Experts say it is likely that dementia does not increase the risk for COVID-19, just like dementia does not increase the risk for flu. However, dementia-related behaviours, increased age and common health conditions that often accompany dementia may increase risk. For example, people with Alzheimer’s disease and all other dementia may find it more difficult to adopt or comply with protective measures such as hand washing, coughing, social distancing, isolation and lockdown. In addition, diseases like COVID-19 and the flu may worsen cognitive impairment due to dementia.
The COVID-19 pandemic, and the challenges that it poses, means that people with dementia may find their normal routines disrupted, lack cognitive stimulation, feel lonely and anxious, fear being abandoned and risk depression.
They may experience a deterioration of their condition, sleep disturbances, a change in behaviour, self-neglect and premature institutionalisation. Even people with more advanced dementia, who do not fully understand the current situation, may be affected by the loss of support and sense the stress and emotional upheaval caused by COVID-19 through the people around them and in the media. They may have difficulty understanding ‘cocooning’ (at home or in residential care), social distancing and the use of protective clothing (making it difficult to recognise their carers), resulting in them feeling trapped, abandoned, confused or scared.
Tips for supporting persons with dementia who live in long-term care or residential care settings
- Check with the dementia care facility regarding their procedures for managing COVID-19 risk. Ensure they have your emergency contact information and the information of another family member or friend as a backup.
- Do not visit your family member if you have any signs or symptoms of illness.
- 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 visitation is not allowed, ask the facility how you can have contact with your family member. Options include telephone calls, video chats or even emails to check in.
- If your family member is unable to engage in calls or video chats, ask the facility how you can keep in touch with facility staff in order to get updates.
- Continue with regular, routine medications, particularly in case of those who have chronic conditions like diabetes, hypertension, thyroid issues.
- Persons with dementia and their carers should ideally postpone their routine follow-up appointments, unless it is an emergency.
- Go to the hospital only in the event of an emergency. This minimises the risk of exposure to unnecessary infections.
- Persons with early dementia will need to be encouraged, frequently prompted and reminded, to maintain physical distance from others and to wash hands.
- Access support for persons with dementia and their caregivers, through virtual platforms, or telephonic calls to their doctor.
- Persons with dementia and their carers should continue to carry out basic physical exercises and relaxation techniques.
- In response to signs of stress: Carers must use positive and simple communication techniques, to initiate activities, provide daily encouragement and reassurance.
- Recreate interest in music or art, or any other hobbies. Making their immediate environment more soothing can help address certain behavioural issues.
- If the person with dementia requires isolation, create a special space for them—adjust the lighting, play soothing music, and ask the caregiver in-charge to communicate with them in simple language. Carers must listen to the person with dementia, attend to their feelings, and validate their emotional experience.
- Caregivers at home must distribute the work equally between themselves, to make sure that there’s time to rest for each person involved. This is especially important given their current responsibilities and heightened stress. Rotate caregivers at home, so as to provide respite for each caregiver; this is crucial due to their responsibilities and heightened stress.
Keeping the person in the facility
- Ask the facility about their quarantine procedures. What is your level of confidence that the prescribed guidelines are being followed?
- How many people in the facility have been impacted by COVID-19? Are those affected staff, residents or both?
- Is your family member able to follow social distancing procedures (with or without help)?
- In some cases, the person may not be able to walk or move about on their own. This could help maintain social distancing.
- Does the facility have and use personal protective equipment?
- How many staff members interact with your family member on a regular basis? Is the facility able to limit the number of staff who work with your family member?
- Is the facility adequately staffed to provide the level of care your family member requires?
Moving the person from the dementia care home to a family members home.
Things to consider are:
- What level of care does the person need on a day-to-day basis? (For example, is the person able to bath and dress him- or herself? Are they continent? Are they ambulatory or do they need assistance moving?)
- Is your family able to provide the level of care needed?
- While limiting the number of people who have contact with the individual is important, it is also important to assess the number of people needed to provide adequate care.
- Does anyone in your family have COVID-19 currently?
- Are there individuals in the home who work outside of the home? If so, the risk for exposure is increased.
- Is it possible to hire home care workers? This option comes with its own level of risk.
Blog post submitted by Jill Robson ( Western Cape Manager)