The impact of the Corona-virus on people living with dementia cannot be underestimated.  No one was prepared for the virus that hit our country earlier this year, and which has become a part of our lives.  Hand sanitising, social distancing and wearing of masks have become the new “normal”.  As we try make sense of the severe impact of the Corona virus on the worlds’ population, people living with dementia are confronted with these same realities amidst confusion, agitation, loneliness and frustration.

Although dementia as such is not a risk factor on its own, many of these people are above 60 years of age which puts them into the vulnerable category, and they may also have comorbidities such as lung diseases, heart conditions and diabetes. Added to that, the fact that people living with dementia often have difficulty understanding the need for hand sanitising, social distancing and wearing of masks one realises that Covid-19 brought its unique challenges for people living with dementia and their caregivers/families.

Tips for families caring for a person living with dementia at home

  • Identify and utilise support systems in the community.  Contact your local branch of Alzheimer’s South Africa for support and guidance on how to care for the person during this challenging time.
  • Caregivers may find that they are taking on more responsibilities now with lockdown without assistance or breaks, as visits from family members and friends are limited.  This may cause physical and emotional fatigue and even depression.  Families and caregivers need to put respite care systems in place to avoid caregiver burnout and stress.
  • Think ahead and make alternative plans in case the primary caregiver becomes ill.
  • Be aware of the fact that the person living with dementia can experience a rise in anxiety levels, frustration and uncertainty. Try to keep to daily routines, invent activities to keep the person busy and occupied as far as possible.
  • People living with dementia may need extra reminders to sanitise hands and practice personal hygiene. Consider placing dementia friendly signs in the bathroom to remind people to wash hands regularly.
  • Demonstrate thorough hand washing with a 70% based alcohol sanitiser/water and soap.
  • A rise in confusion is usually the first indicator that the person living with dementia is not well. If he/she presents with rapid increased confusion, contact your local health system for advice.
  • Keep in touch with other family members (siblings, children, grandchildren) and friends through Skype, Zoom, WhatsApp calls, telephone or FaceTime.
  • Support and comfort the person living with dementia by showing respect, patience, warmth and understanding when communicating with them. Make sure that your tone of voice is friendly and warm and keep eye contact.
  • Focus on the person’s abilities and enjoy the activities that are familiar and of interest to them like music and movies from the sixties/seventies, singing songs together and reading from a special book/Bible.

Tips for people living with dementia

  • Limit your face to face contact with people.
  • Avoid close contact with people who are sick.
  • Encourage the wearing of masks whenever you have face to face contact with anybody.
  • Wash your hands regularly with soap and water or an alcohol-based sanitiser especially before eating, after going to the bathroom and after coughing, sneezing or blowing your nose.
  • Cough and sneeze into a bent elbow or a tissue, then throw the tissue in a dustbin or toilet.
  • Avoid touching your eyes, nose and mouth.
  • Clean or disinfect frequently touched objects/surfaces.
  • Try to fight boredom and loneliness. Do what you normally enjoy doing, like going for a walk in the garden, listen to music, watch movies, do knitting, cross word puzzles, Sudoku etc. and make contact with family members and friends.
  • Keep a list of emergency contact numbers next to your phone where you can easily find it in case of an emergency.

Additional section on private caregivers in the home

  • Contact the caregiver agency and ask them to explain their protocols to reduce the spread of COVID-19.
  • Check the caregiver’s temperature every time before they enter your home. Anyone with a temperature over 37.5°C should be excluded from providing care.
  • Ask the caregiver if they have been exposed to anyone who has tested positive and if so, do not allow them into your home.
  • Ensure that the caregiver washes their hands upon arrival and regularly throughout their time in your home.
  • Insist that the caregiver wear a mask at all times.
  • Be aware that bringing anyone into your home increases the risk of spreading COVID-19, even if all the guidelines are followed.
  • If at all possible assist the carer staff with private transport so avoid them using public transport.

Tips for supporting people living with dementia in long term care facilities

  • Always adhere to guidelines regarding infection control and prevention when engaging with your family member. At this time each facility will have its own regulations which have been formulated to keep residents safe.
  • Depending on the situation in your local area, facilities may limit or not allow visitors. This is to protect the residents but it can be difficult if you are unable to see your family member.
  • If the long term facility does not allow visits, negotiate contact with your family member with the help of the facility. Regular contacts can include telephone calls, WhatsApp calls, Facetime or even email messages etc.
  • Should your family member not be able to connect via telephone calls or other means of communication, engage with staff members to get regular updates.
  • Support the care facility personnel and show your appreciation for what they are doing under the trying circumstances.
  • Assist the carers by arranging private transport to and from work so that they do not have to use public transport.
  • Assist the staff by arranging that the staff change into their uniforms at work and then again undress when they leave work. The care home should launder the uniforms for the staff.
  • Staff in care homes should wear protective clothing in the form of aprons and gloves when necessary. Masks must be worn at all times by the staff.
  • When visits are allowed, do not visit your family member if you show any symptoms of the disease.
  • Create guidelines for scheduled contact visits e.g., visits in the garden or in an identified area that is well ventilated and isolated from the general care home community.
  • Should visits be allowed, remember to wear masks at all times.

Tips for long term care facilities

  • Adhere to all the prescribed regulations regarding infection control and prevention.
  • Ensure that the information regarding the virus, is from a reliable source.
  • Do not switch the TV on a 24hour news channel.
  • Provide the residents with suitable information to prevent anxiety about the virus.
  • Provide easy to understand explanations about the current situation.
  • Spend regular time with residents to listen to their fears, questions and concerns.
  • Avoid the use of negative language like crises, lockdown or pandemic.
  • People living with dementia may need extra reminders to sanitise hands and practice personal hygiene. Consider placing dementia friendly signs in bathrooms to remind people to wash hands regularly.
  • Demonstrate thorough hand washing with a 70% alcohol-based sanitiser/water and soap.
  • Wearing of masks may be a challenge, but need to be communicated and explained to the person living with dementia.
  • Maintain open communication with the residents and their families about the staff and/or families that have been impacted by Covid-19.
  • Support the personnel who are walking the extra mile to ensure quality, personal care.
  • Discourage people who are ill in visiting your facility to ensure protection for all the residents.
  • Remember, this is a stressful time for everybody.

Sources:

https://www.alz.org/help-support/caregiving/coronavirus-(covid-19)-tips-for-dementia-care

www.dementia.org.au

Blog post compiled and submitted by Petra du Toit – Executive Director, Alzheimer’s SA