Activities of Daily Living Archives - DementiaHub.SG

Location-tracking Technology in Dementia Caregiving

Peter Cher — Mon, 27 Nov 2023 06:42:30 +0000

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When a person living with dementia is still able to run errands such as grocery shopping or manage their personal appointments independently, caregivers should encourage them to continue to do so. These activities, when safely carried out, can help persons living with dementia feel integrated into the community and increase physical and cognitive stimulations that can improve their overall well-being.

Adopting location-tracking technology is one way to empower persons living with dementia to continue to enjoy their routines and outdoor activities, while allowing their caregivers to be involved by keeping watch from a safe distance.

This article explores the use of location-tracking technology* in dementia caregiving, how it works, and some of the consideration factors caregivers should take note of when deciding on a tracking device for their loved ones living with dementia.

*Location-tracking technology allows caregivers to know where a person living with dementia is by showing them the location on a portable device.

Role of Location-tracking Devices in Dementia

As dementia progresses, memory impairment, confusion, and disorientation in a person living with dementia may become a serious concern for caregivers who worry that their loved ones may lose their way while navigating the community or places on their own. Wet weather and unsafe road conditions may also expose a person living with dementia to an increased risk of accidents, falls, and other injuries. The fear and anxiety for their loved one’s safety may lead caregivers to limit outdoor activities of their loved ones living with dementia¹ and, inadvertently, the loss of independence and social interaction.

Whilst safety remains a top priority, it is also important that caregivers strike a balance between the need for safety and their loved ones’ need for autonomy and independence. One of the ways in which caregivers can achieve this is to include a location-tracking solution in their caregiving. This will enhance safety and traceability of their loved ones, and provide peace of mind for caregivers.

How Location-tracking Technology Can Help

1. Enabling Independence and Autonomy

Studies have shown that maintaining a person’s independence, freedom to participate in activities, and the autonomy to make choices for social interactions can contribute positively to improving one’s quality of life. ² Location trackers can enable persons living with dementia to continue their daily outdoor routines, such as strolling, shopping or engaging in social activities with confidence, while providing caregivers with assurance that they can effectively locate their loved ones.

2. Peace of Mind for Caregivers

Location-tracking devices can provide caregivers with information on where their loved ones are at any point in time and help them quickly locate their loved ones in situations where they are lost or require assistance to go home. This can help caregivers to alleviate anxiety and constant worrying.

3. Joint Caregiving

Some location-tracking devices allow multiple caregivers or family members to access tracking information or receive location alerts and updates. This enables a more collaborative approach to care coordination, where family members can be involved in the caregiving process for their loved ones living with dementia.

4. Understanding Daily Routines

When a person living with dementia carries a location-tracking device, the device can store a record of commonly visited places. Such information offers caregivers valuable insights into understanding their loved one’s daily routines, frequently visited locations, as well as behavioural and travel patterns. This provides an in-depth understanding of your loved one’s individual needs, which can be used when tailoring a more effective and person-centred care plan.

Types of Tracking Device Technologies

Location-tracking device or location tracker, as the name suggests, provides real-time or near real-time updates on location information of the person living with dementia who carries it. A location tracker typically consists of a small personal device that is worn or carried by the person living with dementia. This device can send location updates to a designated app or web portal accessible by one or more caregivers via a mobile phone or the web. Depending on the type of technology, location updates may either be in real-time or delayed. These updates also normally include the current location, historical locations, and battery status.

There are different types of technologies used in location trackers that are suitable for persons living with dementia. The more common ones are:

Bluetooth Low Energy (B.L.E.): This leverages Radio Frequency (RF) and Bluetooth technology for wireless communication. It uses Bluetooth signals to interact with nearby devices, such as mobile phones, connected to the Internet to locate a transmitter.³ It covers much shorter distances of between 30-40 meters.⁴ Once outside this range, it may be difficult to gather precise location data. Such a tracker is typically lower in cost, lightweight, and does not require frequent charging.

Global Positioning System (GPS): GPS location tracker uses data from satellites, mobile phones, and Wi-Fi signal networks to determine the location of the GPS receiver. Such a tracker is suited for wider radius and outdoor positioning, but it is less effective in small, indoor spaces. GPS location tracker comes with a built-in GPS receiver that provides tracker’s position in real time; hence, it requires frequent charging. Devices with GPS function typically cost more and may require data SIM cards or monthly data subscription.

Additional Useful Features

Newer locations-tracking devices also come with new functionalities that can further enhance monitoring.

Geofencing

Geofencing feature allows caregivers to create virtual geographical boundaries or safe zones for their loved ones living with dementia. Instant alerts are sent to caregivers’ mobile phones when their loved ones venture outside these virtual boundaries, allowing caregivers to be more vigilant. For example, caregivers can set up alerts when their loved ones leave home at night.

Emergency Call Features

Some location trackers come with built-in telecommunication features, such as an emergency button that notifies caregivers when their loved ones living with dementia require urgent assistance. Such a feature on the location tracker can be useful for a person living with dementia to connect with family members and caregivers when using a mobile phone becomes a challenge.

Fall Detection

Some models of location trackers have in-built motion sensors that trigger an automated alert to caregivers when it detects that the person living with dementia has fallen. This allows caregivers to attend to the person living with dementia immediately.

Caregiver Tips for Selecting Tracking Devices

Selecting the right location-tracking device that is effective and suited to your loved one’s preference is an important decision. There are various factors that caregivers can consider when selecting a device that ensures safety which is also suitable as dementia progresses.

We have listed some helpful tips and considerations to help caregivers to make the right choice.

1. Physical Activity Level

A good starting point is to consider the current physical activity level of your loved one with dementia: What does the daily routine look like? Their specific preferences such as time of day when going about certain activities or their preference for more outdoor or indoor activities. This gives you a sense of the kind of places your loved one frequents, as well as safety precautions to take note of.

For example, if your loved one prefers to go outdoors, selecting devices that offer more precise location tracking with a longer battery life, water resistant, and have more robust features such as fall detection can be considered.

2. Lifestyle Preferences

Caregivers can also consider how location-tracking devices can help their loved ones maintain their routines and interests for as long a period as possible. Understanding lifestyle preferences can also help caregivers determine if the devices should be carried or worn, how discreet these devices are, and whether incorporating alerts and prompts at appropriate times can help support their lifestyles.

Location-tracking devices come in a variety of shapes and sizes. Many of these devices are small, which can be placed on keyrings or wearable items, such as watches, jewelry and even shoes’ in-soles. Caregivers can choose from a range of designs based on preferences of their loved ones.

As dementia progresses, your loved one may gradually forget to use the tracking device. It is advisable for you to talk about these interventions early to give your loved one time to get used to using the device as part of the daily routine.

3. Upkeep & Maintenance

Just like a mobile phone, location-tracking devices need to be charged to be effective for outdoors use. GPS trackers typically require more frequent charging, which is an important factor to consider.

4. Compatibility

Check that the device is compatible with the caregiver’s smartphones and other portable devices. Some location-tracking solutions allow for more than one caregiver to view location information and receive alerts. It is, thus, helpful to select devices that can work across the various mobile operating platforms to maximise effectiveness.

