Setting a Routine for Yourself

I was always somewhat of an organized person. I was diligent about to-do lists and being sure I was always on task. When I first started having cognitive issues I found myself becoming confused by my ever important to-do lists. They became overwhelming to me. I had always been a multitasker, so it made me feel good to cross 4 or 5 things off at a time on that list. But when my mind starting playing tricks on me, that list became daunting. 

Setting a routine for people with dementia

So, a different approach was to think more of my life in the terms of a routine. A routine that I could manage instead of my day managing me. Having a routine reduces my anxiety and makes me feel more in control. To set up my routine, I had to evaluate my days. With the help of my family and friends we figured out when I was at my best, when I needed to rest, and when I might need the most help. 

It was important for me to not get over stimulated with lots of activities but try to stay engaged when I could. I’m at my best in the morning so we determined that would be the ideal time for me to get out and get some physical activity and social interaction. In the afternoon, I start to wind down and by evening, I definitely need my quiet time.

As people living with dementia, routine is important for many reasons. We don’t learn new things easily, so we are comfortable with doing the same things every day. We can feel normal even though our life is anything but normal.

Managing routine interruptions

Of course, there are going to be days when the routine is interrupted and having someone around to help you through those times is helpful. They can sense that you may have a difficult time and need help. They can also step in when they think you are becoming overwhelmed. They can be your advocate when you cannot speak for yourself. I find myself feeling so anxious when things are not as I want them to be that I have panic attacks. Many times, I know that things are “off” but can’t express that to someone, so I turn inward and shut down.

There are times I know exactly what I need to do or say but the words do not form in my brain or get out of my mouth. That is when I feel helpless. I want to scream out what is wrong and ask for help but simply cannot do it. It’s best to not get yourself into those situations, and by having a routine, it can cut down on those stressful times – for everyone. If we can predict a change in routine, we try to combat it by maybe getting more rest or doing less that same day.

Routines sometimes have to change. If something isn’t working or causing stress with your loved one it is fine to change the plan. Just make subtle changes – nothing too drastic all at once. Start slow and add or decrease activity as you see fit as long as the person you care for can handle the change. Everyone needs to be comfortable.

A caregiver's role in setting a routine

As a caregiver, you may have heard that routine is important when caring for someone with Alzheimer’s. Those of us who suffer from this disease find comfort in a daily routine. We can’t predict what our brain will do, thus robbing us of a certain independence. A routine brings a structure to us that creates normalcy. It brings order to the day and can actually make us feel in control. A routine also makes it easier for the caregivers by reducing stress.

Routines don’t have to be complicated. Start with the simple things like always putting a person’s clothing out in the same place every morning, or establishing meal times and favorite foods. Always giving medications at the same time every day. Routines should include things their loved ones like to do, such as having morning coffee in the sun room or listening to their favorite music after lunch, taking a nap in the afternoon.

Some form of physical activity should be included in the day's routine, such as taking a walk in the garden or dancing to the music. Sometimes adding tasks that make your loved one feel as if they are helping with everyday things around the house, like folding laundry, can be added even if you just give them a stack of towels to sort and fold every day, or putting silverware into a silverware drawer every day.

Perhaps an art activity, like coloring or sorting buttons, could be done. Time can also be spent going through photo albums or reading to them. There may also be times when they can watch television, but be sure that whatever they are watching is not too complicated that they cannot follow the storyline.

Keeping routines simple and sustainable

Some families have shared with me that they ask their loved ones what they would like to do but in a tricky way. They will think of 3 things they think the person would like to do and give them those options. Don’t ask an open-ended question – think ahead of what you want the desired outcome to be.

Caregivers also have to be thinking long-term when working to set up a routine. If it gets to the point of having to move your loved one into an assisted living center or other facility, think about what that will do to their routine. My personal opinion is that when you hear of stories about loved ones not wanting to leave their home, they are fearing the unknown more than the move itself. It will change their routine and take them out of their comfort zone. Will the facility you take them to tell them when to eat, when to sleep, and when to be active?

While it may be necessary to make a move like that, understand that the independence they may have felt at home by having a routine is changing and finding a new routine with more people involved becomes more complicated. Keep that in mind when looking for facilities for your loved one. How adaptive can they be? Can you bring furniture to make it feel more like home? Can you hang family photos on the wall that are familiar to your loved one? How can you set a new routine in a new place?