Your approach to personal care should always take full account of the feelings and dignity of the person you are helping. People with dementia cannot always tell you if they feel embarrassed. Personal care must be given to the individual: these are not just tasks that must be completed. Respect his or her feelings at all times.
Advice on lifting
You should never attempt to carry anyone on your own as you could hurt yourself and the person. Simply supporting someone who is heavy can be risky unless you are very careful. That is why it is so important to ask an expert for advice on the safest ways to lift and support the person. If you do have to lift someone, make sure you get help.
- Both of you should keep your feet apart and firmly on the ground when lifting. Bend at the knees and hips. Keep close to the person. Say what you want him or her to do.
- Always take your time and never lift the other person’s weight till you are absolutely comfortable.
- Lifting and twisting can damage your back. Avoid twisting movements by rearranging the furniture or taking things in easy stages.
- Never pull the person up by the arms as this can harm his or her shoulders.
- Make sure there is enough room to move and there is nothing in the way.
Helping the person out of a chair
It is harder to get up from a low chair. If the chair is too low for the person, a cushion on the seat may help. Chairs with firm arms will help the person to manage better.
If the person can co-operate easily
- Stand at the side of the chair and encourage the person to move forward and to the edge of the chair near you.
- The person’s feet should be firmly on the ground and tucked back.
- Take hold of the hand nearest to you, palm to palm, and put your other hand firmly against his back, under his arm on the opposite side.
- You can then support him to stand up.
Co-operation and safety
It is necessary to get people’s co-operation, whether you are helping them to move or just suggesting that they do so.
- Try to approach them in a calm, relaxed way, even if you are feeling very upset. You are far more likely to succeed if they do not feel anxious or rushed.
- Spend time explaining what you would like them to do, such as getting up from the chair or putting on a coat. Even if they cannot understand what you say, the sound of your voice and the expression on your face can help to reassure them.
- If necessary, you can break down the action into small steps, offering suitable encouragement such as, ‘Now put your hand here. That’s right’.
- You may be able to find other ways of communicating such as by showing them an action or by gently guiding their movements.
- If the person does not want to move, it is often better to leave him a little while, if you can, and then try again. Forcing the person will only make things worse.
- If the person with dementia is moving about or if you are helping the person to move make sure the area is clear and safe.
- Loose rugs, slippery floors, electrical cords on the floor, wobbly furniture or things in the way are dangerous for someone who is confused and perhaps unsteady on his feet, and for the person supporting him.
- There is no need to be very neat and tidy, unless that is what the person is used to, but make sure that the floors or stairs where you walk are clear.
- Also make sure that neither of you wears slippery shoes.
- Take special care when you are feeling tired as that is when accidents are most likely to happen.
There are things that you can do to make it easier for the person with dementia to move and for you to help. Ask an occupational therapist (OT) to visit and advise on the possibility of rails and other aids to help the person get in and out of the bath, on and off the toilet or around the house, or on walking aids, if these are suitable. The OT can also suggest ways of raising the height of a chair or bed, for example, or of rearranging the furniture to make it easier for you to help the person to move.
- It is important to encourage people to exercise regularly and to be active in doing things for themselves, as far as possible, in order to stay fit.
- This will not only improve their quality of life, it will make caring less tiring for you.
- Walking and other forms of movement will help to prevent joint stiffness, muscle wasting and bone softening as well as improving the circulation and promoting a general feeling of well-being.
- As the dementia progresses, you may need to use more imagination to get the person to exercise and remain active and you may need to give increasing assistance in moving around.
- An occupational therapist (OT) or physiotherapist can advise on suitable exercises for people at all stages of dementia and on the safest ways of supporting the person to move around. Ask the doctor or clinic staff to refer the person to an OT or physiotherapist.
Moving and lifting
If the person you are looking after is suffering from dementia you will want to do everything you can to ensure that he or she remains as healthy and mobile as possible. Eventually, however, the person may need help to stand and move around. Each person is different and responds to situations in his own way but here are some suggestions, which you may find helpful.
- Keeping mobile
- Co-operation and safety
- Advice on lifting
Pressure sores, sometimes referred to as bed sores or decubitus ulcers, are sores that develop as a result of continuous pressure on one area of the body for some time. The sore develops because of pressure on the capillaries, cutting off the blood flow to that area. It takes two hours for a pressure sore to develop on an elderly person. The risk is greater with a person who is always in bed or sitting in a chair (“chair-bound”) or very inactive and is increased with an elderly person. Their skin is thin and has little fat to protect the tissues underneath it. It is therefore very important to ensure that you check the person for signs of a pressure sore developing every time you wash or dress them. The first sign of a pressure sore is a red patch on the skin that does not go away after a few hours.