5. Be Ready to Improvise

Caregivers can also consider using different solutions at different stages of dementia to ensure the technology can supplement the abilities of their loved ones.

For example, at the mild stage of dementia where persons living with dementia may still be able to manage their mobile phones, it is possible for the mobile phone to serve as a tracking device with installed maps such as Google Maps or OneMap that generally helps with wayfinding and can be improvised to help with remote monitoring. As dementia progresses, caregivers can then consider GPS-location trackers with other features such as fall detection and geofencing.

Read our article on 10 Ideas for Outdoor Monitoring to find out more about alternative solutions.

6. Contingency Planning

Caregivers and other family members should always discuss implementing an appropriate backup plan in cases where location-tracking devices fail to work or if the person living with dementia removes or misplaces the device. Technology is never 100% failproof and early planning for sources of support available to the caregiver would be a worthwhile exercise for the family to be able to intervene when situations escalate.

Conclusion

Helping persons living with dementia to maintain their sense of freedom, independence and autonomy is an essential part of caregiving. Caregivers may not always be available to accompany their loved ones as they go about their daily activities. Including location-tracking technology into caregiving toolkits can help caregivers balance the need for safety and their loved ones’ need for freedom.

It is advisable to have an open and honest discussion to understand how your loved one feels about introducing technologies. Caregivers should consult healthcare professionals to select a solution that is tailored to their loved one’s unique needs.

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10 Ideas for Outdoor Monitoring

dementiahub — Wed, 15 Nov 2023 09:17:13 +0000

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Looking for a solution to help your loved ones living with dementia to safely enjoy their activities outside the home while offering caregivers the ability to monitor movements from afar?

Below is a list of outdoor tracker solutions and alternatives that may be helpful for caregivers to explore with their loved ones.

*Note: This list is not an endorsement of products. Interested caregivers may wish to contact the respective sellers for more information.

1. Tracker with SOS and Geofencing Capabilities
2. Tracker with Call-and-Fall Detection Capabilities
3. Adapting Bluetooth Trackers
4. Adapting Tracking Through “Find My Device” Apps
5. CARA – Engaging the Community
6. Hyperlocal Dementia Search Networks
7. Tracking Public Transport History
8. Google Maps and Timeline
9. Location Sharing Through Chat Apps
10. Activating Family & Friends

1. Tracker with SOS and Geofencing Capabilities

The Tack GPS offers a small and lightweight personal GPS tracker for real-time tracking (both indoors and outdoors). This device comes with SOS notifications and geofencing capabilities and 30-day battery life. Additional subscription package is required.

For more information: Visit Tack GPS.

2. Tracker with Call-and-Fall Detection Capabilities

The iHelp 2 is a GPS tracker with built-in motion sensors for fall detection. It can auto-trigger SMSes and calls in emergencies. This tracker is equipped with an SOS call button to communicate with family members.

For more information: Visit OMG Solutions.

3. Adapting Bluetooth Trackers

Bluetooth trackers are an option for caregivers to explore. However, these trackers come with limitations to take into consideration when assessing their suitability. This range of trackers are readily available and are less costly than GPS trackers. They are great for indoor tracking to help pinpoint users’ general location. They require little installation, come with extended battery life, and are easy to use.

As these devices rely on Bluetooth signals paired with devices, these trackers typically have a limited radius of about 30 meters. Bluetooth signals may also weaken in indoor spaces due to walls and other obstructions, making it difficult for trackers to accurately provide location data outside of the signal range.

These trackers are best suited for loved ones who are mostly accompanied and tend to stay close to their caregivers.

Bluetooth trackers are readily found on all online marketplaces.

4. Adapting Tracking Through “Find My Device” Apps

Smart phones are natural GPS receivers. If your loved ones living with dementia is carrying a smartphone or wearables such as smart watches, you will be able to track the location of your loved ones through the native “Find My Device” feature.

These apps are free for use. The devices of your loved ones can be added to the device list to provide general location of your loved ones’ whereabouts.

The “Find My Device” app is a good option if you loved ones are actively carrying their charged mobile devices.

5. CARA – Engaging the Community

Developed by Dementia Singapore with the support of AIC and the Dementia-Friendly Singapore movement, the CARA mobile app is a lifestyle and community digital platform created specifically for the dementia community.

CARA is an alternative to provide caregivers with a peace of mind while their loved ones actively engage in the community.

Membership is open to persons living with dementia, caregivers, and the general public. Sign-up is currently free. Verified caregivers will receive an electronic membership card and verified persons living with dementia members are issued a physical card with a unique QR code identifier. This card can be shown to members of the public if your loved ones require assistance, and the member of public will be able to scan the unique identifier and call the registered caregiver(s).

Persons living with dementia and caregivers can also access a range of specially curated benefits to encourage persons living with dementia to continue their participation in community activities. This mobile app is also integrated with Vintage Radio, enabling access to music from the yesteryears.

Although it is not classified specifically as a tracking device, CARA leverages technology and the community to help keep a lookout for persons living with dementia who may be distressed while outside their home.

Caregivers will also be able to notify the CARA community when their loved ones are found to be missing, enabling caregivers to enlist help from members of the CARA community to search for their loved ones.

These notifications have also been integrated with the Municipal Services Office’s OneService App, amplifying the broadcast of notifications to a larger search network.

Read more about CARA:

Visit cara.sg to download the app
CARA: A Pioneering Membership Programme

Dementia care: OneService app broadcasts missing person reports to its 500,000-plus users

Source: ChannelNewsAsia

CARA is currently tied up with MSO’s OneService app to help persons with dementia who are lost to reunite with their families much quicker and more effectively, widening the search process.

6. Hyperlocal Dementia Search Networks

Another initiative by the Community Outreach Team (CREST) team at AWWA is the Woodlands-Sembawang Dementia Search Activation Network (DSAN) that helps to facilitate searches for lost seniors in the neighbourhood via Telegram chat.

Caregivers living within the Woodlands-Sembawang vicinity may register to join this chat channel and broadcast to the group if their loved ones go missing. The group will be notified to actively support.

Read more about DSAN:

Building a Telegram Community to Find Lost Seniors with Dementia
Register to join the Telegram Chat channel here

7. Tracking Public Transport History

For persons living with dementia who prefer to move around on their own via public transport, caregivers may consider a combination of technologies to support their loved ones’ while monitoring their transit movements.

The EZ-Link has developed the Family Account feature on the EZ-Link app where caregivers are able to add their loved one’s SimplyGo EZ-Link card details to their Family Account. Through the Family Account, caregivers can monitor their loved ones’ detailed transit history, including the latest bus stop and MRT station they were at with their EZ-Link cards. This may be helpful for caregivers to narrow down their location based on last known MRT station or bus stop.

Caregivers will have to upgrade their loved ones’ EZ-Link cards to SimplyGo EZ-Link in order for it to be added to the Family Account.

All concessionary privileges will remain, and caregivers will also be able to top up their loved ones’ SimplyGo EZ-Link cards through the app without using the physical card.

