For Carer


Maintain a healthy lifestyle through different “activities”

Dementia does not have to put a halt to your life. Family of dementia patients tend to recruit a domestic helper to take care of the patient and avoid accidents, but over-protection may keep patients idled at home, which could lead to deterioration of their conditions. You can arrange meaningful activities for patients based on their previous jobs, hobbies, education level and remaining abilities:
  • Set roles to increase the sense of satisfaction in life
  • Make good use of their strengths to help maintain their self-esteem
  • Maintain intelligence, physical fitness and ability in self-care
  • Maintain a social life
  • Provide sensual stimulations

Everyday activities

Let patients perform self-care activities, such as washing their face, shaving and doing make-up. If patients have difficulties performing these activities, you can simplify the steps based on their capacity.
 

Housework

Perform housework following the old habits and hobbies of the patients, such as wiping table, placing cutleries, tidying up clothes and simple cleaning to make patients feel they can still take up certain tasks and maintain their usual roles at home.
 

Physical activities

Dementia patients will experience gradual decline in their balance and activity level, as well as a reduced sense of space and judgment, all of which will increase their risk of falling. Regular physical activities can help slow down the degradation of physical functions. Suitable activities include taking a stroll in a park, dancing, taking stairs, stretching, ball games and swimming.
 

Interest groups

Allow patients to take part in different activities based on their hobbies and capacity, such as knitting, listening to music, yum cha, meeting their children and grandchildren, hiking, playing chess and performing Cantonese drama.
 

Intelligence activities

Dementia patients will experience a gradual decline in intelligence, as well as loss of memory, organization and judgment. Integrating intelligence activities with medication has been proven to be the most effective in slowing down intelligence degradation. Suitable activities include reality orientation, such as placing a big clock and calendar at home and asking the patient to tear off old pages from the calendar, playing mahjong, chess, computer games, poker card games, word chain, spotting differences on similar pictures, writing diary, discussing current issues, doing handcraft and preparing snacks; reminiscence activities such as looking at old pictures and listening to old songs; festival activities which include making rice dumplings and writing Lunar New Year decorations.
 

Daily schedule

Design a regular daily schedule with patients for a good allocation of time and cultivation of healthy habits. Avoid long afternoon naps due to the potential adverse effect on night sleep. Patients can follow the schedule to prevent forgetting or repeating some activities.
 

Jot down the important tasks on the monthly plan


Come up with a shopping list to make everyday life easier to manage

Examples:

Categories Items
Food Eggs, bread
Bathroom items Tissue paper
Kitchen items Mugs, chopsticks
Detergents Washing up liquid

 

Home Care

Interior design

A comfortable home environment can help maintain or improve the conditions of dementia patients and make life more delightful.
  • Keep the original interior design, do not change the positions of furniture or layout to avoid adaptation problems.
  • Use contrasting colours, such as painting walls in lighter colours and switches in darker colours for easy identification.
  • Use pictures and descriptions as indicators to help patients find out the items they need easily.
  • To prevent falling, remove messes, clear the aisles and use tapes in bright colours to highlight the heightened threshold.
  • Place some familiar items in the flat, such as family photos or handcraft by the patient to create a cozy atmosphere.
  • Reminders for going out: Put a checklist at the back of the door to encourage patients to check whether they have all the important personal belongings, such as mobile phone, wallet and keys.
  • Play soft and familiar music to help patients relax and start a conversation with them for reminiscence.
  • Use safety bell, safety mobile phone and anti-lost bracelet to protect elders or patients living alone while making it easier for the family to go to work or head out.

 

Everyday life questionnaire

Compare the cognitive abilities of patients before and after dementia onset and give them a score on the respective items in the corresponding box of the month.
 
