Dementia Care and Activities of Daily Living (ADL)

As dementia progresses, there is a steady deterioration of abilities, including the capacity to perform activities of daily living, or ADL for short.

ADL such as eating, dressing, showering, and eventually even using the toilet may be affected as dementia patients gradually forget daily routines and lose their abilities to perform such activities.

Caregivers play a vital role in helping those with dementia make these daily activities easier. Proper assistance helps prolong the dementia patients’ independence and allows them to feel productive.

You can help a patient with elderly dementia manage ADL with these tips.

Daily Activity #1: Incontinence

• Establish a routine for using the toilet. Remind your loved one to use the bathroom every two hours.
• Use signs or different colours to indicate which door leads to the bathroom. A person with dementia may have incontinence if he/she is unable to locate the bathroom in time.
• Restrict fluids with diuretic effect (drinks that cause the person to urinate more often, such as coffee and tea) to mornings.
• Limit fluid intake in the evening before bedtime.
• Consider having a stationary commode in the bedroom for night-time usage. Or keep the light in the toilet switched on at night to allow safe and easy access.
• Use easy-to-remove clothing with elastic waistbands or hook-and-loop fasteners (such as Velcro tapes) to enable easy removal.
• Use easily washable clothes.

Daily Activity #2: Showering

• Adopting your loved one’s previous shower preferences may help in getting him/her to shower.
• Setting routines always help. For example, having a fixed time for showering, preference of the temperature of water and shower gels, and shower method (using a shower head or from a pail).
• If washing hair causes distress to your loved one, make it a separate activity.
• If showering is constantly a struggle, try a towel bath which may be more soothing and can be done with no-rinse soap.
• Dressing up may be difficult for people with dementia as well. Choose loose-fitting, comfortable clothes with easy fasteners like Velcro tapes, and minimise the use of buttons.

Daily Activity #3: Changes in Eating Patterns

• Make meal and snack times part of the daily routine. Schedule these tasks around the same time every day. Instead of three big meals, try small frequent meals.
• Do not allow too many food choices as it can be confusing for people with dementia. Instead of asking, “What do you want to eat?” ask, “Do you want to eat rice or noodles?”
• Make mealtimes special. Try placing a vase of flowers on the table or playing soft music. Turn off loud radio programmes and the TV.
• Sit down and eat with your loved one. Often, they will mimic your actions, and it makes the meal more pleasant to share it with someone.
• Prepare meals with your loved one in mind.
• If they have dentures, trouble chewing or swallowing, use soft foods or cut food into bite-sized pieces.