For more information:

Visit ezlink.com.sg
The Straits Times: New ez-link family account feature lets users link 7 cards to 1 account and top them up remotely

8. Google Maps and Timeline

For persons living with dementia who are still carrying their mobile phones, another helpful solution is the use of the Timeline feature in Google Maps. Google Maps is free for use and a good wayfinding solution. To use the Timeline feature, you will need to enable “Location Sharing” on Google Maps on your loved ones’ smartphone. This can then be shared with trusted caregivers and family members.

Google Timeline tracks places visited by your loved ones and creates a day-by-day historical record of your loved one’s movements, providing caregivers with insights into their loved ones frequently visited locations and daily routine.

In cases your loved ones go missing, a guided search feature can help guide caregivers to their loved ones last known location.

9. Location Sharing Through Chat Apps

For persons living with dementia who are still fairly proficient with chat apps, these chat apps come with additional features which allow persons living with dementia to share their locations with their caregivers. Chat apps such as WhatsApp, Telegram, and WeChat have this feature. Caregivers can discuss this function with their loved ones.

An alternative to this is to request for your loved ones to take photos of prominent landmarks and their surroundings (when feeling disoriented) to help caregivers locate their precise location.

10. Activating Family & Friends

Life360 is a family safety mobile application that helps families track movements of members within a private family circle. Caregivers will be able to view the location history of their loved ones living with dementia and place an SOS message to the family circle should the need arises.

One-tap direction is also a helpful feature to guide caregivers to their loved ones when needed.

This app is currently free for use, but it comes with a monthly subscription for additional safety features.

For more information: Visit life360.com

Every person living with dementia is unique. They have different needs and preferences. Caregivers may consider using a combination of different technological solutions to ensure the safety of their loved ones.

We encourage caregivers to view technology as a compensatory option to continue supporting your loved ones with dementia to remain active. The usage of these tools can be modified over time as your loved ones’ ability change over time.

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Tips to Improve the Shower and Bath Experience

Admin — Thu, 09 Feb 2023 06:15:42 +0000

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Dementia is a progressive condition, in which those living with moderate or advanced dementia will require support in carrying out activities of daily living (ADLs) such as bathing, dressing, grooming, toileting, walking, and eating.

For many, bathing and showering are activities that are rather private and intimate. The same applies to persons living with dementia. Thus, it is understandable that they may feel uncomfortable receiving assistance and may find it difficult to adjust to this change. These feelings of uncertainty are also felt by caregivers, who often have trouble convincing their loved ones to have a bath, or making the process a calm and comfortable one for everyone involved.

However, it is crucial that caregivers like yourself approach these activities with understanding and compassion as this will go a long way toward reducing feelings of anxiety and frustration, hence improving the quality of life for both you and your loved one with dementia.

1. My loved one refuses to shower when I tell them to. What do I do?
2. My loved one is often stressed and agitated when they have to take a shower. What can I do to make them feel more relaxed?
3. My loved one feels embarrassed when I assist them with their shower/bath in the washroom. What can I do to protect their modesty during the process?
4. I’m new to this. How do I even begin to assist my loved one with showering?
5. I think I need additional support. Who can I reach out to for help with my loved one’s ADLs?

Additional Resources

How Does Dementia Affect Bathing and Showering?

Dementia affects every individual differently. This includes their experience of the symptoms, the rate at which the condition progresses, as well as the type and level of support required.

Find out how the symptoms affect persons living with dementia and develop gradually throughout the mild, moderate, and advanced stages of the condition here.

In the context of personal hygiene, persons living with moderate (and in some cases, mild) dementia may find it challenging to carry out a sequence of activities in the correct order, such as the steps required to take a shower. They may also have difficulty with perception, recognition and understanding the objects around them, which can make bathing and showering distressing. Conversely, persons living with advanced dementia are likely to depend completely on their caregivers to perform their ADLs.

Tips to Improve the Shower and Bath Experience:

1. My loved one refuses to shower when I tell them to. What do I do?

In moments like this, it is important to understand why your loved one does not want to take a shower. Here are a few things to consider:

Does my loved one think they have already taken a shower?
Does my loved one feel anxious or embarrassed about taking a shower with other people around?
Are there any physical problems that may make showering difficult or painful for them?
Do they feel uncomfortable using the showerhead in the shower?
Would they prefer to shower slightly later? Before they were diagnosed with dementia, when did they prefer to take a shower?
Does my loved one feel unsafe taking a shower in the bathroom? Were there incidents of falls or near-falls in the bathroom before?

It is important to take into consideration your loved one’s preferences for shower or bath, products, time of day, etc.

It is also useful to make sure that showers happen at the same time every day, so that it becomes part of the normal flow of their day. This predictability will reduce their stress and anxiety which might make them more willing to bathe.

Additionally, you may further encourage your loved one to take a shower by giving them reasons to. For instance, you may mention that you may be expecting visitors or have made plans to go out later in the day, or mention that they can have a warm cup of tea and do something fun after the shower. Remember to keep the conversation generally positive and avoid discussing or arguing about the shower.

2. My loved one is often stressed and agitated when they have to take a shower. What can I do to make them feel more relaxed?

Before going about the bath or shower, it is important to ensure that your loved one’s surrounding environment is relaxing and ideal for the activity.

Ensure that the bathroom or the place in which the bath will take place is properly illuminated.
Organise the shower or bathing essentials. You may consider labelling the items to make it easier for your loved one to identify them.
Ensure that the bathroom is clutter-free so that your loved one has enough space to find what they need.
If your loved one finds physical activities more difficult, you may wish to prepare a shower commode so that they can have a less tiring experience whilst showering. In the absence of a shower commode, you may place a plastic chair with a backrest against the wall to ensure that the chair is stable. You may also install grab bars that your loved one can hold on to or place non-slip mats for added safety.
Some persons living with dementia may feel distracted, confused or agitated when they see themselves in the mirror. It is advised to cover the mirrors in the bathroom with a towel to reduce feelings of discomfort and displeasure in your loved one.
Test the temperature of the water to ensure that it is not too hot or too cold. You may also use a hand-held shower head with a milder spray or a pail so that it is more comfortable on the skin.
Play relaxing music during the activity to create a sense of calm.
Communicate clearly, gently, and encouragingly with your loved one while assisting them in the showering process.

Coupled with enhancements to the physical environment, it is important for caregivers to tailor interactions with their loved ones to their specific needs in order to make the most of each conversation. Find out how to best communicate with your loved one here.

Additionally, do not rush the activity. Allow plenty of time for the shower or bath to take place so that your loved one does not feel rushed. They may take a longer time to process information, which affects their ability to make certain decisions. You may wish to remind your loved one of the steps they need to take and support them in identifying the correct shower essential. It might take slightly more time, but your loved one will have a sense of control over what is happening, which will reduce anxiety and increase their level of confidence.

In instances where showers may be too distressing for your loved one, remember that there are alternative ways of maintaining their personal hygiene. For instance, you may give them a sponge or towel bath while they are sitting or lying down on their bed. Body wipes are good alternatives as well.

3. My loved one feels embarrassed when I assist them with their shower/bath in the washroom. What can I do to protect their modesty during the process?

