Recommendations for emotional care in an isolated situation

Try to prevent them (*)

• Favours a peaceful environment. Avoid, as far as possible, sudden noises; shortage or sudden changes of light; excessive stimulation (TV or music in the background without stopping, talking at the same time,...). Some soft music (some people find headphones very effective). If you are a believer, listening to the rosary or a mass can help to relax you.
• Invite her to participate in meaningful and enjoyable activities such as caring for animals or plants, sorting objects, washing and folding clothes, housework, playing cards.
• Maintain daily routines and changes life and the daily environment as little as possible, ensuring that the person's significant objects are in view.
• Encourage her and help her move. A walk around the house or some exercise.
• Avoid exciting drinks.

If they have appeared...

1. Show a loving and conciliatory attitude. Express yourself clearly, simply and calmly. Walk and breathe deeply with her.
2. Encourages the person to express herself about his feelings and the causes of what's wrong with her.
3. Press very lightly on the part of the body that is agitated and encourages the person, with kindness, to cease movement, reducing contact progressively until agitation ceases.
4. Entertain her, when she calms down. Take her thoughts to topics that are stress-free and comforting to help create a pleasant state.
5. "Calm" the environment in which the person is. Eliminate the direct and strong lights, noises, amount of people present...
6. Ask for help and consult a doctor if the agitation is sudden and for no apparent reason. There could be some medical or pharmacological cause. Don't forget, asking for help in these cases is not a sign of weakness, but of strength.

Try to prevent them (*)

• Promotes a quiet environment. Avoid sudden noises; sudden shortage or change of light; excessive stimulation (radio and television can be entertaining for some people, but can also cause the person to think they are hearing voices...). Some soft music may be helpful.
• Keep the house well lit and covers the mirrors if the person doesn't recognize his image and thinks it's other people.
• Ventilate all rooms well. Use fragrances and aromas that the person is used to. Sudden changes in odors can also trigger these episodes.
• Avoid exciting drinks
• Try not to make any drastic changes in the decoration or furniture. It may generate more confusion in the person. Identify which objects are relevant to them and keep them in their sight so that they do not become distressed if they do not see them.

If they have appeared...

1. Go with her. It is not necessary to act if what the person perceives does not cause suffering or there is a risk.
2. Calm her down and give her confidence when she is upset or frightened by the disturbance she is experiencing.
3. Try to react calmly so it's easier for her to feel safe and comfortable. Sometimes holding her hand and hugging her can be reassuring.
4. Make sure he can see or hear you. When you address her, stand close and facing her, before you start a conversation.
5. Answer in a neutral way without compromising. When you know what he says, sees or hears is false, avoid arguing. For her it's real.
6. Move to another area of the house with her and offer her some rewarding and meaningful activity. A good starting point can be to start a conversation about real, everyday issues.
7. Don't doubt to ask for help if you need it. Consultation with the doctor to evaluate organic or pharmacological causes. Don't forget, asking for help in these cases is not a sign of weakness, but of strength.

(*) In some cases it can help to get out on the street. Ask your family doctor for a document that justifies the need to go out. Recommendations based on the following readings: "Consejos y orientaciones no farmacológicas para pacientes con deterioro cognitivo en el domicilio y unidades psicogeriátricas". Arriola, E., Alaba J., Buiza, C., González M.F. y Zulaica, A.

LIVING AT HOME WITH A PERSON WITH DEMENTIA. WHAT DO I DO IF...THE PERSON HAS DELUSIONS

Try to prevent them (*)

• Ensure that the person is in a familiar and familiar environment.
• Make sure he sees or hears you when you talk to him by standing close and facing him. Speak clearly and softly.
• Include her in your conversations so she does not think you are talking or plotting against her, etc.

If they have appeared...

