Caregivers find themselves jumping from one task to another: making breakfast, followed by helping their loved one complete their morning grooming and dressing regime, followed by a doctor’s appointment, then clearing those breakfast dishes to make room for lunch preparation.
The to-do list goes on and on.
Many of these activities are considered “activities of daily living,” or ADLs—very basic activities that allow a person to care for themselves. First coined more than 70 years ago, the term refers to the following six categories:
- Eating: The ability of a person to feed oneself.
- Dressing: Selecting appropriate clothes and putting the clothes on.
- Personal hygiene: Bathing and grooming oneself and maintaining dental hygiene, nail and hair care.
- Continence: Controlling bladder and bowel function.
- Toileting: Getting to and from the toilet, using it appropriately, and cleaning oneself.
- Ambulating: Moving from one position to another and walking independently.
A national survey determined that 20.7% of adults aged 85 or older, 7% of those aged 75 to 84, and 3.4% of those aged 65 to 74 needed help with ADLs. And that number is much higher for older adults with dementia.
These stats mean that ADLs become common to-do tasks for caregivers and can often consume large blocks of time—even entire days.
Yet, ADLs don’t have to overcome your life. Madison Serfas, a certified dementia specialist with Assistance Home Care, weighs in on tips and tools that can make ADLs easier for caregivers and their loved ones.
Caregiving hacks for the six activities of daily living
Food and water are the most vital part of your loved one’s day—essential to their entire well-being. When your loved one is properly nourished and hydrated, your day will go much easier. But this is typically one of the most difficult ADLs to manage. Several simple solutions can make meal times and hydration much easier.
Loss of appetite or interest in food is a normal part of the dementia journey. A simple paper menu is an easy way to improve eating habits.
“Having a physical paper menu with photos of the dishes can also be a helpful tool for a caregiver to prompt their loved ones that it is mealtime as well as spark interest,” Serfas explained.
Have a ‘Plan B’
“It’s common for one’s palate to suddenly change when it comes to food preferences, so it’s important for caregivers to have an alternative meal or meal supplement choices available,” Serfas said.
The ability to maintain independence in as many ADLs as possible is important in the dementia journey. Therefore, food accessibility is key in ensuring a person with dementia can be as independent in feeding themselves as possible.
“Foods that require a fork and knife can often be challenging to have on the menu, even in early to middle stages. For best accessibility, foods that are easy to chew and are handheld are recommended,” said Serfas.
Nobody likes to eat alone. Although it’s tempting to do the dishes or pick up the kitchen while your loved one eats, joining them will increase their food consumption and promote their socialization.
Food delivery services
Serfas recommends food delivery services for people who need them:
“For seniors with dementia who live alone or may be facing food insecurities, consider connecting with a local Meals On Wheels chapter.”
Flavor your fluids
Hydration is also a sticking point. Serfas recommends flavoring the fluids—but not by offering juice, tea or coffee. Instead, make a pitcher of water infused with various fruits or vegetables to promote hydration!
There’s no easy answer when it comes to the dressing of a person with dementia. Dementia is a progressive disease unique to the individual, so every situation and every person is different. There is no one-size-fits-all, but there is one commonality: Everyone likes to feel independent.
A sense of autonomy goes a long way to improving the dressing process. Serfas recommends options:
“Caregivers can set their loved one up for success in showing a few ‘choices’ or options when getting dressed or assisting with dressing. Selecting a certain blouse or sweater, even from a curated collection, can impact a caregiver’s loved one positively and provide them with a feeling of autonomy.”
Stop and think about all the steps you take to get ready in the morning, and then break each step down into their many nuanced microsteps. Imagine how overwhelming the process would be for a person with cognitive impairment. This is why simplification is key.
Simplify, then label
“Simplify the process. Too many products on the bathroom sink can be overwhelming to a person with dementia. After reducing your loved one’s personal care products to the bare necessities, consider using labels on countertops, on cabinet doors or outside of drawers as a guide to where they are stored and kept.”
Create a step-by-step list with pictures
It helps to create a short list of grooming tasks in order of importance. Start the list with hand hygiene and oral care, and add visual elements or pictures to each step as appropriate.
Toileting is another area where each caregiver will have a different experience, and this experience may change from day to day, as toileting habits are often dependent on other fluctuating factors such as medication side effects, fatigue and illness.
Regardless, Serfas again emphasizes the importance of visual cues.
“If a caregiver’s loved one is independent in their own toileting and incontinence care, visual cues like sticky notes on the counter or mirror as reminders can still be appropriate to use for things like proper handwashing.”
Once continence becomes an issue with your loved one, keeping a toileting schedule becomes key.
“Most common toileting schedules are every 60-120 minutes or as needed for toileting reminders and/or incontinence care,” Serfas said.
The ability to find one’s way in their environment, known as “wayfinding,” is impaired in persons with dementia. Research shows that wayfinding problems cause anxiety, distress and decreased interaction in persons with dementia, but that placing visual cues into their environment helps.
Colorful, familiar (easily identified) and personally meaningful cues help people with dementia find their way when placed at key decision points in their path.
Pairing familiar icons alongside text (e.g., icons of a fork and spoon next to the word “Kitchen”) reinforces legibility. Creating signage with large letters and numbers in sans serif fonts with bold, bright colors with consistency across all signage helps as well.
Your whole day doesn’t need to be devoted to ADLs. Incorporating these simple tricks and tools can free up some time for more enriching activities to enjoy with your loved one.