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Topic last reviewed: April 2008

Caring for Someone with Alzheimer's

Daily Activities

Caring for a person with Alzheimer's disease at home is a difficult task. Alzheimer's symptoms grow worse over time, and there is no way to predict how quickly the disease will progress or exactly how behavior will change. Managing the basic activities of daily living -- eating, talking, sleeping, finding things to do -- can be hard for both the person with Alzheimer's and the caregiver, especially as the disease becomes more severe. Here are some tips that may help you cope.

What to do all day? Finding activities that the person with Alzheimer's can do and is interested in can be a challenge. Building on existing skills generally works better than trying to teach something new.

Don't expect too much. Simple activities often are best, especially when they use current abilities.

Help the person get started on an activity. Break the activity down into small steps and praise the person for each step he or she completes.

Watch for signs of agitation or frustration with an activity. Gently help, or distract the person to something else.

Incorporate activities the person seems to enjoy into your daily routine and try to do them at a similar time each day.

Take advantage of adult day services, which provide various activities for the person with Alzheimer's as well as an opportunity for caregivers to gain temporary relief from tasks associated with caregiving. Transportation and meals often are provided.

Trying to communicate with a person who has Alzheimer's can be a challenge. Both understanding and being understood may be difficult.

Choose simple words and short sentences and use a gentle, calm tone of voice.

Avoid talking to the person like a baby or talking as if he or she weren't there. Minimize distractions and noise, such as the television or radio, to help the person focus on what you are saying.

Call the person by name, making sure you have his or her attention before speaking. Allow enough time for a response. Be careful not to interrupt.

If the person with Alzheimer's is struggling to find a word or communicate a thought, gently try to provide the word he or she is looking for.

Try to frame questions and instructions in a positive way.

Eating can be a challenge. Some people with Alzheimer's want to eat all the time, while others have to be encouraged to maintain a good diet. Ensure a quiet, calm atmosphere for eating. Limiting noise and other distractions may help the person focus on the meal.

Provide a limited number of choices of food and serve small portions. You may want to offer several small meals throughout the day in place of three larger ones.

Use straws or cups with lids to make drinking easier. Substitute finger foods if the person struggles with using utensils. Using a bowl instead of a plate also may help.

Have healthy snacks on hand. To encourage eating, keep the snacks where they can be seen.

Visit the dentist regularly to keep mouth and teeth healthy.

For the exhausted caregiver, sleep can't come too soon. For many people with AD, however, the approach of nighttime may be a difficult time. Many people with AD become restless, agitated, and irritable around dinnertime, often referred to as "sundowning" syndrome. Getting the person to go to bed and stay there may require some advance planning.

Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.

Try to schedule more physically demanding activities earlier in the day. For example, bathing could be earlier in the morning, or large family meals could be at midday.

Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.

Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.

Restrict access to caffeine late in the day.

Use night lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.

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