• Put yourself in their shoes, realizing that the person is scared because of thoughts that make them suffer
• Stay calm to convey peace of mind and security, and reduce his discomfort with that unsettling thought.
• Attend to what the person is feeling. Avoid making her see reason, for her what she thinks is reality.
• Speak to her a soft tone, even if she does not understand, hold her hand, listen to her so that she feels that she is cared for and protected.
• Don't belittle what she says, or ridicule her for it. Listen to her. It's very important for the person to feel that you support them.
• Gradually introduce topics that you know he will like. Talk to him about his hobbies (sport, reading...), his favourite music, the food he likes best,...
• In the face of the belief of theft:
  • Offer to help her find the object she thinks has been stolen, not by following the theme of the theft, but by focusing on helping her find it.
  • You can put some money in her wallet or a photocopy of the documentation. That might make her feel better.
  • Give her a key to lock her room or her closet if that will reassure her.  
  • Tell her we'll keep an eye out and watch for anyone to come in.
• In the face of beliefs such as: "I have to go home and take care of my children or prepare food for them".
  • Try to talk about the issue that concerns you, but from another perspective: "tell me something about the children, what you're going to prepare to eat..."
  • Don't remind her that her children are currently 60 (or whatever age they are).
  • When she insists on going home or to work, it is best to pay attention to her, staying by her side to avoid putting herself in danger.​
• Don't be hesitate to ask for help if you need it. Remember, asking for help in these cases is not a sign of weakness, but of strength.

(*) In some cases it can help to get out on the street. Ask your family doctor for a document that justifies the need to go out. Recommendations based on the following readings: "Consejos y orientaciones no farmacológicas para pacientes con deterioro cognitivo en el domicilio y unidades psicogeriátricas". Arriola, E., Alaba J., Buiza, C., González M.F. y Zulaica, A.

LIVING AT HOME WITH A PERSON WITH DEMENTIA. WHAT DO I DO IF...THE PERSON HAS CONSTANT WANDERING

Try to prevent them (*)

• Favor a pleasant physical environment. Adequate lighting, familiar and reassuring objects, calm atmosphere.
• Preserve the routines and customs avoiding, as much as possible, big alterations.

If they have appeared...

• Put yourself in her shoes. Wandering can be a manifestation of some unmet need (going to the bathroom, being hungry, thirsty, tired, afraid, insecure, lack of exercise, bored, in pain).
• Accompany her to the bathroom, kitchen or invite her to a comfortable place. If she manipulates the knobs or seems to be looking at where to go, she may be wanting to do something she can't express. Try to find out what it is.
• Orient the wandering to safe áreas. If there is no risk, allow the person to walk quietly, even from one side of the corridor to the other.
• Stay calm and don't be overwhelmed if the person follows you around the house. It may be due to lack of stimulation, curiosity or, in cases of advanced dementia, a reflex action.
• Reassure her if she shows a sense of urgency and try suggesting another activity. For example, if she says she has to go make the kids' lunch, you can say, "Don't worry, the food is ready. I'll take care of it. Come over to the couch while it's being done."
• Encourages contact with the outdoors. Take advantage of the moments available to you to go for a walk in the street.
• Favor orientation and a comfortable tour of the house. For this purpose:
  • Use orientation signs: indicator panels, places and objects that are especially well known, such as personal and significant adornments.
  • Arrange objects in their usual places.
  • Assure an easy and safe passage through corridors and rooms. If necessary, reorganize the location of furniture that may interrupt the passage.
  • Open the doors so that if the person is looking for a specific space it is easier to identify it from the corridor.
  • If there are clear glass doors in the house, place a sticker at eye level to help the person know whether the door is open or closed.
• Ask for help if you need it. Remember, in these cases it is not a sign of weakness, but of strength.

(*) In some cases it can help to get out on the street. Ask your family doctor for a document that justifies the need to go out. Recommendations based on the following readings: "Consejos y orientaciones no farmacológicas para pacientes con deterioro cognitivo en el domicilio y unidades psicogeriátricas". Arriola, E., Alaba J., Buiza, C., González M.F. y Zulaica, A.

LIVING AT HOME WITH A PERSON WITH DEMENTIA. WHAT DO I DO IF...SHE SHOWS INAPPROPIATE SEXUAL MANIFESTATIONS

Try to prevent them (*)

• Favor a pleasant and quiet environment. Certain content offered by television can over-stimulate the person.
• Help to create, if that is what the person wishes, spaces and times for intimacy.

