia. One of the most common forms of it is Alzheimer's disease, which millions of people over the age of 65 live with. 

Here are some helpful tips for caregivers when taking care of dementia patients.

Allowing Independence

Dementia patients often want to go through the routine of their regular daily activities, so don’t feel you have to assist them. It’s important to let them do things independently and even provide small tasks for them to do on their own. 

It can help if you involve them in helping with small things, such as helping to set the table for eating, deal cards for a game, or pick up and put things away. Giving dementia patients a task to do helps provide them with mental stimulation to ensure they are calm and occupied.

Limit Nap Times

One helpful tip for caregivers working with dementia patients is to avoid allowing them to take long naps during the day. Sleeping at odd times can throw off your body’s internal clock, and an abnormal sleep pattern can keep them more awake at night. 

Rather than having a patient wandering the night awake, it’s better to keep them from sleeping during the daytime. A good night’s sleep helps ensure they awake more refreshed for the day ahead.

Create a Safe Space

A safe and secure environment is necessary to ensure the patient is not hurt. There are several companion care actions you can take to ensure that, whether you’re in the home or caring for your patient in a facility:

  • Avoid things scattered on the floor or any obstructions in pathways. Dementia patients pose a fall risk. It can help to have walkers to help assist with mobility.
  • Keep outdoor areas enclosed so your patient doesn’t wander away.
  • Take time to learn and read more about links to incontinence and dementia to identify early signs, so that you can help loved ones cope - or if you’re a loved one and a caregiver, you can find great resources to help learn about these types of issues and how to handle them with specific incontinence products for women.
  • Ensure that bathing and toilet areas have support, especially if your patient is having trouble balancing.
  • Keep track of car keys. Many dementia patients eventually lose their driving skills, making them more likely to be in an accident as their memory skills fade.

Create a Routine

Routine is necessary for dementia patients. Planning out your days also ensures that you’re not trying to figure out what activities or things to do, so you can get your patient excited for the day. Important daily activities to note that need to occur with your patient include eating, bathing, sleeping, and dressing. Try to keep those recurring activities happening at the same times every day to stay consistent.

Set Up Mealtimes

Besides having your patient eat at the same time each day, there are ways to ensure that mealtime is less of an overwhelming experience. Things like temperature changes, vision, and attention can confuse your patient during mealtime, so keep a few things in mind to help ensure that it’s a pleasant experience:

  • Provide one food at a time. Too many food options and sides or a loaded plate can be challenging for those suffering from dementia. Instead, start by giving them one side, then the main entree, and end with the second side.
  • Use bright, contrasting colors for the plates, tablecloths, place settings, or bowls. Changes in spatial and visual abilities in dementia patients make it hard to distinguish the objects on their plate, so having greater contrast in colors ensures less confusion. Keep patterns to a minimum and opt for solid colors.
  • Limit distractions during mealtimes, such as music, cell phones, or running televisions. Keep things quiet and focused on the task at hand - to eat!

It’s also good to ensure you provide your patient with healthy and nutritious foods.

Play Familiar Music

Dementia patients can recognize music that they heard, even if it was music from their youth. Music therapy can be helpful for patients dealing with dementia. To help them feel more at home, creating a music playlist and allowing them to listen to songs they know can be helpful.

Music has the power to help with moods, and the same goes for those with dementia. Music can even help with agitation and other behavioral issues in the middle to late stages of dementia and Alzheimer’s. 

You may see your patient tapping their foot, singing along, or even making grander movements as they enjoy a song from childhood.

Learn About Sundowning

Caretakers in palliative and hospice care need to understand that many dementia patients suffer from an experience called sundowning.

In most cases, you’ll notice that your patient's behavior gets exacerbated as the daylight fades and gives way to the evening (sunset). They become more agitated, irritable, restless, or tend to feel more confused.

Take Care Of Yourself as well as Your Patient

If you’re exhausted or experiencing a challenging time, it can be harder to be a responsible caregiver. 

It may be helpful to explore respite care, which is one of the levels of care provided for hospice and palliative patients. It gives caregivers a break to allow them to take some time to focus on other priorities for themselves.

Do Not Engage in Arguing or Become Visibly Upset

One last tip for caregivers is when dealing with a patient when they become argumentative. Dementia patients don’t have the same abilities to think and reason as we do since their nervous system is affected by their illness.

So, if they talk about traveling somewhere, don’t immediately tell them that they can’t go; rather, come up with a good reason to deter them, such as no availability, or the traffic is too bad during that time, etc. 

Come up with good reasons to help them cope, such as they don’t need to work because the weather is bad or their office is closed for the day. 

Sometimes patients lash out and become harsh. It is crucial not to let your feelings get hurt but to understand that forgetfulness can upset people. You need to work to stay calm and do your best to serve your patient without taking it too personally, and it can be challenging if you’re a family member and caretaker. 

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William Rivers is an editor with a master’s degree in Human Services Counseling at Maine State University. He has more than 20 years of experience working in the senior healthcare industry.
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