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Editor’s note: the following is an excerpt from the National Institutes of Health’s “Caregiver’s Guide.” NIH Publication No. 01-4013

Caring for a person with Alzheimer’s disease (AD) at home is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Many caregivers have found it helpful to use strategies for dealing with difficult behaviors and stressful situations. The following are some suggestions to consider when faced with difficult aspects of caring for a person with AD.

Bathing

While some people with AD don’t mind bathing, for others it is a frightening, confusing experience. Advance planning can help make bath time better for both of you.

• Plan the bath or shower for the time of day when the person is most calm and agreeable. Be consistent. Try to develop a routine.
• Respect the fact that bathing is scary and uncomfortable for some people with AD. Be gentle and respectful. Be patient and calm.
• Tell the person what you are going to do, step by step, and allow him or her to do as much as possible.
• Prepare in advance. Make sure you have everything you need ready and in the bathroom before beginning. Draw the bath ahead of time.
• Be sensitive to the temperature. Warm up the room beforehand if necessary and keep extra towels and a robe nearby. Test the water temperature before beginning the bath or shower.
• Minimize safety risks by using a handheld showerhead, shower bench, grab bars, and nonskid bath mats. Never leave the person alone in the bath or shower.
• Try a sponge bath. Bathing may not be necessary every day. A sponge bath can be effective between showers or baths.

Dressing

For someone who has AD, getting dressed presents a series of challenges: choosing what to wear, getting some clothes off and other clothes on, and struggling with buttons and zippers. Minimizing the challenges may make a difference.

• Try to have the person get dressed at the same time each day so he or she will come to expect it as part of the daily routine.
• Encourage the person to dress himself or herself to whatever degree possible. Plan to allow extra time so there is no pressure or rush.
• Allow the person to choose from a limited selection of outfits. If he or she has a favorite outfit, consider buying several identical sets.
• Arrange the clothes in the order they are to be put on to help the person move through the process.
• Provide clear, step-by-step instructions if the person needs prompting.
• Choose clothing that is comfortable, easy to get on and off, and easy to care for. Elastic waists and Velcro enclosures minimize struggles with buttons and zippers.

Eating

Eating can be a challenge. Some people with AD want to eat all the time, while others have to be encouraged to maintain a good diet.

• Ensure a quiet, calm atmosphere for eating. Limiting noise and other distractions may help the person focus on the meal.
• Provide a limited number of choices of food and serve small portions. You may want to offer several small meals throughout the day in place of three larger ones.
• Use straws or cups with lids to make drinking easier.
• Substitute finger foods if the person struggles with utensils. Using a bowl instead of a plate also may help.
• Have healthy snacks on hand. To encourage eating, keep the snacks where they can be seen.
• Visit the dentist regularly to keep mouth and teeth healthy.