Alzheimer's: Dealing with daily challenges

People with Alzheimer's disease often need help handling routine daily activities, such as bathing, dressing, eating and using the bathroom. If your loved one needs this type of care, balance the loss of privacy and independence with gentleness and tact. Consider these tips to make everyday activities easier.

Bathing

Bathing may be a frightening, confusing experience for a person who has Alzheimer's disease. Having a plan can help make the experience better for both of you.

• Find the right routine. Some people prefer showers, while others prefer tub baths. Time of day is often important as well. Experiment with morning, afternoon and evening bathing.
• Make it comfortable. Make sure the bathroom is warm, and keep towels or bath blankets handy.
• Keep it private. If your loved one is self-conscious about being naked, provide a towel for cover when he or she gets in and out of the shower or tub.
• Help your loved one feel in control. Explain each step of the bathing process to help your loved one understand what's happening.
• Be flexible. If daily bathing is traumatic, alternate tub baths or showers with sponge baths.

Dressing

The physical and mental impairment of Alzheimer's can make dressing a frustrating experience. But helping your loved one maintain his or her appearance can promote positive self-esteem.

• Establish a routine. Try to have the person get dressed at the same time each day so that he or she will come to expect it as part of the daily routine.
• Limit choices. Offer no more than two clothing options each morning. Clear closets of rarely worn clothes that may complicate the decision.
• Provide direction. Lay out pieces of clothing in the order they should be put on. Or hand out clothing one piece at a time as you provide short, simple dressing instructions.
• Be patient. Rushing the dressing process may cause anxiety.
• Consider your loved one's tastes and dislikes. Don't argue if your loved one doesn't want to wear a particular garment or wants to wear the same outfit repeatedly. You may even want to buy duplicates of a few favorite outfits.

Eating

A person with Alzheimer's may not remember when he or she last ate - or why it's important to eat. Some people with AD want to eat all the time, while others need encouragement to eat.

• Eat at regular times. Don't rely on your loved one to ask for food. As Alzheimer's progresses, your loved one may not respond to hunger and thirst.
• Vary the menu. Offer limited but healthy food choices with varied textures, colors and spices.
• Choose foods that contrast with the color of the plate. Alzheimer's disease may compromise your loved one's visual and spatial abilities — sometimes making it tough to distinguish food from the plate.
• Serve things one at a time. Putting only one item on the plate at a time can help keep meals pleasant and simple.
• Be careful when serving hot food. Your loved one may not recognize that a food is too hot to eat.
• Limit distractions. Turn off the television or radio and the ringer on the telephone to help your loved one focus on the task at hand.
• Eat together. Make meals an enjoyable social event so that your loved one looks forward to the experience. Offer encouragement and praise during the meal.

Toileting

As Alzheimer's progresses, problems with incontinence often surface. Help your loved one maintain a sense of dignity despite the loss of control.

• Make the bathroom easy to find. A sign on the door that says "Toilet" may be helpful. You can even use a picture of a toilet.
• Be alert for signs. Restlessness or tugging on clothing may signal the need to use the bathroom.
• Establish a schedule. Schedule bathroom breaks every two hours, before and after meals and before bedtime. Don't wait for the person to ask.
• Make clothing easy to open or remove. Replace zippers and buttons with Velcro. Choose pants with an elastic waist.
• Be proactive. To help prevent nighttime accidents, limit certain types of fluids — such as those with caffeine — in the evening.
• Take accidents in stride. Praise toileting success — and offer reassurance when accidents happen.

Patience is key

As you help your loved one meet daily challenges, be patient and compassionate. If a certain approach stops working, don't be discouraged. Simply try something new. As Alzheimer's progresses, every bit of understanding, flexibility and creativity you can muster will make life easier for both you and your loved one.