If dementia patient experiences difficulties and requires assistance, please inform medical workers (check the corresponding box)
Self-care
  • Eating
  • Shower
  • Excretion
  • Taking medicine
Housework
  • Cooking
Going out, shopping
  • Going out
  • Finance
  • Using public transport
  • Talking
Others, please specify: ________________________________________

Source: 香港老人科醫學會 - 認識認知障礙症 - 日常生活錦囊

Emotional problems caused by dementia

Dementia patients will experience different emotional and behavioural changes during their illness, which may differ from person to person. Patients may show different kinds and degrees of emotional symptoms at different stages of the disease. Common symptoms include depression, anxiety, turning night into day, suspicion, irritability, delusion and hallucinations.

These symptoms tend to bring extra barriers to the everyday life of patients, reducing their cognitive functions, activity level, ability in self-care and living standard significantly. Meanwhile, these symptoms tend to be sources of stress for caregivers, posing even heavier mental and physical burdens on them.

When dementia patients demonstrate emotional or behavioural problems, they usually do not mean to create problems for their caregivers or embarrass them. Patients may have been affected by their compromised cognitive abilities, physical conditions, environmental factors, interpersonal relationships or medication that makes them unable to express or control their emotions and behaviour properly.

 

Consider elders as VIPS

We should respect and accept elders with dementia and believe they are still valuable people. Therefore, we should make good use of their remaining capacity and let them do whatever they can still manage without trying to intervene too much. Meanwhile, we should create a “no failure” environment. Avoid using an innocent tone to talk to elders, which may make them feel belittled and bad. Brooker believes the correct way to talk to elders with dementia is to use concise and short sentences with key points reiterated, a moderate speed and an affirmative tone. Try to call them by their names, use “yes” or “no” questions as much as possible and establish eye contact.

 

To make the concept of person-centred care (PCC) more accessible, Professor Brooker translated the abstract and complex concept into a simple and catchy formula:

PCC=V+I+P+S

The four elements of “People-centred Care” are as follows:

  • Valuing people: Value and respect every elder from the bottom of our heart
  • Individualised care: Consider elders as individuals and conduct personalised assessment and caring plans
  • Perspective of elderly: Set your own values aside and learn to see the world from the perspective of elders
  • Supportive social environment: Awlays provide a positve and caring environment for elders
*Sources: Evangelical Lutheran Church Social Services Hong Kong — “Sharing on Social Practices”
 

When we notice the behavioural problems of dementia patients, we tend to find them hard to deal with. Some may try to use all means to change their behaviour. However, it helps alleviating the stress on both sides if we can try to tolerate some rather harmless actions of patients or people around us.

But if the behavioural problems have to be tackled, we need to pay close attention to the cause and effect of such behaviour and find out the best solutions to the problems concerned.

ABC analyzes behavior problems ABC analyzes behavior problems
Antecedents of the behaviour to observe:
  • Who, where, when and what causes that particular behaviour?
  • Does the patient have any preference, habit, need or anything he/she is scared of that may cause that particular behaviour?
Example 1When the domestic helper had a day off, the patient did not take a walk in the park and stayed in bed the entire afternoon.
Example 2The patient was reluctant to take a shower when the weather got chilling even before the onset of dementia

Things to observe as the behaviour takes place:
  • Nature of the behaviour
  • Frequency of the behaviour
Example 1Wandered around at home in the evening
Example 2Unwilling to shower

Consequences of the behaviour to observe:
  • How does the behaviour affect the patient?
  • How do people around the patient react to it? Does the behaviour intensify?
Example 1Played around with the scissors found in a drawer at night, which posed himself/herself at risk and kept the family up at night.
Example 2Family raised their voice as the demanded him/her to shower, which drew even stronger rejection and created tension between both parties.

To solve the behavioural problems, we need to pay attention to the antecedent and change the consequences.

In example 1

You may avoid the antecedent by bringing the patient to a daytime community centre or arranging other activities at home on the day off of the domestic helper

You can change the consequence by hiding the scissors at somewhere the patient cannot reach.

In example 2

You may avoid the antecedent by using a heater to warm up the bathroom.

