11 Tips to Help with a Loved One's Disorientation

The disorientation of a loved one with dementia is a particularly vexing challenge for caregivers.  Therefore, I was very excited to find a tipsheet prepared by the Texas A&M System's Agrilife Extension about caring for a disoriented person. Here are 11 suggestions from the tipsheet:

1. Simplify routines and reduce choices. At this point, I think of caregiving as being akin to being a kindergarten teacher in the sense that you need to really simplify complex topics and activities. Limit choices. Maintain daily routines that are simple and familiar Remember that those with dementia have very limited attention spans.

2. Maintain a calm atmosphere. A loved one with dementia is easily confused and frightened when you start rushing or become upset. And having a lot of activity in the house also can be stressful for the loved one.  Maintaining a calm environment is critical for helping a loved one with dementia maintain an emotional equilibrium.

3. Be consistent. Consistency is important in behavior, routines and environment. When you do need to make changes, be sure to prepare and support the person. For instance, when I knew Mom was going to need to move to a different room in the nursing home, I began talking to her several weeks beforehand and then tried to arrange her room in the same way  as we had arranged her former room.

4. Use memory aids. Use signs, clocks, calendars, and seasonal decorations to help the loved one maintain orientation. I did this by having a large marker board beside Mom's bed where I could write notes for her (and in my absence, the nursing home staff also could write information that Mom would need). Also, you may want to post pictures of family members to help your loved one remember.

5. Reassure and praise. Praise will help your loved one feel like they have achieved success. Use praise for any tasks accomplished.

6. Lower expectations. This one is a hard one since the caregiver often is used to what the loved one with dementia could do previously. However, it is important not to have the same expectations as dementia progresses. This is why it's critical to simplify tasks by breaking them down into individual steps, and even demonstrating these steps at times.

7. Make the environment safe.  The list can be daunting - stairs, cigarette lighters, power tools, knives, poison, and scatter rugs. You may need to remove locks on the bathroom and bedroom doors. And you may want to supervise the loved one if they smoke or use a razor. Also, you need to lock medications, poisons and other harmful substances away. And never leave the individual alone in a parked car.

8. Treat the loved one as an adult.

9. Use reminiscence. Discussions about unique historical events as well as significant personal experiences may give the loved one something to which he or she can respond. In addition special holidays and old familiar songs may encourage interactions.