Intentional Caregiver Coaching with Dr. Lori

This is common in persons living with Alzheimer’s. They may feel fearful of water, confused about the process, or even embarrassed about needing assistance. Create a calming atmosphere by warming the bathroom, playing soothing music, and gently explaining each step. Offering choices, like using a sponge bath as an alternative, can also help. Patience and understanding are key. Here are some specific strategies to encourage her:

1. Create a Routine: Establish a specific time each day for her bath, so it becomes a regular part of her schedule. For example, you might say, "It’s almost 7 PM—bath time is our evening ritual."
2. Gentle Reminders: Use positive, non-judgmental language to encourage her. For example, "You’ll feel refreshed and comfortable after your bath," or "It’s such a nice way to relax before bed."
3. Eliminate Barriers: If she has physical discomforts (e.g., arthritis), ensure the bathroom setup is safe and comfortable. Non-slip mats, grab bars, or a handheld showerhead can make bathing easier.
4. Offer Choices: Let her choose between a shower or a bath, what soap to use, or the time of day. Having control may increase her willingness.
5. Minimize Anxiety: If she feels overwhelmed, break the process into smaller steps. For instance, suggest she start by washing her face and hands and gradually continue.
6. Provide Privacy and Support: Reassure her she has privacy and remind her you are nearby if she needs help.
7. Positive Reinforcement: Praise her effort and make the experience pleasant by offering something enjoyable afterward, like a cup of tea or watching her favorite show.

 If the behavior persists, consider whether she might be feeling physical pain, confusion, or emotional distress about bathing. Consulting her healthcare provider could help uncover any underlying issues. 

No, this is a normal feeling for caregivers. It reflects your compassion and desire to see your loved one free from pain. While these thoughts can feel overwhelming, focusing on providing comfort and quality of life in the present moment can ease your burden. Don’t hesitate to seek emotional support from a counselor or caregiver support group. 

Start by visiting your home with her regularly, allowing her to become familiar with the environment. Gradually introduce her to the idea by highlighting positive aspects, like spending more time together, visiting her favorite place, i.e. a restaurant, park, etc. Consider setting up her space with familiar items to create comfort. Maintain open communication and reassure her of your love and support.

Repetition is a hallmark of Alzheimer’s. Answer with patience and try redirecting the conversation. Tools like memory aids (e.g., a whiteboard with daily schedules) can also help reduce repetitive questions. 

Yes, Alzheimer’s can affect temperature regulation. Dress him in layers and keep blankets accessible for comfort. 

This behavior, known as sundowning, can often be eased by keeping her engaged with calming activities earlier in the day, ensure good lighting, and maintain a consistent routine. Avoid caffeine and large meals in the evening, however, make sure that she is not hungry before bedtime. Try to prepare a calming environment for her to rest, as well as a calming bedtime ritual. 

Offer small, frequent meals of finger foods that are easy to eat. Experiment with flavors and textures, and ensure that the environment is calm and distraction-free during meals. 

Install door alarms and secure locks out of her line of sight. Ensure she has an ID bracelet with emergency contact information. Consider placing a pressure-sensitive mat by the bed to alert you if she gets up. Also, try baby doorknob covers on exterior doors. These require a special procedure to open. 

Try mixing medications with food or drinks, if possible, and explain their purpose in simple terms. If resistance continues, consult his doctor for alternative forms, like liquid or patches. 

Though painful, focus on connecting with her in ways she still understands, like talking about happy memories or engaging in activities she enjoys. Use her name and keep interactions calm and positive. Also, begin making new memories with her not based on the fact that you are her daughter. 

Aggression often stems from fear or discomfort. Stay calm, ensure the environment is non-threatening, and try to identify triggers. Approach tasks slowly and explain what you're doing step-by-step. 

Offer clear verbal cues and create a bathroom routine. Adaptive clothing and bathroom aids can make the process easier while preserving privacy as much as possible. 

This is a form of paranoia linked to Alzheimer’s. Avoid arguing; instead, reassure him and help "find" the missing items. Keeping duplicates of frequently misplaced items can be helpful. 

Adapt activities to her current abilities. For example, if she enjoyed painting, provide simple coloring books. Keep the focus on the process rather than the outcome. 

Be honest but age-appropriate. Explain that their grandparent’s brain is sick and they may forget things or act differently. Encourage them to ask questions and express their feelings. 

Gently remind him of the time since his last bath and suggest a routine like “bath day.” Keep the process quick and dignified to reduce discomfort. 

Engage with her story and show interest. Redirect the conversation when appropriate by introducing related topics or activities. Try not to make her feel bad about talking about the same thing over and over again. 

Validate his feelings by saying something like, "Tell me about home." Redirect his attention to comforting activities or familiar items in the current environment. 

Start by having the caregiver assist with tasks while you're present to build trust. Gradually step back as she becomes comfortable. 

Encourage daytime activities and exposure to natural light. Avoid naps and establish a calming bedtime routine. Plan activities that he will like, which are also outside of the house. Try to reduce the number of opportunities for him to sleep during the day.

Clear clutter gradually, keeping sentimental or harmless items. Offer her a designated space for her "treasures" to satisfy the need to collect. 

Buy duplicates or even triplicates of his favorite outfits and establish a daily dressing routine. Gently explain the need for clean clothes. 

 Sit with her, hold her hand, and reassure her with soothing words. Distracting her with a pleasant activity may also help. Try reading a story with her, putting together a puzzle, tell stories, or even coloring. As you are participating in these activities, engage your mom in conversations that make her at ease with being in her current space. If there was a recent loss (even if it was not so recent), she may be grieving and not understanding that her feelings may stem from the loss. If there was a recent move from her home, she may feel a loss of independence, friends, old activities, or more. Be sure not to alienate her from familiar activities, friends, and places.

Encourage but don’t force him. Offer small, low-pressure gatherings to help him feel comfortable. 

 Cover mirrors in areas where they cause distress. This fear often stems from not recognizing her own reflection.