Create a more comfortable environment for showering; you may consider using scent diffuser if the patient likes it.

To change the consequence, you may avoid direct confrontation with the patient; try to encourage the patient to shower in a soft tone and divert his/her attention and use other ways to encourage him/her to shower after he/she has forgotten about the task.

Everyone is unique and there is no single theory that can be applied to everyone. The above example are just some simple illustrations. Caregivers need to do close observations and make more trials to find out the best solutions.


Source:香港老人科醫學會 - 認知障礙症的情緒行為管理

Common problems and caring tips

Patients tend to have incontinence, falling, eating disorder, as well as communication and behavioural problems. There may also be complications such as abuse by caregivers and infections.


Falling

Falling is a fairly common problem dementia patients experience. After falling, they may have injuries and bone fracture in mild cases or brain damage in serious cases, which could trigger stroke, paralysis or even death. Therefore, it is a problem that should not be taken easily.

Major reasons that cause dementia patients to fall

  1. Brain degeneration may cause muscle cramps, which reduces the activity level and balance of the patient, thereby increasing the risk of falling.
  2. The decline in cognitive abilities leads to compromised alertness to and judgement about the surrounding environment, making patients prone to getting lose and subject to a higher risk of falling.
  3. Vision problems
  4. Wearing clothes and shoes in wrong sizes
  5. Side effects of psychiatric drugs, such as
    • Postural hypotension
    • Stiffness and difficulty in movement
    • Lethargy
  6. Environmental factors
    • Potential danger at home
    • Potential danger outdoors

Precautionary measure for falling

  1. Appropriate physical therapy, balance, stretching and muscle exercise can increase patients’ balance and mobility while reduce the chance of falling.
  2. Use of proper walking aid can increase the mobility of patients. Consult a physiotherapist if necessary.
  3. Arrange a daily schedule for the patient to reduce confusion.
  4. Assist patient to participate in interest groups to reduce their tendency of wandering.
  5. Use a night light to direct the patient to the bathroom or place a bedpan next to the bed.
  6. Wear suitable glasses or seek medical assistance to treat curable vision problems
  7. Use signs with large and clear fonts so that the patient can easily locate the places and items they need
  8. Wear fit-sized clothing, comfortable and non-slip shoes, trousers with suitable length and avoid wearing slippers.
  9. Pay close attention to the side effects of medication on dementia patients:
    • Postural hypotension
      If the patient finds himself/herself dizzy when switching body postures, for example from sitting to standing, then remind him/her to take it slow when he/she changes posture to avoid falling due to dizziness.
    • Stiffness
      Stiffness compromises the body’s ability to maintain a balance while increases the risk of falling. In case of stiffness, inform the doctor to allow adjustment on medication to improve the situation, and follow the advice of physiotherapist on maintaining joint mobility.
    • Lethargy
      Dementia patients with lethargy will experience reduced concentration and judgment about the surrounding environment, making them prone to falling. Family of the patient should make close observations and inform the doctor in case of severe lethargy.
  10. Environment
    Indoors:
    • Use non-slip non-reflective floor surfaces. Wipe it dry immediately if it is wet; keep a sharp contrast between the colour of the floor and that of the furniture items
    • Reduce the use of threshold or reduce its height by one inch; use a colour that is different from that of the floor
    • Use toilet seats with an appropriate height and install handrails if necessary.
    • Choose furniture items without sharp corners; fix the position of furniture items so that they would not be pushed away or down by the patient; keep the furniture at a regular position so that the patient can get used to the setting of the environment.
    • Do not place cables and telephone on the floor.
    • Keep household items at accessible places to reduce the need for patients to climb up.
    Outdoors:
    • When going out, pay attention to the children, pedestrians, joggers and bikers to avoid them from running against the patient.
  11. Studies showed that dementia patients would have a higher risk of osteoporosis, which in turn increases their risk of bone fracture after falling.

