In the home setting, communication may be easier because the environment is familiar with fewer distractions although caregivers are often alone and cannot turn to a co-worker for help. No matter what setting, a calm tone, short direct sentences, a slow rate of speech, and patience encourages independence in people with dementia. Clara is a year old, Caucasian woman with severe macular degeneration, significant hearing loss, and moderate to severe dementia.
The caregiver sometimes forgets to give Clara her hearing aids, sometimes puts the hearing aids in with dead batteries, leaves the TV on when trying to talk to Clara, and speaks in long, complicated, thickly accented sentences. She uses phrases and words that are completely unfamiliar to Clara. Emphasis is on encouraging independence in all activities while providing appropriate assistance when needed.
ADL skills training promotes involvement in self-care, minimizes caregiver stress, and reduces the amount of physical labor required of a caregiver.
A skilled caregiver learns to continually assess the strengths, comprehension, and capabilities of the person they are caring for. More or less assistance may be needed depending on the task, the time of day, co-morbidities, and level and type of dementia. For example, a person who is otherwise capable of independent self-care tasks but has poor balance might need help setting up a place to safely brush her teeth and do other grooming. If forced to stand during these activities, the person will likely need more help from the caregiver than is needed if a suitable sitting area is arranged.
Caregiver skill training provides caregivers with information, strategies, and tools to develop an individualized program that provides just the right amount of assistance. This might involve gestures, verbal and visual cues, assistive devices, planning and problem solving, and physical assistance.
Planning an activity for someone with dementia must take into account their abilities and interests, which promotes success and leads to a wider range of activities. For example, a person who loved to go for hikes but can no longer walk will still enjoy going for a drive or visiting a park with paths that accommodate wheelchairs. That same person may not enjoy sitting in front of a television tuned to a game show. Assistive technologies—devices designed to enable people with a disability to function more independently—have been developed to support people with dementia and their caregivers.
Assistive technologies focus on safety and social participation. They are different than assistive devices, which aid with mobility and physical activities of daily living.
Assistive technologies can reduce the cost of care, decrease caregiver burden, promote independence and autonomy, and increase quality life for people with dementia.
They may also promote aging in place, delay transfer into a care facility, and help people with dementia maintain independence Czarnuch et al. Adaptive aids are devices and equipment designed to assist a person with daily activities such as mobility, transfers, dressing and grooming, bathing, and eating.
They can help individuals with disabilities compensate for lost functions, increase their independence, and develop their potential Yeung et al. Conventional exercise programs such as walking, resistance training, and seated exercises that focus on improving aerobic endurance, strength, balance, and flexibility have beneficial effects on physical function in individuals with cognitive impairment and dementia. Exercise improves the ability to perform basic activities of daily living such as eating, dressing, bathing, using the toilet, and transferring from bed to chair Barnes et al.
Environments that are dementia friendly and safe promote independence and physical activity. This can include developing environments that are safe to walk around and navigate, environments that are not confusing, and policies that limit unneeded moves from one facility or area to another Handley et al.
Care techniques are the skills needed by the caregiver for monitoring, assisting, and providing total care in dressing, grooming, eating, bathing, or toileting and incontinence. As with other activities of daily living, people with dementia often need time to dress and groom. The caregiver must assess the person they are caring for to determine the amount of help needed, must be patient, and must resist jumping in to help if no help is needed.
Depending on the severity of the dementia and co-morbidities such as visual and perceptual changes, balance, and strength—even the time of day—caregivers must train themselves to encourage as much independence as possible. For example, Clara, mentioned in the case example earlier in this section has severe macular degeneration and fairly severe dementia. There are a number of professionals who can assist older adults in carrying out the instrumental activities of daily living.
These professionals include physical therapists, occupational therapists, nurses, companion caregivers, social workers, and personal support workers. The average cost of assistance with instrumental activities of daily living can vary widely depending on the amount and type of assistance required, your location, and the number of caregivers needed.
There are also alternative programs like Caregiver Homes that help family members to assist with IADLs at home through coaching and support. Share this with a friend:. Seniorlink Blog. By Angela Stringfellow on Mar 27, AM Definition of Instrumental Activities of Daily Living Instrumental activities of daily living are the skills and abilities needed to perform certain day-to-day tasks associated with an independent lifestyle.
Improving Abilities Related to Instrumental Activities of Daily Living Supporting your loved one in maintaining their instrumental activities of daily living can allow for them to live independently in their own home for a longer period of time.
Even Sudoku can be enjoyed by someone in the early stages of dementia, especially if she liked that sort of thing when she was younger. Keeping them strong and limber will make it easier to do many of the activities listed above.
In later stages you may need clothing that is designed for someone who needs help dressing. Eventually, clothing that he cannot remove may be necessary, as inappropriate undressing can be a problem in the middle and later stages of dementia. Something as simple as a cane can make it possible for him to get around. Specially designed forks and spoons make it easier to eat by himself. Sturdy grab bars that are securely fastened to the wall make getting in and out of the tub easier and safer.
Raised toilet seats extend his independence by making toileting easier. Begin by defining the problem. It is very likely that someone has found a solution that fits. If you would like help, contact us, describe the issue, and we will do our best to help or point you in the right direction.
This picture phone makes calling easy! When dementia begins to effect memory, just dialing the phone can become an insurmountable task.
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