Making the Most of Alzheimer's Caregiving at Home

Caring for someone you love who has Alzheimer's is a big step that can be both rewarding and challenging. There are many changes to anticipate, and because the condition is progressive, as needs change, modifications must be made. Choosing to keep your loved one in their own home or your home (if those are different) is an important decision along the caregiving pathway.

Making active choices will help to offer the best care and do the best job of taking care of yourself. It is essential to good caregiving. Providing care in an optimal way for each person with Alzheimer's involves a number of evaluation steps to ensure both that person's health, safety, and welfare and your own.

Understand how much care is needed

Make a list of all the tasks you do during the day and at night. You can break them down into personal care, companionship and supervision, homemaking, and skilled services. Once you understand how much you are doing, it may be time to evaluate what kind of assistance you require. That could be in the form of home services from an aide, friend, volunteer, or family member.

Remember that sharing responsibilities with others will allow you to have a break and keep up with your work, family, and other responsibilities. Be creative and flexible in the ways you ask for help.

Safety in the home

Preparing a home for someone with Alzheimer's takes planning and a systematic review.¹ A loose rug or dog toys on the floor, which were once just a nuisance, could now be a hazard. Just as you may have once baby-proofed the home, it is now again important to revisit what in the surroundings could be harmful. A physical or occupational therapist could help do an evaluation. There are also expert services for hire and checklists available in books and online.

The basics

Avoid clutter. Create clear pathways for walking, limiting furniture, electrical cords, table décor, stray bags, objects, and plants. The objective is to prevent someone from tripping, falling, breaking bones, or eating something that can hurt them. Consider removing door locks, so they do not lock themselves in a bedroom or bathroom.²

Kitchen: Keep knives put away and breakables out of reach. Use safety knobs on the stove and install safety latches on cabinets and drawers to secure dishes, silverware, detergents, and other items that could be sharp or harmful if swallowed.

Bedroom: A baby monitor or home surveillance camera system can let you hear or see if your loved one has gotten out of bed at night or after a rest. Limit access to thermostats and electric heating devices, including blankets with cords or portable heating devices, which can be tripping or fire hazards.

Bathroom: Like the kitchen, keep cabinets latched to prevent access to harmful things, including cleaning products, nail scissors, etc. Install grab bars by the toilet, in the bath, and shower. Consider a shower chair or bench for safety. Cover the floor if it is a naturally slippery surface. Water temperatures can be restricted to prevent hot water burns.

Laundry/Garage: If possible, restrict access. If not, the same rules apply - lock up hazardous chemicals and sharp or heavy tools and lock car doors with car keys out of reach.

Be prepared

Don't leave your loved one with Alzheimer's unattended at home. Keep a list of emergency phone numbers posted throughout the house. Use night lights to illuminate hallways. If you have stairs, put up a gate, so they are not accessible when your loved one is unaccompanied. If you have someone who wanders, let your doorman or neighbors know to call you if they see your family member unattended in the neighborhood.

The importance of nutrition

Eating healthy is important to staying healthy and strong, not just for people with Alzheimer's. But a good nutritional program can be especially helpful for caregivers and their loved ones to be better able to keep up their stamina, prevent colds, and avoid other comorbid conditions like heart disease and diabetes.

What to eat? A diet rich in fruits, vegetables, fiber, and protein. Some people suggest that the Mediterranean diet is an excellent plan to follow.

As the disease progresses, a person with Alzheimer's may no longer be able to feed themselves. Watch for safety in swallowing and make adjustments in dietary offerings as needed. A swallowing expert can provide exercises, advice, and special instructions on a soft diet if appropriate. If there are certain preexisting dietary restrictions, be sure to follow the advice of your physician.

Changing needs

Like with all care for people with Alzheimer's, as their needs progress, you will need to reevaluate the appropriateness of the existing care plan. Make sure your current home care setup can continue to maintain and manage the best interests of your loved one as their condition worsens.
To identify and learn about local resources, consider the options below:

• Medicare-certified home health agencies in your local area can be identified using an online tool from Medicare.gov.
• Community Resource Finder can link you to local information about programs near you, including Adult Day Care Programs, community offerings, and transportation assistance, attorneys, and health care case managers that specialize in assisting older adults and people with Alzheimer's.
• US Administration on Aging has tools and resources for older adults, their families, and caregivers.