It is important to respect their privacy as far as you can, especially during activities that are rather personal and intimate like showering and bathing. You can do so by:

Ensuring that nobody will walk in while they are washing or getting dressed
Closing the blinds, windows or shower curtain for privacy
Uncovering only the part of their body that you/they are washing. A towel can be useful for this. You may also wish to start with the extremities of the body like their hands and legs to slowly ease your loved one into the showering process.

Ask The Expert: Episode 4 – Living With Dementia (Daily Activities)

Source: Agency for Integrated Care

In this episode, Ms Low Mui Lang, Executive Director of Peacehaven Nursing Homes and Peacehaven Day Centres, answers questions related to managing the daily activities for persons living with dementia, such as how to respect a loved one’s privacy during the shower process.

Your loved one may also prefer someone in the family (or otherwise) who is of the same gender as them. They may also prefer a certain person to assist them in the shower over another.

Should someone new (i.e. domestic helper, care professional, family member who is not as close to your loved one) be assigned to assist them in the washroom, priority should be to build rapport and familiarise themselves with the newly assigned person. Remember to allow some time for your loved one to become more comfortable with being assisted by the new person.

It is important that you empower your loved one to make these decisions and to consider their preferences so that they feel comfortable during the activity.

4. I’m new to this. How do I even begin to assist my loved one with showering?

Activities of Daily Living – Resource Guide for Caregivers
Source: Agency for Integrated Care

This resource by AIC is a step-by-step guide on how to support your loved one with their personal hygiene needs. These may include bathing, shampooing, mouth care, shaving, foot care and various other ways of washing.

5. I think I need additional support. Who can I reach out to for help with my loved one’s ADLs?

It is perfectly alright to seek help, especially if you are new to this and are feeling unsure. Home Personal Care service is provided by trained care professionals to assist clients and their caregivers with ADLs, medication, mind stimulating activities, elder-sitting and other care tasks.

Prior to the start of the Home Care service, a registered nurse, therapist or doctor will assess the cognitive and functional skills of your loved one before coming up with a care plan that is best suited for them.

Home Care Services

Name	Address	Telephone
Active Global Home & Community Care	51 Goldhill Plaza, #12-11 Singapore 308900	6536 0086
Bethesda Care & Counselling Services Centre	300 Bedok North Ave 3 Singapore 469717	6445 1500
Comfort Keepers (Toa Payoh / Bishan)	627 Aljunied Road #07-03 Pacific Building Singapore 389837	6282 0577
Comfort Keepers (Bedok)	1301 Bedok North Ave 4 #04-02 Goldbell Centre Singapore 489945	6446 7361
Comfort Keepers (Bukit Merah)	221 Henderson Road #07-18 Henderson Building Singapore 159557	6336 3376
Dorcas Home Care Service	Blk 105 Jalan Bukit Merah #01-1912 Singapore 160105	6377 5183
Generation Home Care Pte Ltd	1 Kim Seng Promenade #15-12 Great World City West Tower Singapore 237994	6402 6407
Handicaps Welfare Association (Whampoa)	15 Whampoa Drive Singapore 327725	6254 3006
Loving Heart Multi-Service Centre	210 Jurong East Street 21 #01-389 Singapore 600210	6897 4766
Moral Home Help Service (East)	2 Chai Chee Lane Singapore 469030	6441 6280
Moral Home Help Service (West)	301 Henderson Road Singapore 108931	6273 2239
NTUC Health (Home Care)	Islandwide	6715 6715
Sunlove (Home Help Service)	70 Buangkok View Singapore 534190	6386 9312
SWAMI Home	5 Sembawang Walk Singapore 757717	6257 6117
Tembusu Rehab Centre – Sathya Sai Social Service	715 Jurong West Street 71 #01-47 Singapore 640715	6790 7226
Thong Teck Home for Senior Citizens	91 Geylang East Ave 2 Singapore 389759	6846 0069
Touch Home Care	Blk 173 Toa Payoh Lorong 1 #01-1264 Singapore 310173	6258 6797

For other services near your home, refer to the Agency for Integrated Care (AIC) E-locator.

You may also wish to enrol in courses or training programmes to gain a better understanding of how to support your loved one in their daily activities. Refer to the AIC Caregiver Training Courses E-Calendar to view available caregiving training courses surrounding home personal care.

Additional Resources

Caregiving for Seniors – A Practical Guide

Source: Caregiving Welfare Association

This handbook was developed to provide a deeper perspective on the common issues faced by caregivers. It features:

Various practical approaches to challenges that caregivers face during their journey of caregiving
Step-by-step guide on how caregivers can support their loved one with activities of daily living, plan for the future, and engage in self-care.

Ask the Expert: Episode 3 – Living With Dementia (Communication)

Source: Agency for Integrated Care

How do the changes brought about by dementia impact communication? What are some words to avoid? Does talking speed, words you use and body language matter when speaking to a person living with dementia?

In this episode, Ms Michelle Ong and Mr Anjang Rosli answer questions related to communicating with person living with dementia.

Nutrition & Hydration Needs for Persons Living with Dementia

Admin — Thu, 06 Oct 2022 09:24:54 +0000

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The type of food we eat will affect our health and quality of life. While there is no special diet required for persons living with dementia, the condition may bring about challenges to proper nutrition, hydration, and weight maintenance. Here are a few ways to ensure that your loved one has a well-balanced and nutritious diet, drinks sufficient amounts of liquid, and maintains physical and mental well-being.

The nutritional and hydration needs of persons living with dementia will be similar to other people of their age. People who are undernourished tend to get sick more often and recover from illness and injury more slowly. However, those who experience increased physical activity from restless behaviours (such as pacing up and down, wandering and fidgeting), may need a higher amount of nutrients to try to minimize weight loss.

For most persons living with dementia, maintaining good nutrition may be a challenge. Some of the changes they may experience include a loss of appetite, forgetting to eat and drink, forgetting how to chew or swallow, or developing an insatiable appetite.¹

People in the later stages of dementia may lose a considerable amount of weight. Learn about strategies to help promote oral intake and create a positive eating environment here. If there is persistent weight loss or poor appetite despite these strategies, it is recommended to seek advice from a dietitian.

Eating Well for Healthy Ageing

Eating a well-balanced nutritious diet is important for overall health. My Healthy Plate shows the portions required for a balanced and healthy diet, which is a guideline for one to aim for.

¼ Plate of Wholegrains

Wholegrains provide us with energy, fibre, vitamins (e.g. vitamin B and vitamin E) and minerals (e.g. zinc, magnesium). They are rich in nutrients as they are not overly processed, with their original form being kept. Eating more wholegrains have been shown to lower one’s risk of developing chronic diseases such as diabetes, heart diseases and certain cancers.

Wholegrains include brown rice, wholegrain bread and oatmeal. Wholegrains can also be used to make products such as brown rice vermicelli, chapati from wholemeal flour and wholegrain breakfast cereals.

It is recommended to consume at least 2-3 servings of carbohydrates/wholegrains per day

1 serving of protein equals to:
1 palm size of lean meat/poultry/fish	2 glasses of low-fat milk
4 slices of low-fat cheese	¾ cup of cooked beans/peas/lentils (120g)
4 pieces of tempeh (120g)	¾ block of tau kwa (150g)

Incorporating a variety of wholegrains will help to ensure one gets more nutrients and makes mealtime more interesting. Do keep a look out for “Higher in Wholegrains” Healthier Choice Symbol during grocery shopping.

