Both the Centers for Disease Control and Prevention and the Alzheimer’s Association have excellent general resources for dementia caregivers in the wake of the COVID-19 pandemic. Please refer to those sites first; I am not going to repeat their advice on this blog. Instead, I provide some additional and practical COVID-19 and dementia caregiving tips here.
Persons with mild dementia may need frequent verbal or written reminders to wash their hands after using the toilet, before eating, and after touching objects like money or elevator buttons. Those with moderate and severe dementia will need more guidance and help.
What if the person with dementia refuses to wash his/her hands?
Ask them to help you do the dishes. Plunk some plastic cups or silverware in a sink already filled with warm, soapy water. You can sneak-scrub their hands by saying something along the lines of “Ooops, you got some stuff on your hands. Clean them with this” and then hand them a sponge or washcloth. You may need to pantomime the act of washing hands; you may need to take over the task while their hands are in the soapy water.
You can adapt this approach based on your loved one’s personality and life experiences. Ask him to do something that would logically require hand-washing before or after the task. Some ideas include light gardening and outdoor chores. If the person living with dementia can see actual dirt on their hands, it may help trigger a related memory around the need to wash hands.
Helpful hint: make sure you have moisturizer to avoid drying out their hands with frequent hand-washing. Olive oil and coconut oil work in a pinch!
Proper hand-washing is more effective than hand sanitizer. I entered nursing in the early 1980s. We did not use gloves for basic patient care and many invasive procedures, like drawing blood and starting IVs. This was early in the AIDS epidemic, before the practice of universal precautions. I cleaned up pee, poop, vomit, and blood without gloves. No one told me to wash my hands, I did it constantly. In spite of my exposure to body fluids, I did not contract any illnesses. I only share this experience to emphasize the effectiveness of proper hand-washing. No need to stress about whether or not you have hand sanitizer.
Managing Isolation, Finding Virtual Support
Isolation and loneliness are major issues with dementia caregiving; closings and cancellations are making it worse. Closing of a respite program or cancellation of weekly church services can be disruptive to both the caregiver and person living with dementia. The person living with dementia loses access to safe places where they can socialize and feel purposeful. The caregiver may lose access to the support group that met while the person living with dementia was occupied.
One solution is to substitute new scheduled activities. Cannot go to church? Create your own “Hour of Power” where you both read scripture out loud, say favorite prayers, and sing favorite hymns. Does your church, temple, or synagogue broadcast services? Tune in and participate as if you were sitting in the pew.
Physical activity and outdoor activities are other options. Do exercises together. YouTube has plenty of free exercise videos to help you with ideas. Walk around the neighborhood, work in the garden, wash the car. Have meals on the patio or deck. You can adapt favorite activities so that the person living with dementia can safely participate.
Now is the time to use FaceTime or Skype to communicate with friends and family members. Face to face interaction is the best, but video communication is a decent option. Schedule routine calls with friends, children, and grandchildren.
If support groups are cancelled, or you are unable to attend, ask the support group leader if he or she would be able to run virtual meetings. Video-conferencing platforms like Zoom are surprisingly easy to use. Zoom has a free basic plan. Many platforms are compatible with smart phones and tablets.
Social Distancing Practices
Avoid the temptation to hunker down inside the house (unless you or your family member is sick!!). Parks and green spaces provide opportunities for exercise, fresh air, and social distancing. A nice walk around the neighborhood will break up the monotony.
If you have to go into stores for groceries or medication (now may be a good time to try mail-order options, pick less crowded times. Early weekday mornings may be a good time to run into the grocery store. Weekday trips to larger stores like Home Depot, Tractor Supply, and Lowes around 7:30 in the morning or early in the evening may be an option. Home Depot and Lowes sell cleaning supplies and toilet paper. From a social distancing perspective, these stores have wide aisles and, unless a hurricane is on its way or you go on a pretty weekend afternoon, tend to be less crowded than large box stores like Sams, Costco, and Walmart.
Persons in the mild to moderate stages are going to ask (understandably) about the changes in routine. Because of poor short-term memory, lengthy explanations about COVID-19 may not be helpful. If your loved one has mild dementia, you can tell them that there is a virus like the flu but stronger. Depending on your loved one’s ability and personality, it may be perfectly OK to go to the CDC website on your tablet, smartphone, or computer and let them read the information. For persons in the moderate to severe stages, it may be easier to simply say there is a flu outbreak.
It may be a good idea to limit exposure to COVID-19 news, or any news for that matter. Constantly playing news channels throughout the day can increase anxiety and trigger behaviors.
Back-Up Caregiving Plans
Many caregivers are so involved with the day-to-day caregiving activities that they do not put a back-up plan in place. This may be a good time to think about how your loved one will be cared for should you get sick. Click here for more information.
The COVID-19 pandemic is causing unique situations in the United States. We are literally moving in uncharted waters. It is important to stay informed and use common sense. I welcome your comments and ideas.
Dr. Rita Jablonski
Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.