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Simple care tips for the early stages of dementia

01 May 2013

In this extract from Dementia Essentials, author Jan Hall asks carers to consider how user-friendly their homes and possessions are, and offers some practical tips to help loved ones retain as much independence as possible in the early stages of dementia.

Simple tasks, like making a cup of tea, can become strangely long and convoluted procedures
Simple tasks, like making a cup of tea, can become strangely long and convoluted procedures

Stride boldly into a stranger’s kitchen – your mission is to make a cup of tea.

Regard all the smooth surfaces, the expanse of cupboards with identical glossy doors concealing whatever delights are stored there ... because this is your chance to play ‘Guess which cupboard contains the teabags’.

Scrabble at a few false drawer fronts in search of a spoon and wonder why the fridge is disguised as another cupboard.

Experts agree that people with dementia should be cared for in their own home for as long as possible, but there comes a time when their homes need to be made more suitable for them to live in comfortably and safely.

Carers and family members will need to look at rooms and household items with a critical eye, taking into account how perceptions and cognitive patterns change with dementia. 

What is dementia?

Everyday tasks become difficult

Simple tasks that people have performed without much conscious thought can become strangely long and convoluted procedures in the middle stages of dementia, and they are likely to need help and understanding to carry on with everyday tasks as the disease progresses.

Take the kitchen as an example. A tidy kitchen with everything tucked neatly away may be a great source of pride and joy, but to someone with dementia it can seem a bleak landscape shorn of clues as to where to find whatever they might need.

A friend went on a dementia awareness session and they asked him to write down in detail the steps you need to go through to make a cup of tea. Of course, the first step was to get a cup ... Well, where are they? In the cupboard. Yes, but which cupboard?

One way of signposting and putting function first is by replacing the solid doors on kitchen units and cupboards with glass-fronted doors. This can instantly translate a series of uniform and anonymous doors into a friendly guide to the contents of each cupboard.

Alternatively, placing the ingredients for making comforting warm drinks – teabags, coffee, cocoa and sugar – in transparent storage jars on the work surface will have the same effect. A mug tree or hooks to hang mugs where they can be seen will help make the whole process much more straightforward.

You might prefer other ways of clarifying where things are and what they’re for. Simply putting a large label on the important cupboards is one strategy, but some people with dementia will resent this and find it humiliating.

If you’re looking for crafty solutions, try asking the children or grandchildren to make a beautiful colourful drawing of, for example, a steaming cup of tea for the cupboard where the mugs and teabags are kept, and a big tin of beans for the food cupboard. One partner even labelled key objects around the house with their names in Italian and English, claiming that it helped him brush up on his language skills.

What are the different types of dementia?

Think about how equipment is designed

Once you’ve found the cup and the teabag, how user-friendly is the kettle? Some kettles are designed so that it is easy to see how much water they hold, while others guard their contents like a commercial secret.

Malcolm and his wife had always enjoyed sitting down together with a nice warm drink, but he became an expert at jumping up to put the kettle on before his wife offered to do it.

 “I eventually had to stop her making tea or coffee because she kept boiling the kettle with no water in it. I suppose the upside of that was that I no longer got coffee so strong you could stand a spoon up in it or tea made of nothing but hot water and milk.”

The downside was that his wife felt another black mark was made against her name, another despairingly simple task added to the list of things she couldn’t do.

It is possible to find a kettle that is easier to use correctly, so that the important sharing of the tea-making chore can continue. Finding one with a clear indication of how much water is inside is a start, but the switches on kettles also vary widely – the simplest types for people with dementia to use have a large visible switch that clearly shows when it’s been switched on, either by a button lighting up or by a clear shift in the position of the switch. Some kettles, with tiny switches tucked away, are much more confusing.

Six surprising symptoms of dementia.

Unfamiliarity is also a problem

Just replacing a kettle or any kitchen appliance is not straightforward in a household affected by dementia, where the advantage of buying something designed to be easier to use can be outweighed by the challenge for someone with dementia of coping with unfamiliarity.

If you can’t find a new kettle that works just like the old model, then it may be better to stay with the old one until you are forced to replace it. It’s a problem that frustrated Patrick, as he wondered what he could do to help his wife carry on playing an active role in the house.

“We changed from a gas cooker to an electric one because having gas seemed to me to be much more dangerous for her. And then she couldn’t use the electric cooker because it was all new and confusing.’

Changes that Patrick began to introduce around the house to allow his wife to carry on as normal an existence as possible seemed to baffle her more, with the result that he became exasperated and she felt even more helpless and confused.

“It became more and more obvious that she was simply unable to work out how to use any of the new equipment that I was buying, unless the new item operated in exactly the same way as whatever it replaced.

“So the timer on the new cooker was “stupid”, the new remote control for the TV was “unusable”, finding stations on the radio by her bed was “impossible” – anything that I changed seemed to disorientate her.”

What's my risk of dementia?

Foresee difficulties before they arise

His wife had always done the cooking, leaving Patrick in charge of the garden, but the jobs she had done in and around the kitchen for years with hardly a thought became bewildering and complex procedures that she could just not get right.

Food was forgotten, shopping half done, meals undercooked or blackened, and saucepans boiled dry as the basic steps of cooking were jumbled in her mind.

“If you’re cooking some potatoes, you’ve got to find the pan, you’ve got to add the right amount of water – and the potatoes! And then you’ve got to turn on the electricity or the gas – there’s a lot to remember! Most of the time we just laughed at the result, but sometimes there was a bit of shouting.”

If there’s no need to change the standard household appliances, then it makes sense to keep the ones that the person with dementia has become used to using. Newer models are often more complicated, and many carers looking for a replacement washing machine, for example, will wish that manufacturers did not provide a dozen different washing cycles to perplex confused users.

Sometimes carers can head off confusion by foreseeing the difficulties that could prevent someone with dementia from feeling able to carry on with everyday tasks and pleasures.

As you know that short-term memory retention becomes erratic in dementia – particularly in Alzheimer’s – then try to imagine how you can help your loved one retain as much independence as possible in the early stages.

For more tips and useful information, browse our health articles.

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The opinions expressed are those of the author and are not held by Saga unless specifically stated. The material is for general information only and does not constitute investment, tax, legal, medical or other form of advice. You should not rely on this information to make (or refrain from making) any decisions. Always obtain independent, professional advice for your own particular situation.