Gerald and his wife Maggie recently relocated from Southern California to be near their children and grandchildren. Since the move, Gerald has noticed that Maggie has become more forgetful. She was previously diagnosed with cognitive impairment; however, had been functioning fairly well in their Southern California home. Recently, Maggie yelled at Gerald when he left to go to the grocery store. Gerald feels lost. He does not sleep well, has heart palpitations, and recently has lost interest in the activities he used to enjoy.

Unfortunately, primary caregivers such as Gerald can experience numerous mental and physical ailments as a result of caring for a loved one. This may include anxiety, depression, high blood pressure, and compromised immune function. So, what can individuals like Gerald do?

First, it is important to recognize that behaviors that present are attempts to communicate an unmet need. The unmet need could be pain, fear, loss, loneliness, or even boredom. Sometimes, individuals may also experience agitation or even aggression. As challenging as it can be, it is important to take a deep breath, be patient, and evaluate why the behavior is presenting.

So, what tips and tricks are beneficial to ensure quality of life for all?

First, it is important to remember that the individual is still a person with unique needs and wants. You want to speak to them like you would any adult, but with greater patience, empathy, and reassurance. Do not rush, interrupt or even engage in questioning the person’s memory. Although it is natural to explain reality, that is not a great approach. It is better to enter the world your loved one is in.

Next, eating can be another element that needs a modified approach. It is important to note that no one likes to eat alone. Make it time for social interaction with a calm and quiet atmosphere. Provide the person with choices but only a few so as not to cause confusion. Provide dishes and eating tools that enable independence like a bowl instead of a plate, utensils with built-in handles, straws, and cups with lids. Pay close attention to notice if the person needs a reminder to swallow and if they easily choke on liquids or food. Also, be sure to limit the number of items on the plate, you don’t want your loved one to become overwhelmed with numerous items on the plate.

Personal hygiene can also be a challenge for an individual who has cognitive impairment. As we all know, bathing regularly and changing into clean clothes is imperative to health. The benefits of showering include improving outward appearance, self-esteem, physical health, and skin condition; getting rid of dead skin cells; reducing risk of bacterial and fungal infection; improving body odor; and relieving stress and fatigue. However, it is important to be aware that some people with cognitive impairment find bathing frightening. Respect the fact that bathing is uncomfortable and scary. Be empathic, gentle, and patient. Creating a consistent routine can be helpful. Have the mindset that you are assisting the person, not doing it for them. However, be sure to have a towel and a robe nearby and ensure the room is set up and warm before even approaching the topic of bathing time. Ask if the individual would like your help before stepping in and be sure to let the person know what you are going to do. It is also important to note that routines are important. If your loved one always showered in the morning but you are now attempting to shower in the

evening, change your approach back to the morning to see if that helps. Remember, people are unique individuals with unique needs.

After bathing, dressing in clean, seasonally appropriate clothing is important. At times, this can be present as another challenge. Choosing what to wear may require you to select out two outfits for an individual to choose from. Thereby, limiting the amount of decision making but still providing a choice. Be mindful to take your time, don’t rush, and allow for your loved one to express themselves.

Being a primary caregiver for a loved one is often a thankless job. But, know you are a gift, even when you are feeling frustrated, overwhelmed, and at the end of your rope. You provide care and compassion for those that are most important. So, take it a day at a time, be patient, and most importantly take time for yourself because you are important too.

Robin Milner, MA LPCC is a Care Manager with Elder Options. She possesses a passion to advocate for those who cannot advocate for themselves, providing them with the care and dignity each of us deserve.