Originally published on HelloCare.  

Maintaining a routine is extremely important for anyone living with dementia. The coronavirus pandemic has inevitably disrupted those routines, regardless of whether the person living with dementia is in a residential facility or at home.

Typically, those living with dementia have trouble with processing new rules, information and creating new memories. This proves challenging in normal circumstances, let alone in times like these.

We’ve detailed some of the things aged care workers, family and friends can do to help alleviate potential struggles. From printing off hygiene reminders to visiting virtual museums, while the pandemic proves great challenges there are many creative ways to make life a little easier and more enjoyable.

Firstly, to explain the coronavirus or not to explain?

“People living with dementia, depending on their symptoms and the level of their abilities, will have varying levels of understanding of the changing situation with COVID-19,” says Dementia Australia CEO Ms Maree McCabe.

It’s difficult for anyone to process how the coronavirus has so rapidly changed our lives, but particularly hard for those who have memory loss.

Depending on the situation and how advanced someone’s dementia is, it may be helpful to explain the coronavirus. You’ll have to ask yourself these things first:

• How much can they understand?
• How do you think they will respond to the news?
• Will explaining the coronavirus cause great anxiety? Or bring a level of comfort?

Dementia Australia’s advice on how to care for someone living with dementia during the coronavirus – for aged care workers, family and friends – is as follows:

For primary carers:

“Introducing yourself by name, using a reassuring tone and pitch, and repeating important key messages are imperative to communicating effectively, as is focusing on person-centred care,” says Ms McCabe.

• It is important to stay connected as much as possible at this time. You may not be able to have visitors but keeping in touch with friends and family over the phone or on video chat may help.
• Many social activities and respite programs have been cancelled or limited during this time. Unless you or the person you care for are required to self-isolate you might find it helpful to structure your day and include activities that you and the person you care for to enjoy.
• You may schedule some time for a walk, or spending time in the garden, calling a friend or family member, listening to music, reading or watching a television show or movie. The Dementia Australia Library also has many ebooks and audiobooks available online.
• If you are required to self-isolate but the person you care for is not living with you, there are some things you can do to continue to support them.
• It can be helpful to write out an activities care plan if different people are sharing caring responsibilities. This will ensure that activities are consistent and are suited to the individual.

For family, friends or neighbours:

• Do not visit if you have any signs or symptoms of illness.
• Ask how you can help. If you know someone living with dementia who is self-isolating, you may be able to help with tasks such as grocery shopping, collecting medications or dropping off library books or jigsaw puzzles.
  If you can visit, engage in physical distancing of 1.5 metres.
  Bring activities that can be done indoors, such as colouring in, magazines, sock matching, movies and books.
• If you have children, bring drawings or artworks from them to show that you are thinking of them.
  If your close one is in an aged care facility, ask staff if they can keep in touch with regular updates if your loved one living with dementia isn’t able to engage with phone calls.
• If you are concerned about the response to coronavirus of your service provider, speak to them in the first instance. If you are not satisfied with their response, please contact the Aged Care Quality and Safety Commission.

Activities in self-isolation a home:

• Staying as active as possible is important. Try some gentle exercises either in a chair or around the house.
• Put plans in place to connect with others, during this difficult time it may need to be over the phone or via video links.
• Participating in activities at home such as reading books and magazines, doing jigsaws, listening to music, knitting, watching tv and listening to the radio may help.
• Consider sensory experiences such as hand, neck and foot massages, hair brushing, smelling flowers from the garden, or a rummage box that contains things that the person has been interested in.
• Why not try some artistic expression? Check out this help sheet.
• There are also ways to explore the world without leaving the couch. Many museums, theme parks and zoos are available to explore virtually.
• Some of the many to choose from are: perusing the Guggenheim Museum, take a (virtual) walk through national parks or visit the Taj Mahal thanks to Google Arts & Culture. The Metropolitan Opera in New York City is streaming full performances online for free. You can watch on its website.
• Visit Disneyland in Anaheim, California here.
• If you are looking for more thrill and adventure, you can also go on a virtual roller coaster. There are plenty of virtual rollercoaster rides on YouTube. Explore some of the many videos here.
• You can see what the baby snow leopards and the penguins are up to at Melbourne Zoo and Werribee Open Range Zoo by watching their live stream.
• If you prefer underwater animals you can also tune in to the live stream from the Monterey Bay Aquarium in California, USA to watch the jellyfish, turtles and sea otters.