If they have appeared...

• Put yourself in her shoes. Try to understand and minimize these situations. Rule out causes like irritations, infections... That the person is undressing may respond to being hot, wanting to go to the bathroom or feeling some discomfort, for example.
• Keep calm. Reacting naturally promotes the person's peace of mind. Remember that this behavior is a manifestation of the disease.
• Offer conversation. Sometimes sexual behavior reflects a need for interaction with another person. Lead that need into a conversation or other shared activity.
• Redirect sexual expression into activities that help the person focus on something else. For example, get some physical exercise. Sometimes simple distractions, such as offering some water or juice, can also help.
• What do I do if the person...​
  • ... gets into my bed. Redirect him to his room. This behavior may stem from a search for non-sexual intimacy or simply from disorientation.
  • … appears naked. Cover him up with a robe and take him somewhere private without giving him any importance. His behavior may be because he is hot or needs to go to the bathroom. Or he just needs activity and that's what's available to him at that time.
  • … masturbates in public. Try to stay calm and lead her to a private place without giving her too much importance. Don't scold her, don't embarrass her.
  • ... makes touches to other people. Explain directly to her that such behavior is not appropriate with that person or place. Firmly, but without getting into arguments or confrontations.
  • ... flirts by making offensive comments and/or inappropriate gestures. This behavior may be linked to old social roles. Remind the person, in a kind and practical way, that this behaviour is not acceptable, giving them opportunities to re-experience their social role in other aspects.​
• Ask for help as soon as you feel you need it. Remember, in these cases it is not a sign of weakness, but of strength.

(*) In some cases it can help to get out on the street. Ask your family doctor for a document that justifies the need to go out. Recommendations based on the following readings: "Consejos y orientaciones no farmacológicas para pacientes con deterioro cognitivo en el domicilio y unidades psicogeriátricas". Arriola, E., Alaba J., Buiza, C., González M.F. y Zulaica, A. / "Desinhibición sexual. Pautas de abordaje". Gracia, P.

LIVING AT HOME WITH A PERSON WITH DEMENTIA. WHAT DO I DO IF...

The person is apathetic and unwilling

KEEP THE PERSON INVOLVED WITH THE ENVIRONMENT

• Generate opportunities to interact with the surrounding environment. Their interest can be arosen by having those objects in sight and at hand that invite some kind of meaningful activity for the person.
• Stimulate, motivate and participate. Offer options for action, the simpler you make them, the better. "I'll bring you the paper," "Would you like to make some juice?" Don't leave the activity in the person's hand if you can share it.
• Incorporate the practice of day-to-day activities, try not to do them for the person, and progressively introduces options for new activities or activities that were already being done, but were left behind. Making the bed, hanging out the clothes, sweeping the kitchen, watering the plants...
• Converse with the person. Talk to the person as an equal, with patience and time to listen to what they say and without criticizing them if they do not participate.
• Give him challenges adapted to the person's level, neither too simple that infantilize or bore them, nor too complicated that can frustrate them. 

AND IF THE PERSON HAS BEEN LIKE THIS FOR A WHILE...

1. Ask and listen to what he says. If she can't speak, her expression and her body can say a lot without words.
2. Try out options and try to give her new things, he might surprise you by doing things she's never been interested in before.
3. Take advantage of mistakes. Offer activities and if they do not work or are not well received, try again in another quieter situation, or with the more active person.
4. Use physical contact. Closeness and tact, if desired and welcomed, are a way of communicating.
5. Take your time, slowly and calmly. It may be a matter of time and ease before the person participates or interacts with something.
6. Value positively your actions, not just yours. If the person does not react to the offer, then only the attention you give and the attention the person gives you is valuable in itself. Sometimes attention precedes action.
7. Incorporate the person into social situations. Visits, family and friends. It's good to be included, even if you don't participate.
8. Keep in mind that it's all about sharing. Providing stimulus to leave the person alone does not compensate. The activity has more value if it is done in company.

10 RECOMMENDATIONS IF YOUR OLDER RELATIVE IS IN ISOLATION AT HOME