Meeting the above protein requirements per day will help to ensure that one gets sufficient amounts of iron and vitamin B12 daily. Iron and vitamin B12 help in the formation of haemoglobin in our red blood cells, which are needed to carry oxygen to all parts of our body. There are two types of iron in foods. Haem iron comes from animal sources (such as meat, poultry, fish) and non-haem iron come from eggs and plant sources (such as beans, lentils, peas), nuts, fruits and vegetables. Our body absorbs haem iron better than non-haem iron. Eating foods rich in vitamin C (e.g. oranges, lemons, tomatoes, cabbage) together with foods containing non-haem iron, and drinking coffee/tea away from meals are some ways to help to increase iron absorption. Sources of vitamin B12 include meat, fish egg, yoghurt, fortified soymilk and fortified cereal.

Dairy products (low fat milk/cheese/yoghurt), high calcium soy milk, tofu and canned low sodium sardines are both good sources of protein and calcium. Calcium helps to strengthen our bones and teeth and reduces the risk of osteoporosis. Drinking 2 cups of high calcium low-fat milk or high calcium soy milk will allow one to meet their daily calcium requirements of 1000mg per day. Vitamin D helps our body to better absorb calcium into our body. Food sources of vitamin D include oily fish (e.g. salmon, mackerel, cod), eggs, margarine, fortified cereals, fortified dairy (milk, cheese, yoghurt) and fortified soy milk. Meeting above protein and calcium requirements will generally mean that one is meeting recommended amounts of vitamin D per day.

½ Plate of Vegetables and Fruits

Similar to wholegrains, vegetables and fruits are rich in fibre. They are also rich in vitamins, minerals, phytochemicals and antioxidants. Consumption of adequate fibre daily helps protect one against chronic diseases such as heart diseases, stroke and certain cancers. Fibre helps to regulate our bowel movement, control blood sugar and cholesterol levels, and manage weight gain.

It is recommended for women to take 20g of fibre per day and men to take 26g of fibre per day. This equates to 2 servings of vegetables and 2 servings of fruits per day. Starchy or root vegetables like corn, sweet potato and potato do not count towards the 2 serves of vegetables per day.

1 serving of fruit equals to:
1 small apple, orange, pear or mango (130g)	1 wedge of papaya, pineapple or watermelon (130g)
1 medium banana	10 grapes or longans

1 serving of vegetable equals to:
¼ round plate of cooked vegetables	150g of raw leafy vegetables
¾ cup of cooked leafy vegetables (100g)	100g of raw non-leafy vegetables
¾ cup of non-leafy vegetables (100g)

Overall, it is recommended to:

Enjoy a wide variety of nutritious foods across and within food groups
Eat at least 3 meals a day
Eat 2 servings of fruits and 2 servings of vegetables a day
Eat a diet low in saturated fats and salt
Include foods containing calcium, vitamin D, iron and vitamin B12
Use added sugars in moderation

Drinking Enough Fluids

Persons living with dementia who are older may be more susceptible to dehydration due to reasons such as a blunted sense of thirst, poor memory, immobility or medications interfering with their thirst mechanism.² Low hydration levels are associated with incidences of acute confusion/delirium, urinary tract infections, constipation and delayed wound healing.³

It is recommended to aim for 6-8 glasses of water per day.

Tips to increase fluid intake include:

Frequent encouragement of small amounts of fluids throughout the day
Keep a cup/bottle of water within reach of the elderly
If the senior is not keen on drinking plain fluids, other sources of fluids such as soup, juices, milk, honey water, barley water can be encouraged

Preservation of Cognitive Function

There is currently a move in research to consider the evidence for whole diets (particularly those which are plant-based, rich in good fats), rather than individual nutrients, to help with the prevention of cognitive and functional decline.⁴ This could probably be due to the synergistic beneficial effects of various nutrients in a diet.⁵

Research suggests that healthy dietary patterns with an emphasis on higher consumption of vegetables, fruits, wholegrains and healthy fats, while minimising red meat, refined sugars and processed foods intake may work as a preventative measure to cognitive decline by reducing cardiovascular risks.⁴

Some examples include the Mediterranean Diet, Dietary Approaches to Stop Hypertension (DASH) Diet, Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet and NU-AGE Diet.

Understanding Dementia: Part 7
Source: Agency for Integrated Care

Today, there has been no clear and consistent information on dietary factors that may increase or decrease the risk for the onset of dementia. However, adopting a Mediterranean diet may lower the risk of cognitive decline and dementia. This means eating higher proportions of grains, fruits, fish and vegetables.

These dietary patterns share similar recommendations with My Healthy Plate from the Health Promotion Board (Singapore), though with additional advice for specific food groups and portion sizes. In common, these dietary patterns recommend:

Selecting wholegrains (aim for at least 2 serves of wholegrains per day)
Choose lean meat and oily fish (aim for at least 1 serving of oily fish such as sardine, mackerel, and salmon per week)
Aim for at least 2-3 serves of vegetables per day
Aim for at least 2 servings of fruits per day, including 2 serves of berries per week
Incorporate healthy oils (e.g. olive oil)

However, current research has not yet been able to determine how long the exposure to these diets must be or during which ages is it more effective.⁴ Hence, individuals should be encouraged to follow the above recommendations if they are nutritionally well, as a preventative measure to cognitive decline. There should also be focus on meeting caloric and protein requirements for individuals who are undernourished as poor nutrition can lead to a myriad of health issues.

Additional Resources

Nutrition and Dementia
Source: Alzheimer’s Disease International

This report investigates how a healthy diet and the right nutrition can improve the lives of persons living with dementia. The publication features:

Dietary factors across the life course that might increase or decrease the risk of onset of dementia in later life;
Relationship between dietary nutrients and dementia prevention;
Recommendations on the actions to take in order to improve the nutrition of persons living with dementia; and
The need for more research on nutrition and dementia.

Eating Well with Dementia
Source: Alzheimer’s Society of Ireland

Provides caregivers with information on:
Understanding how dementia can affect a person’s appetite and experience with food;
Meeting the nutritional needs of a person with dementia;
Encouraging a person with dementia to enjoy and be involved in meal preparation and mealtimes; and
Dealing with weight loss, weight gain and other issues that can emerge.

Eating and Living With Dignity
Source: Ministry of Health of Israel

This guide for care professionals and family caregivers provides information, tips, and recommendations addressing the following in persons with dementia, such as:

Difficulties with eating and choosing food;
Constipation problems;
Changes in eating and swallowing as dementia progresses; and
Maintaining health nutrition.

AUTHOR BIO

Clarissa Tai, Senior Dietitian

After graduating from the University of Queensland with a Master in Dietetics degree, Clarissa has been working as a dietitian at Tan Tock Seng Hospital since 2019. Her interest lies in working with the geriatric population, to help improve their health, quality of life and awareness of nutrition related issues.

