Common Problems and Recommendations for Patients with Dementia

1. Eating Common problems include forgetting that they have already eaten, not knowing how to use spoons or forks, problems with swallowing, chewing, or may require feeding

Approaches to managing the problem

• Regular dental and gum health checks, assessing the ability to chew and swallow periodically
• Maintain the same dining atmosphere, including the time food is prepared, dishes, and table and chair positions
• Remind them ahead of time when it is nearly mealtime
• Prepare familiar foods that are easy to chew and be careful of choking; sometimes it may be necessary to puree food or prepare liquid meals focusing on the nutritional value and portion of each meal
• Gently instruct them to chew slowly and swallow slowly
• Do not be overly strict with dining etiquette; create a relaxed atmosphere
• Be cautious with very hot food as patients may not perceive extreme temperatures
• Do not have too many varieties of food on the table at once to avoid confusion

Note Do not leave food within sight of dementia patients as they may eat uncontrollably, and those who cannot chew might choke on their food

2. Forgetting to take medications Most elderly dementia patients need to take regular medication. Those with dementia may overdose just as easily as skip doses, due to forgetfulness

Approaches to managing the problem

• Solving the problem of overdosing requires caregivers to manage medication, which may make some patients, especially those in the early stages of dementia, unhappy, but it is necessary for those with severe dementia
• Organize daily or weekly medicine using a pill organizer available at pharmacies
• Fill the pill dispenser daily or weekly; patients can then take their pills according to doctor’s instructions, with both caregivers and patients helping to monitor remaining pills and usage each day via a calendar

3. Sleeping Common issues include refusal to sleep at night, wandering, and excessive napping during the day

Approaches to managing the problem

• Try to establish a regular sleep schedule
• Remind elderly patients of bedtime as it approaches
• Avoid napping during the day, though a short nap after lunch is acceptable but should not exceed 30 minutes and not later than 3 PM
• Encourage regular physical activity, such as walking in the morning and evening
• Ensure there is sufficient lighting in the bedroom
• Avoid caffeine (tea, coffee), carbonated drinks, and energy drinks
• If experiencing several sleepless nights, consult a doctor instead of giving sleeping pills

Note  If the weather is gloomy and there is no sunlight, the elderly might think it’s night time and may sleep without having their meal; they need to be awakened to eat

4. Dressing Common problems include forgetting where they kept their clothes, not knowing which clothes to wear first – last, how to wear them, or what clothes are used for

Approaches to managing the problem

• Help prepare clothes in order for dressing
• Guide or assist in dressing in order every time
• Keep the dressing location consistent
• If the elderly can dress themselves, allow them time without rushing
• Try to choose comfortable and easy-to-wear clothes

5. Toileting Common problems include elderly patients not knowing when to use the bathroom, may be incontinent, cannot find the bathroom, do not know what to do once in the bathroom, or may even defecate inappropriately

Approaches to managing the problem

• Try to establish a toileting schedule similar or close to their original routine
• Limit liquids before bedtime
• Facilitate easy access to the bathroom, such as keeping the lights on in the bathroom and hallway, and clearly marking the bathroom
• Clothing should be easy to remove, such as stretch waist rather than buttons or ties
• Food should be easy to digest and high in fiber for ease of bowel movement
• Keep a portable urinal close to the bed
• If necessary, use adult diapers