Incontinence

This condition tends to embarrass the patient and his/her family, as well as cause skin problems.
Major reasons of incontinence include:
  • Physiological factors, such as urinary or excretory problems
  • Unable to locate or identify bathrooms
  • Unable to take off the clothes for using the toilet in time

Suggestions for improving the condition

  1. Use touch fastener to replace zip or buttons; male patients are advised to wear looser underpants.
  2. Help the patient develop a habit of regular excretion and give him/her reward or compliments after urination.
  3. Put on signs at home to pinpoint the location of the bathroom.
  4. Put a toilet sign at the entrance of the bathroom; highlight the toilet seat with colourful adhesive tape so that the patient can figure where to sit on.
  5. Insufficient intake of fibres and exercise may lead to constipation and incontinence. Make sure the patient drink plenty of water as well as eat more fruits, vegetables and cereals.
  6. Carers should explain the causes of incontinence to patients clearly to avoid embarrassment; do not blame them.
  7. To avoid staining the furniture, put on washable covers and add a layer of thin plastic foil on top of the mattress.
  8. Use auxiliary tools such as bedpan, commode or adult diapers if necessary.

Eating

As the disease progresses, the everyday life of patients will be affected; common eating problems include:
  • Forgetting that they have eaten and keep asking for food
  • Forgetting how to use utensils and make a big mess during eating
  • Having difficulty chewing or swallowing
  • Having dehydration due to the inability to remember drinking water
  • Forgetting the steps of eating due to weakened concentration

Signs of difficulty chewing or swallowing

  1. Dirty mouth
  2. Lack of concentration during eating
  3. Reduced appetite and weight loss
  4. Increase of eating time
  5. Having food residual in mouth
  6. Constant chewing
  7. Forgetting the steps of eating
  8. Unclear articulation after eating
  9. Drooling
  10. Coughing and shortness of breath when swallowing

How to improve the ability to eat

  1. Maintain oral hygiene
    • Make sure the dentures are securedly worn before eating. Check to see if there is any food residual in the mouth after eating and clean the mouth and teeth.
    • Maintain the habit of brushing or soaking the denture in the morning and evening
  2. Environmental assistance
    • Patients may easily be distracted. So, it is necessary to arrange for a quiet dining environment, reduce the amount of disturbance such as passerby or the sound from TV.
    • Use place mats and utensils with contrasting colours to help patients identify different items.
  3. Choose the right utensils
    • Use simple utensils
    • Patients tend to misidentify the use of different utensils. It is advised to use plain colours or plates and bowls with simple patterns to avoid misunderstanding that there are foreign objects on the cutleries.
  4. Proper sitting posture
    • Keep the head centred, chin slightly tilted towards the front. Consult speech therapist on the correct way and techniques of eating if necessary.
    • Keep the back straight; if the patient cannot keep the back straight, consult occupational therapist on the need to use assisting devices if necessary.
  5. In case of reduced appetite, increase the types and textures of food to attract the patient to eat
    • Choose foods with different colours
    • Choose foods with stronger flavor or smell, such as onion (beware of whether the patient has other diseases such as diabetes/high blood lipids)
    • Choose sweet dishes or adjust the food temperature based on patient’s preferences.
    • Use of nutritional supplement may be suitable for patients who are underweight or who have poor absorption. Make sure to consult nurses/nutritionist before use.
  6. Pay attention to the speed and portion of eating
    • Take a small bite at a time; use a small spoon to control the amount of each bite.
    • In case of feeding, keep the speed moderate and do not urge the patient to eat.
    • Use thickener to increase the viscosity of the liquid to improve difficulty swallowing. Make sure to consult a therapist before use.
  7. Hint about eating steps
    • Explain to the patient before meals that it is time to eat
    • Give verbal hints or demonstrations such as “take the spoon, get some rice and put it into the mouth”.
    • If unsuccessful, make a move to hint at eating, such as tapping on the forearm or pointing at the spoon.
    • If unsuccessful, hold his/her hand to bring the spoon to the lip, then observe if the patient can eat on their own after practicing for a few times.
    • If the patient cannot eat on his/her own after all the previous steps, start feeding.
    • Check the mouth of the patient after eating to see if there is any food residual.