For residential aged care workers and home care workers:

“Engaging with the family wherever possible, even if they are unable to be on-site, will help aged care workers in their role,” says Ms McCabe. “The familiar voice of a loved one on a phone call may help to calm someone who seems distressed.”

“Family members may be able to share the person’s story with staff that will help them to better understand what the person in their care might be experiencing or how they are responding. They will appreciate being included,” she says.

“At this time it is vital to ensure thorough handovers about the needs of residents living with dementia at shift changes, especially with the increase of agency staff who may be unfamiliar to the resident and unaware of the specific needs of individuals.”

Information management:

• Minimise the flow of media information by turning off the 24-hour news cycle on TV.
• Provide accurate information and an explanation to residents who are aware of and concerned about what is happening.
• Provide reassurance about the use of masks and personal protective equipment.
• Use memory aids and visual prompts to simply explain the current situation.

Communication:

• Make sure regular time is spent with residents to ask how they are going and if they have any questions.
• Take the time to listen to the person and their concerns.
• Validate how the person is feeling and provide reassurance.
• Minimise staff discussion, speculation or opinions on the impact of COVID-19 in front of residents.
• Support continued engagement with families and carers.
• Communicate with families through a variety of communication channels what the infection control measures are regarding COVID-19 and where to go for further information.
• Be understanding and listen to concerns of family and residents.
• Try to respond promptly to questions and concerns of residents and their families.

Health precautions:

• Discourage visiting if the visitor is unwell.
• Encourage visitors to adhere to physical distancing of 1.5 metres where possible and discuss with them in advance how visits should be conducted.
• Encourage visitors to maintain strict hygiene measures.
• In aged care facilities, try to conduct visits in a resident’s room, outdoors or in a specifically designated area at the facility and not in communal areas, to minimise the risk of transmission.

Management:

• Escalate issues to a supervisor if you’re unable to answer questions or concerns.
• Staff may need to provide people living with dementia with additional support to ensure infection control procedures are adhered to.
• Consider placing dementia-friendly instructional signs in bathrooms and elsewhere to remind people living with dementia to wash their hands with soap for at least 20 seconds.
• Give a demonstration of thorough hand washing. Consider singing a song to encourage them to wash their hands for at least 20 seconds.
• If the person living with dementia cannot get to a sink to wash their hands, hand sanitiser or anti-bacterial hand wipes may be a quick alternative. Hand sanitiser is only effective if hands are not visibly dirty.
• Encourage them to cough or sneeze into a tissue or their elbow, instead of into their hands and ensure the tissue is then discarded in the bin.
• Contact the Dementia Behaviour Management Advisory Service (DBMAS) on 1800 699 799 if you need further assistance.

Promoting social connection and engagement in aged care facilities:

• Consider creating a buddy system between residents or between residents and staff to strengthen support networks.
• Encourage music and singing so that others can join in.
• Use the overhead speakers to play interactive games (bingo could work).
• Encourage regular opportunities to walk outside and exercise, especially where this is part of the resident’s usual routine.
• Encourage family and friends to drop off care packages with letters from family or encourage local school children to write letters or draw pictures to send to residents.
• Motivate the person to consider doing some gentle exercises, either in a chair or around their room.
• Access online exercise or music programs for older people.
• Use technology, such as iPads to access online games and social engagement. Options include ‘A Better Visit’ app, a virtual zoo or virtual museum.
  Provide other activities such as colouring-in, magazines, sock matching, movies or talking books.

Carers, family and friends must always practice proper hygiene:

• Tips on proper handwashing can be found on the World Health Organisation website here.
• If you cannot get to a sink to wash your hands, hand sanitiser or anti-bacterial hand wipes may be a quick alternative.
• Try to cough or sneeze into your elbow or a tissue, instead of your hands, and ensure the tissue is discarded in the bin.
• Make sure that any visitors wash their hands or use hand sanitiser.
• When cleaning pay attention to things that are handled often, such as remote controls, door handles, taps and phones.

Dementia Australia can provide further information and advice surrounding dementia, call the helpline 1800 100 500 or visit the Dementia Australia website.