Setting routines and reminders

Overview

Activities such as dressing, grooming, bathing and eating can form a pattern in daily living. Routines help the person with dementia know what to expect, and help her to continue to do things on her own. Doing so will make her feel better about herself.

People with Alzheimer’s disease will eventually lose the ability to carry out these everyday routines and will depend on others to help. So it is important for them to do as much as they can for themselves, for as long as they can. This will help them feel good about themselves, for greater dignity and confidence.

It will be easier if you continue the routines she has been used to for much of her life. For example, if she is used to bathing in the morning, try to make morning bathing the pattern. Carrying out the activities in much the same order each day will also help her know what to expect.

Reminders will help, particularly during the earlier stages of the disease. These can be written notes on the fridge to remind her to eat, or signs on a cupboard to tell her what is inside.

If he no longer understands words, try using colour cues or pictures. Cues such as a toothbrush on the counter will remind him to brush his teeth. Clothes laid out in the order they are to be put on will make it easier for him to get dressed. Regular reminders might be needed to get him to go to the bathroom.

Helping with routines

If you are supporting someone with Alzheimer’s disease, you may find it difficult to know how to help and how much to help. Sometimes he needs help but wants to look after personal care independently. This can be frustrating, especially when you know you could carry out the task more quickly, or help do the task more efficiently. Try to avoid the temptation to take over, even if he is really struggling. The loss of confidence could make it harder for him to keep trying.

When you do offer help, try to do the task together, rather than doing it for him. This will help him to feel more in control and more involved. When talking through activities like this, try to focus on what she can do, rather than on what she can’t.

Keep in mind that it’s hard for people with dementia to learn new ways of doing things, remember steps involved in instructions, and stay focused for long on a task. Take things slowly, try to be patient, and take breaks. Be encouraging, and try to maintain your sense of humour.

Tips for making routines easier

Try breaking the task down into sections. For example, she may find it easier to continue dressing herself if you put the clothes out for her in the order that she needs to put them on. Or you could pass her the next garment, holding it out ready to grasp at the right place, or encourage her to put her shirt on over her head before you straighten it down for her.
Even if he can't complete a full task, carrying out one or two steps of it—particularly the final step—can give him a sense of achievement.
Make sure that any reminders or instructions are simple. Use short sentences, with gestures and body language to add meaning.
Be tactful. Try to imagine that you are the person receiving help, and speak in a way that you would find helpful if you were in her position.
Try doing things together, such as folding clothes or drying dishes.
If there are activities you do regularly, try integrating them into the daily routine.
Make sure he doesn't feel he is being supervised or criticized in any way. This means checking your tone of voice as well as the words you use.
When the dementia gets to a more advanced stage, try pointing, demonstrating, or guiding an action rather than giving a verbal explanation. For example, she may be able to brush her own hair if you hand her the brush and start by gently guiding her hand. Try using your voice to make reassuring and encouraging sounds rather than using actual words.

(This list was adapted from Alzheimer’s Society (U.K.) http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=115