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Lesson 5. An enjoyable day

Adapting routines to the changing abilities of the person you care for

Adapting routines to the changing abilities of the person you care for

It is important to adapt routines as the abilities of the person living with dementia change.

Here are some common routines to establish during the day for a person living with dementia.

In the morning

Wake up at the same time every day
  • Adaptation: help might be needed to wake up because the person with dementia may not be able to set the alarm correctly.
Have breakfast at a fixed time. In the earlier stages of dementia, your family member or friend might be able to make their own breakfast.
  • Adaptation: the person with dementia may need someone to lay out ingredients. Later on, they may need more help with preparing and eating breakfast.
Performing grooming activities, such as brushing teeth, bathing/ cleaning, getting dressed. In the early stages, the person you care for may be able to do all of these activities without help.
  • Adaptation: items such as the toothbrush, toothpaste, etc. can be laid out in the bathroom in plain view to prompt the activity. In the later stages of dementia, it may be necessary for someone to do these activities for, or with, the person living with dementia.

Keep in Mind

  • It is important to develop routines for morning activities and maintain them as long as possible.
  • Make adjustments as needed when the abilities of the person living with dementia change.
For more tips, please refer back to Lesson 4. Personal care in this module.​
 
During the day  

It is helpful to plan activities that the person you care for enjoys doing, based on their prior interests and current abilities.

Let’s look at an example

Maitha loves baking and used to prepare special cakes and cookies for family gatherings. Now that she has dementia, she sometimes forgets the ingredients and the order in which to put them in.

At first, Maitha uses a cookbook to help her continue baking but she finds this increasingly difficult. The cakes and cookies do not taste very good and have to be thrown away. Sahar wants to help her mother keep up this activity.
​​
2. Check your understanding
Maintaining prior activities and interests during the day.

What suggestions do you have for Sahar?
Please select the correct answer from the responses below.



​What is sundowning?  

Sometimes people with dementia become more agitated, aggressive or confused in the late afternoon or early evening. This is often referred to as ‘sundowning’. It can be particularly distressing for carers. The exact cause of sundowning is not yet clear but a loss of routine might be one of the reasons. Try to give the person something meaningful to do at this time of day.

​Let’s look at an example

Maitha likes to go to a community centre every day from 12:00 until 15:00. She has Lunch there and meets friends to do activities together. At first Maitha walks there by herself but as her memory loss becomes more severe, she cannot find her way to the centre anymore. Sahar asks another family member to take Maitha to the centre and bring her back home. This works well for a while but eventually the family member is unable to take Maitha. Sahar does not know what to do since she cannot be with Maitha every afternoon.​

3. Check your understanding
Maintaining activities and interests outside the house.

What suggestions do you have for Sahar ?
Please select the correct answer from the responses below.



Keep in Mind

  • It is important to respect the daily routines of the person you care for and maintain them for as long as possible.
  • When this is no longer possible, adapt the routine to the best of your ability so that the key activities that are important to the person with dementia are maintained for as long as possible.

At bedtime

​At night, Maitha is used to reading quietly for about 30 minutes before she goes to sleep. As her dementia progresses, she finds that she is no longer able to read. Sometimes she is just staring at her book. She increasingly finds reading confusing.

Sahar wants to adapt this routine to fit Maitha’s current abilities.
4. Check your understanding
Adapting routines.

What suggestions do you have for Sahar?
Please select the correct answer from the responses below.



Tip

  • For the morning, afternoon and bedtime, establish and maintain routines for as long as possible, but be prepared to adapt these as the abilities of the person living with dementia change over time.
  • Printing out a list of daily routines can help. Do one for each day and put it up in a prominent place.
1.Activity
Do you know any of the routines of the person with dementia that you care for?
Please write down any ideas that you have about routines for the person you care for and how they can be adapted.




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