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Volkert D, Chourdakis M, Faxen-Irving G, et al. ESPEN guidelines on nutrition in dementia. Clinical Nutrition [Internet]. 2015 [cited 2022 Aug];34(6):1052-73. Available from https://nutritotal.com.br/pro/wp-content/uploads/sites/3/2016/03/ESPEN_demencia.pdf
El-Sharkawy AM, Watson P, Neal KR, et al. Hydration and outcome in older patients admitted to hospital (The HOOP prospective cohort study). Age Ageing [Internet]. 2015 [cited 2022 Sept];44(6):943-947. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621229/
Bruno C, Collier A, Holyday M, Lambert K. Interventions to improve hydration in older adults: A systematic review and meta-analysis. Nutrients [Internet]. 2021 [cited 2022 Sept];13(10):3640. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4621229 DOI: 10.1093/ageing/afv119
Lavingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet [Internet]. 2020 [cited 2022 Aug];396(10248):413-446. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392084/
Scarmeas N, Anastasiou CA, Yannakoulia M. Nutrition and prevention of cognitive decline. The Lancet Neurology [Internet]. 2018 [cited 2022 Aug];17(11):1006-15. Available from http://old.school.med.uoa.gr/uploads/media/LancetNeurology2018.pdf

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Swallowing Difficulties and Soft Diets

Admin — Mon, 17 Oct 2022 10:13:56 +0000

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Difficulties With Swallowing

In the later stages of dementia, a person living with dementia can develop severe difficulties with swallowing.

Changes in parts of the brain that control swallowing may affect and weaken the muscles involved, affecting various parts of the eating process. As a result, the person living with dementia may not maintain sufficient fluid and nutritional intake for bodily sustenance. Difficulty in swallowing also increases the risk of food or drinks entering the lungs. This can lead to a serious lung infection.

Watch out for these signs and symptoms of difficulties with swallowing:

Coughing during or after meals
Frequently clearing the throat
Feeling breathless while eating
Holding food in the mouth and refusing to swallow
Having difficulty swallowing
Spitting lumps of food out

If your loved one or a person you know lives with dementia has any of the symptoms above, have an assessment with a speech therapist. They will provide advice on the safest dietary options, including changes in diet texture and liquid consistency where appropriate. They may also provide strategies on feeding the person safely. This may minimise their risk of aspiration.

What You May Observe & Suggested Strategies to Prevent This

Coughing/choking

Ensure that the person living with dementia sits in an upright position when eating
Prepare food and liquid that are of the correct texture (for e.g., thickened fluids, minced or pureed diets)
Engage in a slow feeding rate
Control the amount being fed
Avoid offering mixed textures of liquid and solid food (e.g. milk with cereal, or noodles with soup), as it can increase the risk of choking

Holding food in their mouth

Offer food that does not require much chewing
Give verbal reminders to swallow
Present an empty spoon near or in their mouth to prompt them to perform the swallowing action again

Currently, there is no strong evidence that tube feeding helps when a person living with dementia is still able to chew and swallow food. It may also be detrimental to use tube feeding at this stage.

Food Refusal in Advanced Dementia

A person living with dementia may start losing interest in food and consequently losing weight from reduced food intake.

This tends to happen towards the advanced stage of dementia. It may seem as though the person is being starved. However, the reality is that their metabolic rate goes down and they use up less energy too.

The person living with dementia may not be as active or mobile as before and may not require the same amount of calories they had when they were more active. In fact, having a reduced interest in food or fluid intake can be a part of the natural progression of ageing.

Here are some strategies that may help you deal with this issue:

Look for opportunities to encourage the person living with dementia to eat. If they are mostly at night, light night-time snacks may be a good idea.
Encourage them to get involved in preparation during mealtimes where possible.
Encourage them to enjoy a snack.
Offer familiar or favourite food and drinks.
Choose the most flavourful food for mealtimes.
Offer small amounts of food and drinks throughout the day.

In advanced dementia, when swallowing is weakened, the person living with dementia may have an increased risk of food and fluid entering their lungs. Offering food and drinks may no longer be safe when signs of choking or aspiration occur.

The priority may then shift to making the person feel comfortable. Care professionals can:

Moisten their loved one’s lips
Continue to let them have a little taste of their favourite food

This is part of comfort and pleasure feeding as it allows the person living with dementia to maintain some dignity and retain the enjoyment of certain tastes. It is important to never force feed or make them eat when they are drowsy.

Artificial Nutrition

With the family caregivers’ consent, a person living with dementia may be offered artificial nutrition. Artificial nutrition can be delivered through a nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tube. A NG tube involves the insertion of a feeding tube via the nose into the stomach while the latter is inserted directly into the stomach through the abdominal wall via a surgical procedure.

Artificial nutrition can help a person receive adequate hydration, nutrition and may help in weight gain. However, it is important to note that artificial nutrition have not been proven to:

Reduce the risk of aspiration and pneumonia
Improve survival or prolong life in persons living with advanced dementia
Prevent pressure ulcers
Improve functional status

Having a feeding tube may add discomfort to the person living with dementia and prolong their suffering. Additionally, they may need to be restrained, especially if there is a tendency to pull out the feeding tube.

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Improving Eating Environment & Appetite

Admin — Thu, 06 Oct 2022 09:13:24 +0000

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How Can You Improve the Eating Environment?

While it is essential to pay attention to the nutritional aspects of a meal by providing regular, healthy and balanced meals, another important aspect of meals for persons living with dementia is the eating environment. As eating is a social activity, creating a comfortable dining atmosphere can help boost the appetite of a person living with dementia.

Some tips on creating a comfortable eating environment:

Provide opportunities to eat together with others, but be mindful of group size. Too large a group can get noisy and distracting.
Reduce unnecessary distractions (e.g. TV, household chores) unrelated to eating.
Ensure that there is a selection of various foods.
The colours of the food, plate, and table should be different and contrasting.
Avoid the use of patterned plates to prevent confusion.

How Can You Improve the Appetite of a Person Living With Dementia?

We are aware of all the good and nutritious foods like walnuts and green leafy vegetables that persons living with dementia need to keep their brain health in the best possible condition. However, what if persons living with dementia refuse to eat? For most people without the condition, eating and having our meals promptly happens most naturally.

Singaporeans are known to live to eat, some going beyond the recommended three square meals a day with ease. For persons living with dementia, mealtimes are not so straightforward.

Due to problems with chewing, swallowing or digesting, eating sometimes becomes a difficult chore. With their diminished sense of taste and smell, food that was once delicious may also lose their allure, leading to some seniors losing interest in eating. Often, the effects of memory loss may also confuse them into thinking they have already eaten, resulting in them eating less. If a person living with dementia is on medication, some prescriptions can also affect appetite and increase the likelihood of constipation, making their eating and digesting process more difficult.