Constipation

  • Serious constipation may lead to restlessness and other negative emotions, affect sleeping quality or even cause confusion. The problems brought by constipation should not neglected.
  • Help the patient develop healthy habits of excretion, eating and exercise. Choose foods high in fibre, such as whole grains, fruits and vegetables.

Over/underweight

  • It may be a red flag of eating disorder. Family needs to observe if the patient can no longer arrange meals for himself/herself, forget to eat or has any emotional problems and seek professional assistance to allow early intervention.
  • Overeating is a result of losing the sense of time and hunger. Family can prepare meals for the patient beforehand, choose the food items as well as the place of storage at home carefully.

If the patient shows any of the following behaviour, caregivers should handle it carefully:
  • Being agitated and refusing to eat
    Do not feed the patient, use other activities to divert his/her attention and continue feeding only after the patient has calmed down
  • Forgetting to eat or keep asking for food
    Do not argue with the patient; use a timetable to jot down the meal times or prepare frequent meals in small portions and healthy snacks

Communication

The decline in memory, comprehension, language competence and social ability will directly affect daily communication skills. Caregivers should observe the degradation of the patient’s language competence at every stage of dementia to offer suitable assistance.

Early stage

  • Patients may have difficulty carrying a conversation and expressing themselves.
  • Patients may fail to use the suitable words to describe an object but tend to be capable of self-correction in case of wrong choices of words.
  • Patients tend to use vague statements to represent people/objects or places, such as “I’m heading there”, “I’m eating something”, “I’m going there with someone”.
  • Patients tend to use some “catchphrases”, such as “It is just the way it is”, “However you like”, “Hard to tell”, “Whatever” or “I don’t know”.

Middle stage

  • Unable to express themselves in complete sentences
  • Fail to name a person or an object, especially something abstract
  • Unable to control voice projection and intonation
  • May demonstrate confusion in word choices, such as misnaming “sugar” as “salt” and “daughter” and “mom”
  • Can occasionally talk in an organized manner or mention something long forgotten
  • Lose the ability to use any non-native languages. For example, if the patient is native in English, came to Hong Kong at his/her teenage and learnt Cantonese as a second language, then his/her Cantonese ability may be more prone to depletion

Late Stage

  • Form ungrammatical sentences
  • Lose the speech ability, become unable to talk or could only make unidentifiable utterances

How to communicate with dementia patients

There are two kinds of communication—verbal and non-verbal. With suitable communication skills, patience in listening and appropriate expressions, patients can feel the support from other people, less helpless and frustrated.
  1. Observe the surroundings. Patients’ receptive ability may be affected in noisy environment.
  2. If the patient shows any eye and hearing problems, consult a doctor for detailed check-ups.
  3. Introduce yourself to the patient.
  4. With the consent of the patient, call them by their usual name.
  5. Use short and simple sentences in a conversation; speak at a moderate speed, use clear articulations, a calm tone and dialects the patient is familiar with.
  6. Start a conversation with things happened on the same day, such as people, places or weather.
  7. Choose the topics the patient is familiar with to maintain a fluent conversation.
  8. Provide choices for the questions raised to the patient. For example: “Did you get married in Hong Kong or China?”
  9. Give the patient plenty of time to respond to the questions. If the patient gives any answers, show signs of encouragement immediately, such as showing a smile or verbal compliments.
  10. Listen to the patient patiently
  11. Try to understand what the patient means by the unclear phrases
  12. Try not to correct the patient in case of wrong choice of words to avoid embarrassment. Give him/her some hints or switch the subject. For example, you can respond with: “You just mentioned you’ve been to…” to let the patient complete the sentence.
  13. Show some humour when appropriate
  14. Avoid arguing with in a commanding tone; the patient may feel bawled out when you talk to them loudly.
  15. Make good use of facial expressions, body gestures and other non-verbal communication skills to exchange with the patient. Pay attention to the following:
    • Caregivers can promote non-verbal communication with a caring and peaceful attitude
    • Maintain eye contact when facing the patient; observe the emotions and reactions of the patient during communication
    • Body contact may be an effective way to show care and love to the patient. You may tap on the shoulders or arms of elders. But some patients may not like this form of contact.
    • Use gestures and body postures to assist verbal exchange, such as waving to say goodbye.
    • If the patient has earing problems but remains capable of reading to some extent, opt for written communication.

