Care Techniques
A Page from the Daily Life of a Loved One Living with Dementia: The Value of Routines
Life is sometimes like a key you get lost in; you don’t even realize when it goes missing, but its absence leaves a void. As you witness changes over time in the identity, memory, and habits of a family member living with dementia, your desire to support them grows stronger. However, in this effort, it’s common—often unintentionally—to intervene in their daily routines, which serve as a safe haven. Yet, what may seem like an 'ordinary' breakfast, a walk at a certain hour, or a cup of tea has a much deeper meaning for someone with dementia than you might think. Today, together we will look—both scientifically and with your heart—at why and how intervening in these routines can lead to unexpected outcomes.
Dementia and Routine: Why Are They So Vital?
Dementia is a progressive condition characterized by cognitive decline, memory loss, and impairment in daily activities. As the Alzheimer’s Association highlights, as of 2023, over 55 million people worldwide are living with dementia (Source). In this illness, as cognitive functions are gradually lost, 'routines' become the most important means for individuals to maintain their connection with their surroundings.
Routines support learned behaviors and motor memory.
They provide automated processes instead of complex decision-making.
They increase feelings of security and belonging; reduce anxiety and confusion.
Studies published in the International Journal of Dementia Research show that maintaining daily routines can reduce behavioral problems by up to 40% (Source) and also lessen the burden on caregivers.
Why Do We Intervene in Routines?
Your loved one’s safety, health, or changing needs are usually the main reasons for intervention. As dementia progresses, the following may occur:
Sleep issues may arise, and nighttime wandering can increase.
There may be a greater need for assistance with activities like bathing or dressing.
Certain habits (for example, a forgotten lunch) can become risky.
However, we should be aware that while these interventions may have benefits, they can also bring unforeseen side effects.
Possible Consequences of Intervening in Routines
The main issue in coping with dementia is balance. The line between intervention and support is so fine, sometimes you realize its importance only after seeing the results.
1. Increased Anxiety and Confusion
The feeling of predictability in everyday life is especially important in the advanced stages of dementia. Changing the usual breakfast time or postponing an activity can cause restlessness, disorientation, and sometimes anger. Allen et al. reported in 2019 that sudden changes in routines increased agitation by 33% in patients in the short term (Source).
2. Increase in Behavioral Problems
When the routines of people with dementia are disrupted, symptoms such as restlessness, aggression, repetitive actions, or stubborn insistence on their own ways may appear. These changes can be distressing for both the patient and the caregiver. A US study found that in 47% of patients, behavioral problems increased within two weeks of a routine change (Source).
3. Decreased Sense of Independence and Loss of Self-Confidence
People with dementia cling to the self-esteem they gain from performing familiar activities automatically. Frequently intervening in their routines can lead to feelings of 'I can’t do it' or 'they don’t trust me.' Over time, they may lose their independence more quickly. Various studies have reported that this process accelerates and the need for care increases (Source).
4. Communication Difficulties with the Caregiver
Communicating with someone who is frequently intervened with can become more challenging over time. Mutual trust may be undermined. Individuals with dementia often can’t fully understand the reasons behind these changes, but may perceive repeated alterations as 'dissatisfaction.' Research shows that increased tension between caregiver and patient can negatively affect the quality of care in the long run.
5. Risk of Deterioration in Physical and Psychological Health
Disruption of routines can affect sleep, nutrition, and toilet habits. A person with dementia experiencing sleep disruption may become sleepier and more confused during the day, with an increased risk of falling. According to a 2017 review published in The Lancet, frequently changing routines is associated with increases in depression, anxiety, and behavioral problems (Source).
Are All Interventions Harmful? Delicate Balances
Of course, some changes are necessary and vital. For example:
Changing one’s location in an environment for safety reasons
Restructuring meal schedules to support healthy nutrition
Making mandatory adjustments to medication times
Such interventions should be carried out with the highest benefit for the person, while causing the least amount of stress. Scientists state that 'the key to changing routines is to introduce new arrangements in small steps, building upon familiar elements' (Source).
With Scientific Data: Routine Deviations and Outcomes
Type of Disruption | Possible Outcome | Data/Rate |
|---|---|---|
Change in sleep routine | Circadian disorder, daytime sleepiness | 31% increase in sleep disorder (Source) |
Shifting mealtime | Nutrition imbalance | 20% increase in appetite decline (Source) |
Changes in personal care | Poor hygiene, skin problems | 15% increase in hygiene issues |
Disrupted social activity flow | Social isolation | 42% increase in feelings of loneliness (Source) |
What Should Be Done? Practical Suggestions and Guidance with Empathy
Prepare for change: Choose an appropriate time to explain the necessary change and use short, clear sentences.
Progress step by step: Avoid changing multiple habits at once. Start with the simplest and most necessary adjustments.
Maintain familiar objects and sounds: Leaving a few familiar items in the environment during periods of change can reinforce feelings of security.
Monitor and observe: After every change, observe behavior, mood, and communication. If necessary, revert to the old routine or try a different method.
Don’t forget patience and compassion: Sometimes even the best-intentioned interventions can elicit unexpected reactions. Your love is your greatest support…
For the Caregiver: Allow Space for Your Own Feelings
It’s often not easy to avoid intervening in routines; you want your loved ones to be well and protected. But acknowledge that you are human, too, and can become exhausted. Every change can be managed together and with understanding. Remember, if you don’t take care of yourself, you may not be able to help others as much as you’d like.
Final Word: The Silent Language of Routines
Years later, you may be astonished to realize just how meaningful a glass of water you once ‘thought trivial’, being the first to enter through a door, or sitting in an old chair was to your loved ones. Routines are a silent language inscribed in place of lost memories, and understanding and touching them gently is the highest form of compassion.
References
Bir Sonraki Okuma