In the process of caring for someone living with dementia, it can get frustrating when getting them to tuck in to a meal. These are some tips that may ease the process:

Let them choose what they want to eat.
Provide regular snacks or small meals rather than setting designated mealtimes.
Make the look and smell of the food appealing and appetising.
Do not overload the plate with too much food. Small and regular portions work best.
Use brightly-coloured plates to help make eating interesting and distinguish food better.
Encourage the person living with dementia to get involved with mealtimes, such as asking them to help in preparing the food or laying the table.
Maintain eye contact with them during mealtimes, and continuously guide them back their to eating when they pause.
Invite familiar people to join the meal and provide company. However, minimise conversations during mealtimes, as they may be too over-stimulated or distracted to finish their meal

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Tips to Manage Dementia Medications

Admin — Thu, 08 Sep 2022 09:34:28 +0000

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Most persons living with dementia are able to manage their own medication in the early stages of their condition, but may find it more difficult to do so as their dementia progresses. Consuming the wrong combination, dosage or forgetting to take their medicine on time may put them at serious risk. It is, thus, important that both persons living with dementia as well as their caregivers are equipped with the basic skills for effective medication management.

If a person living with dementia forgets to take their medication, it should be administered as soon as possible. However, if it is almost time for the next dose, the missed dose should be skipped. The dose should not be doubled to make up for the missed dose. Caregivers and care professionals should take note of missed or irregular doses and share this information with the medical team working with the person living with dementia.

Being Transparent With the Medical Team About the Consumption of Medications or Other Products

Caregivers, care professionals, and the person living with dementia should be transparent with all doctor(s) and pharmacist(s) looking after the person living with dementia about whether the person is taking:

Any medications or supplements that have been previously prescribed
Those that have been prescribed by other doctors, including traditional medicines
Herbal preparations, supplements, or nutritional products.

These include:

Medications prescribed to address the person’s dementia and those for other purposes
Medications prescribed in different forms, including pills, injections, inhalants, and topical medications and creams (those applied on the skin), etc.

There needs to be transparency between these teams to avoid harmful conflicts in medications. See the section below on the Patient’s Medication List for more information on keeping track of medications.

Pay Attention to and Follow Medication Administration Instructions

Pay attention to and follow special instructions given by the doctor or pharmacist who gives the medications. Examples of instructions include:

The number of times a day to consume the medication, the dosage during each consumption, and how long the prescription lasts for
Whether the person needs to consume the medication before or after food
What food to avoid while taking the medication
How to administer the medication

Look Out for Side Effects

Look out for any possible side effects of medications taken, especially when they take newly prescribed medicine. The person living with dementia may have difficulty finding the words to alert others to side effects they are experiencing. Be mindful to report them to the doctor right away.

Drowsiness

Take note of medications that may cause drowsiness, as this may increase the risk of falling, especially in persons older in age.

Pay Attention to Special Storage Instructions

Know Your Meds: About Storage and Expiry

Source: Ministry of Health

This short video details the steps patients and caregivers can take to store their medication properly, and how to spot medication that have expired or should no longer be used.

It is important to store medication in a cool and dry place, away from direct light and heat. Some medication may require refrigerated storage conditions. If a person living with dementia moves to different locations during the day, such as to a day care centre or for different community activities, arrangements will have to be made such that the medications are kept in suitable conditions.

Administer as per the Doctor’s Instruction

Do not stop using any medication without first consulting the doctor or pharmacist. If you have any doubts, contact the doctor or pharmacist for clarification. Follow the advice of medical professionals. Caregivers and persons living with dementia should not make decisions on their own about their medication prescription. Medication takes time to take effect, so it is important to follow the prescription even if effects are not seen for some time. In addition, effects differ from person to person, so even if other persons respond differently, caregivers and the person taking it should not independently decide to change their dosage.

Coordinating Medication Assistance

The person living with dementia may be cared for by different caregivers and care professionals, and may require medication reminders or assistance from these different persons. It is important that the caregivers and care professionals are all on the same page about what the person’s medication prescriptions are, and are prepared to provide assistance if needed.

Medication Records: The Patient’s Medication List

It is important to keep an updated list of all medications being taken. This list is called the Patient’s Medication List (PML).

This list facilitates communication between different healthcare professionals and contains vital information healthcare professionals can use when seeing persons living with dementia for the first time. It also helps to have one ready in the event of a serious drug interaction or overdose.

The PML should include:

Two identifiers eg. name and NRIC number
Chronic medical conditions
Any drug or food allergies and a description of the allergic reaction
The names of all medications/supplements/vitamins prescribed (brand name and active ingredient), strength, dosing instructions, and reason for use
Date last updated

Bring the updated list for each visit to the clinic, hospital, or pharmacy, and show it to the healthcare professional. It also helps to add a picture of the medication and its bottle for easy identification to the list.

You may download a template of the Patient’s Medication List provided by the Ministry of Health here.

Remembering to Take Medications

Regularly forgetting to take dosages of medicine on time can lessen the medication’s effectiveness. It is important that caregivers and care professionals find ways to ensure that persons living with dementia take their medication in a timely and consistent manner.

Keeping track of the medication that needs to be taken at different times of day can be a struggle for both caregivers and persons living with dementia, especially when there is a mix of medicine that needs to be taken before and after meals throughout the day. This is even more challenging for a person living with dementia.

However, with some simple reminders and other medication management tools, medication can be managed effectively. Doing so can help people living with early-stage dementia continue to take their medication independently.

There are various methods that can be used to do this. Some of these methods allow the person living with dementia to maintain their independence in the early stages of dementia.

Use Pill Boxes

Know Your Meds: How to Pack A Pill Box

Source: Ministry of Health

This short video details the steps patients and caregivers can take when packing a pill box, as well as mistakes to avoid.

One of the simplest ways for keeping track of medication in pill form is the use of pill boxes. By placing each dose into a different compartment, it is easier for the person taking the medicine to identify and consume it at the correct times. By labelling each compartment, it also becomes easier to tell the time of day that each dose should be taken. This solution has the added benefit of making it easy to tell at a glance if a dosage has been missed.

Another solution is to use automatic pill dispensers. Such dispensers may have alarms that remind the user when it is time to take medications, and automatically dispenses medicine for that time of the day. There are a range of devices that offer slightly different functions at different price points that can be suited to the differing needs.

Set Reminders

If there are not too many different medicines to take, and if the person living with dementia needs only a simple reminder to take their medication at the correct time, using a phone to set alarms with simple descriptions can be an appropriate solution. Placing a daily schedule next to a digital clock can make it easier for the person living with dementia to tell which medications they should be taking.

Use a Timetable

Persons living with dementia and those caring for them can use a timetable to take note of when medications have to be taken. This is especially helpful if there are many types of medications to take. It can also be helpful when caregivers hand over caregiving duties to others when they are unavailable, or if the person living with dementia receives medication assistance services from home care personnel or centre-based care staff.

Medication Management Services

Some persons living with dementia and caregivers may require additional medication management services.

Some reasons for needing medication management services include:

Progressing dementia: In later stages, persons living with dementia may no longer be able to take their medication independently.
Living arrangements: Some persons living with dementia may live alone, or may not have family or caregivers around at certain times of the day when medication needs to be administered.
Type of medication: Some medications may be more difficult to administer independently, especially at later stages of dementia, such as injections, inhalers, nebulisers, etc.
Multiple medications and consumption timings: Having many medications to take at multiple times of the day may be difficult to coordinate.