Behavioural problems

Behavioural problems are common in dementia patients. Thinking and behavioural problems may take shape as the disease progresses to a certain stage. Common symptoms include self-isolation, change of appetite, strange thoughts, being prone to anxiety and agitated. Other symptoms could be showing aggressive or repetitive actions, shouting, wandering, depression, suspicion, delusion and insomnia.

Repetitive actions

Patients may not be aware of what they do, while the actions themselves may serve as a sign of insecurity. Do not get angry or blame the patient. Try to divert his/her attention by suggesting other activities. Under safe conditions, not giving any response may also be a solution.

Violent behaviour

Radical reactions from the patient may trigger violent behaviour targeted at caregivers or family. Caregiver should remain self-composed and should never react with violence; try to divert the attention of the patient and find out the cause of such violent behaviour: is it because of the difficult task at hand, or discontent with anyone? If the violent behaviour becomes recurrent, contact the doctor for consultation and consider using medication to control it.

Home safety and care

Intellectual decline affects the memory, thinking and judgment of dementia patients, which may cause chaos in everyday life. If caregivers can provide a safe, simple and clean living environment with reminders for the patient, it may be conducive to the activity level of the patient and home safety.
  1. Floor
    • Keep the floor dry, use plain colours, anti-slip and non-reflective materials
  2. Lighting
    • Make sure everywhere is well-illuminated
  3. Bedroom
    • Decorate the room with personal items of the patient
    • Place items within reach to avoid climbing or squatting
    • Install night light or signposts to help patients identify the location of the bathroom at night
  4. Corridor
    • Bundle up the cables to avoid open exposure
    • Keep the corridors clear; do not use carpet
    • Show clear signs on steps and threshold to avoid using any when possible
    • Install suitable handrails
  5. Living room
    • Place furniture items at a fixed location, do not change the arrangement casually and try to make some free space
    • Choose furniture items with round edges; avoid using foldable tables or stools
    • Place a calendar and clock at somewhere noticeable
    • Keep a list of frequently used phone numbers next to the phone
  6. Kitchen
    • Lock up the dangerous items (such as disinfectants, detergents and sharp objects)
    • Turn off the main switch of stoves after cooking
    • Advise the patient to use the kitchen with the company of the caregiver
    • Lock the kitchen if the patient appears confused or eats carelessly
  7. Door and windows
    • Keep the main door locked, install an alarm system, hidden lock or password lock. Put a “stop” sign on the door as a reminder for the patient
    • Paint the door and the wall nearby with the same colour, but the doors of the rooms the patient uses often with a special or familiar colour for easy identification
    • Install fixed window fences or lock the moveable fences
  8. Bathroom and toilet
    • Use non-slip tiles on the floor and keep the floor dry; install suitable handrails.
    • Use a thermostatic water heater and set the temperature at the lowest heat level
    • Use pictures to show the patient how to adjust hot and cold water on the tap
    • Install handrails or bathtub seat if there is a bathtub
  9. Measures to avoid getting lost
    • Do not leave the patient at home alone
    • Keep the basic information of the patients and contact of the family in his/her personal belonging; make the patient wear an engraved bracelet or information tag
    • Inform neighbours, security guards and employees in the shops nearby that the patient may get lost and the contacts of the family
    • Prepare a recent photo of the patient for use
    • Make the patient wear an anti-lost device or bring a location tracking phone

