OCT 2020: The importance of routine when living with dementia

Developing dementia is a distressing experience, both for those living with the condition and their families. One of the fundamental, most important practices in caring for someone with dementia is to establish routines. That’s because having a routine grounds us, offers reassuring familiarity and triggers positive associations.

The most common forms of dementia – Alzheimer’s disease, vascular dementia and Lewy body dementia – share certain symptoms, to varying degrees: confusion, disorientation, reduced sense of time, short-term memory loss and, consequentially, frustration and anxiety. Each of these symptoms can be reduced in severity, kept at bay and mitigated by establishing a good routine. As time goes by, it becomes increasingly difficult for people to carry out the daily chores and activities we all do with little thought. Building a routine can fix certain activities in the long-term memory, which helps people living with dementia to retain more of their independence for longer. And that boosts self-esteem and confidence and positivity.

Of course, none of this means eliminating all variety – stimulating activities and interaction are important elements in day-to-day enjoyment – but it does take planning and a commitment to consistency.

The key is to tailor the routine to the individual but following the principle of shaping each day around predictable interactions with familiar people. It isn’t just the generic habitual activities themselves which should be familiar, but the time of day at which they happen.

With dementia, structure matters

These are the daily moments we schedule carefully in our care homes for people living with dementia.

• Waking up and bedtime – even by opening and closing curtains at the same time each day
• Personal care - bath or shower time, brushing teeth and hair
• Toilet visits
• Meal times
• Administering medication
• TV watching and other leisure activities.

Of course, none of this should be hurried. Patience and knowing when it’s the right time to step in and help are important characteristics of good care.

It’s also really important that, wherever possible and sensible, the timetable reflects each individual’s pre-existing habits. We’re here to enable, not to dictate, after all.

Planning leisure activities into daily routine

Above all, we need to take our cues from personal history, preferences and past hobbies and loves. Just think about your own daily habits and the things you enjoy doing – and imagine the frustration of having someone else rearrange or remove them.

That means factoring in the little things. If Sunday always meant dressing smartly, it’s worth keeping that habit up. If there’s a daily or weekly favourite TV programme, it’s a landmark to be respected. If reading the paper over breakfast was a tradition, it’s one we’ll continue. Afternoon naps, card games, pottering in the garden…

If it’s enjoyable, possible and safe, and especially if it makes for positive emotional reactions, enables physical exercise or promotes mental stimulation, it should always form part of a daily or weekly routine.

Staying flexible

No schedule is carved in stone. An interrupted night’s sleep or feeling poorly will often throw things out – and that’s fine. Manage the moment.  And sometimes, people just aren’t in the mood for the things that usually bring them joy. Listening and observing are among a carer’s most prized skills. Take a break, try a new activity, stop for a chat and a reminisce. Listen to favourite music. Feeling secure and content in any given moment are the markers in managing dementia. With a well-established routine based on each individual’s own preferences and pastimes, those markers will be met more often.

If you would like to know more about specialist dementia care, do get in touch with us at info@baycroft.co.uk.