Routine is a very important part of our day to day life. Right from when we are born, we rely on a familiar pattern of things. As infants, routines make us feel safe and secure in our environment. Similarly, the elderly also depend on a predictable sequence to the day, specifically those diagnosed with dementia. As the disease progresses their ability to communicate is affected, they quickly feel stressed, disorientated and confused when there is a change to their environment. They can start to become frustrated and agitated. The best way to overcome these responses is to establish a predictable routine and the CogniCare app can help do this.
Routine is associated with our long-term memory, which is often retained till moderate stages of dementia. In contrast, learning something new is associated with short-term memory, which tends to be affected early on in dementia. Therefore, for people with dementia, familiarity and simplicity are key. They are calm and comfortable when they are surrounded by known faces, voices, objects and even taste of food. Caregivers may even notice they maintain some of their independence when a routine has been established because they know what to expect and what is expected of them. This independence makes them feel good.
The following four-step approach can help you create a routine that benefits the person with dementia and their caregiver.
1. Identify Routine
Take notice of which tasks the person with dementia is already doing and when it is being done. Pay attention to which activities they enjoy taking part it and add in other non-preferred activities around it. For example, if PwD takes a walk in the morning then motivate them to take a bath before so they can go for their walk.
2. Basic Needs
A day should have a mix of activities that engages the PwD in various ways, but caregivers should also be realistic about how much can be achieved in a day. The daily plan should be simple, chose quality over quantity. Here are a set of categories that a caregiver can try to aim to include into the daily routine:
Caregiver now has a list of activities and tasks they would like to complete everyday. The next step is getting the timing right. Timing depends on the changes in mood and behaviour the PwD presents and their cognitive and physical strengths and weakness that appear and change throughout the day. Using the existing schedule of PwD (step 1), the list (step 2) and when PwD would respond best to each activity (step 3) , the routine can now be created.
Over time, monitor how PwD responds to the set routine. As the disease progresses, caregivers may need to simplify the routine, allocating more time per activity or changing an activity altogether. For example, if PwD usually reads the newspaper or a book in the morning, caregiver may need to print short articles from the internet in a bigger font and so it is easier for the PwD to read. The caregiver might need to have an audio version of the book or read to them if they lose the ability to read. This way the same activity is still done, but may need to change the manner in which it is done.