Use auxiliary tools

  • Install a bed alarm that will be triggered once the patient leaves the bed to inform the family timely
  • Use a recordable doorbell with sensor to remind the patient not to go out
  • Install a sensor bell or door alarm to inform the family of any sudden events

Relevant information

Source: 律敦治及鄧肇堅醫院 - 認知障礙症照顧者手冊

How to alleviate the stress of dementia patients and their caregivers?

Due to decline in memory and cognitive abilities, as well as the ability in self-care, many dementia patients require the assistance of their caregivers in arranging more complicated everyday activities (such as family gathering and follow-up consultations) and taking over some extra responsibilities (such as financial management and accompanying the patient at follow-up consultations). Studies showed that caregivers tended to feel frustrated, angry, guilty and a strong sense of upset (given the reduced communication and intimacy) amid the changes of the patients. If caregivers do not make use of good stress releasing skills, some may feel depressed, unwell and financially burdened.

1. Caregiver may use alleviate their stress in the following ways:

  • Equip yourself
    Try to learn different caring skills by taking part in relevant workshops, referring to online resources or reading relevant books or brochure.
  • Be kind to yourself
    Allow yourself to quiet down, take a nap at home, take a walk in the park to immerse in the nature, or enjoy some entertainment activities such as watching a movie
  • Reassure yourself
    Give more credit to your efforts and care in looking after the patient, so that you will feel the meaning of the hard work and believe it is worth the while to do so
  • Stress management
    A healthy lifestyle is of utmost importance in stress relief. You should maintain healthy sleeping habits, a balanced diet, stay positive, practice relaxation techniques and exercise regularly.
  • Channeling your emotions
    You should understand that you may also have emotional fluctuation and talk to relatives and friends you trust; avoid keeping the feelings to yourself or forcing yourself to take care of the patient
  • Assistance of relatives and friends
    To avoid shouldering the responsibilities on your own, you can ask for help from relatives and friends, such as keeping the patient company during the day or sharing the housework
  • Community support
    You can encourage the patient to take part in the cognitive training, workshops or services supporting patients at the community centre

2. How can relaxation exercises improve concentration?

When dementia patients and their caregivers are under stress, the sympathetic nerves of the autonomic nervous system will be stimulated to trigger reactions of “fight or run”. Studies showed that people who were under constant stress would experience reduced concentration, which in turn affects the functions of hippocampus which is responsible for learning and memory. Therefore, learning relaxation techniques can help dementia patients and their caregivers improve their concertation and learning ability.

Reactions of “fight or run” under constant stress:

Physical Emotional Thinking/cognitive
Headache
Rapid heartbeat
Muscle stiffness
High blood pressure
indigestion
Nervousness
Depression
Loss of interest (in anything)
Inability to concentrate
Compromised concertation
Negative thinking
Indecisiveness

“Abdominal breathing” is one of the effective relaxation techniques that targets the hyperactive sympathetic nerves; it helps relieve the heartbeat and muscle tension. Long-term practice can help strengthen the parasympathetic nerves and put the body into a relaxed state. The steps for practicing “abdominal breathing” are as follows:
  • Choose a quiet environment; you can sit on a chair on lay down
  • Put your hand on your belly; when you breathe in through your mouth, feel how the belly contracts
  • As you breathe out, slowly relax the belly and allow air to go in naturally through your nostril
  • Practise for 10-20 minutes every day
Source: ”Tips on brain fitness” from the Mental Health Resource Centre at Pamela Youde Nethersole Eastern Hospital


Support and assistance

If the emotional and behavioural problems of the patient intensify or you find it difficult to handle these problems, reach out to your family, medical professional, therapists or social workers for assistance.

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Last Update: 26/2/2021