There are medication-related services available for persons living with dementia by both public and private service providers. These services make it easier to manage medications. Services include:

Medication packing
Administering medication if clients and/or caregivers are unable to do so
Medication supervision
Medication reminders
Monitoring of medication compliance and proper taking of medication
Collection of medication from the pharmacy
Other services: Some other services are listed in the “Additional Resources” section below.

How to Get Medication Management Services

Here are some ways to engage these services:

Get a referral from a hospital, polyclinic or GP who is familiar with the conditions and needs of the person living with dementia.
You can visit an AIC Link location near you for advice on care services and schemes.
You may also use the online Care Services Recommender to find service providers near you.

The average price of the service is about $20 per hour before means-test subsidy. If caregivers and persons living with dementia require financial assistance for the service, they may speak to a service provider or the medical social worker in the hospital or polyclinic.

Additional Resources

HealthHub services: Check medication prescriptions and request prescription refills online

The HealthHub website and mobile application allows patients to check their past medication prescriptions and request medication prescription refills online.

You will need to use SingPass to access these services on the HealthHub website or mobile application.

Download the Android app
Download the Apple app

PILBOX & MDS by SingHealth Polyclinic

SingHealth Polyclinics (SHP) Pharmacy provides both Prescription In Locker Box (PILBOX) and Medication Delivery Service (MDS).

PILBOX allows patients or their caregivers to collect prescription refills any time without queueing.

It is currently available at

1. SHP-Bedok
2. SHP-Marine Parade
3. SHP-Sengkang
4. SHP-Punggol
5. SHP-Tampines

The Medication Delivery Service (MDS) allows patients or their caregivers to have prescription refills delivered to their preferred address, without having to physically turn up at the polyclinic.

This delivery service is currently available in all SHP pharmacies.

ConviDose™ by National Healthcare Group (NHG) Pharmacy

ConviDose™ is a multi-dose packaging compliance service by NHG Pharmacy that helps patients and caregivers arrange their medicines.

The right amount of medicines are packed into each sachet according to the time medications should be taken.

ConviDose™ is an easy-to-follow system which allows patients or caregivers to manage medicines easily and spot any missed doses.

Currently, ConviDose™ service is available from the following polyclinics:

1. Ang Mo Kio Polyclinic
2. Geylang Polyclinic
3. Hougang Polyclinic
4. Kallang Polyclinic
5. Toa Payoh Polyclinic
6. Woodlands Polyclinic
7. Yishun Polyclinic

NHG Pharmacy ConviDose™ Service

Source: NHG Pharmacy

ConviDose™ is a service that helps you arrange your medicines. It is an easy-to-follow system that allows you or your caregiver to manage medicines easily.

‘Ask-a-Pharmacist’ by NHG Pharmacy

‘Ask-a-Pharmacist’ by NHG Pharmacy allows patients and caregivers to direct questions to a patient care pharmacist regarding their medications or any drug-related concerns or issues.

Patients and caregivers can post questions at their website .

If you need immediate advice, consult a doctor, or call an NHG Pharmacist via the NHG Polyclinics contact centre at 6355 3000.

‘Know Your Meds’ by Ministry of Health

‘Know Your Meds’ by the Ministry of Health (MOH) is a series of videos and infographics aimed at teaching patients and caregivers the basic skills to effectively manage their medication.

The skills covered in the series are:

1. Know About Medication Label
2. Know How to Remember to Take Your Meds
3. Know If You Have Enough Medication
4. Know About Storage and Expiry
5. Know How to Create a Medication List
6. Know How to Pack A Pill Box

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Helping a Person with Dementia Who Lives Alone

Admin — Thu, 20 Oct 2022 15:57:58 +0000

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Persons living with dementia, especially in the earlier stages of dementia, may choose to live alone to maintain their independence for as long as possible, or to remain in a familiar neighbourhood. As the dementia progresses to moderate and advanced stages, it is likely that alternate living arrangements have to be made.

Here are some tips for you if you are a care professional working with persons with dementia who live alone.

Make self-care easier

They may forget to shower, change their clothes and have their meals. They may also forget to perform housekeeping duties, or to feed pets, amongst other tasks.
● Arrange for meal delivery services and housekeeping services..
● Write reminders and stick them on places they will look at (fridge, bedroom, living room, etc.). For example, you could write notes that read “Feed the pets”, “Remember to turn off the stove”, “Sweep the floor”, etc..
● Large and easy-to-read clocks and calendars will help the person to orient themselves to the time and date.
Improve safety in the home

They may lack judgment in dangerous situations such as those involving hazardous electrical appliances and slippery floors.
● Install non-slip mats and grab bars in the bathroom.
● Remove hazards from the house such as faulty kitchen appliances, clutter, fire hazards and broken furniture.
● Use technology in the form of monitoring systems to help track the person’s mobility in the house.
Involve others in the person’s care

A person living with dementia may exhibit behaviour that is hard to understand or accept. This may lead to unfriendliness or trouble with the neighbours, the police, and the community.
● Involve their family members in caregiving and encourage them to take turns to visit their loved one regularly. If regular visiting is not possible, encourage them to communicate regularly with their loved one via phone call or text.

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Activities of Daily Living Archives - DementiaHub.SG

Location-tracking Technology in Dementia Caregiving

In this Article

Role of Location-tracking Devices in Dementia

How Location-tracking Technology Can Help

Types of Tracking Device Technologies

Additional Useful Features

Caregiver Tips for Selecting Tracking Devices

Conclusion

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10 Ideas for Outdoor Monitoring

In this Article

1. Tracker with SOS and Geofencing Capabilities ​

2. Tracker with Call-and-Fall Detection Capabilities ​

3. Adapting Bluetooth Trackers ​​

4. Adapting Tracking Through “Find My Device” Apps ​​​

5. CARA – Engaging the Community ​​​​

6. Hyperlocal Dementia Search Networks ​​​​​

7. Tracking Public Transport History ​​​​​

8. Google Maps and Timeline ​​​​​

9. Location Sharing Through Chat Apps ​​​​​

10. Activating Family & Friends ​​​​​

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Tips to Improve the Shower and Bath Experience

In this Article

How Does Dementia Affect Bathing and Showering?

Tips to Improve the Shower and Bath Experience:

1. My loved one refuses to shower when I tell them to. What do I do?

2. My loved one is often stressed and agitated when they have to take a shower. What can I do to make them feel more relaxed?

3. My loved one feels embarrassed when I assist them with their shower/bath in the washroom. What can I do to protect their modesty during the process?

4. I’m new to this. How do I even begin to assist my loved one with showering?

5. I think I need additional support. Who can I reach out to for help with my loved one’s ADLs?

Additional Resources

Source: Caregiving Welfare Association

Source: Agency for Integrated Care

Read Next

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Nutrition & Hydration Needs for Persons Living with Dementia

In this Article

Why is Proper Nutrition & Hydration Especially Important for Persons Living with Dementia?

Eating Well for Healthy Ageing

¼ Plate of Wholegrains

½ Plate of Vegetables and Fruits

Overall, it is recommended to:

Drinking Enough Fluids

Tips to increase fluid intake include:

Preservation of Cognitive Function

Additional Resources

Nutrition and Dementia Source: Alzheimer’s Disease International

Eating Well with Dementia Source: Alzheimer’s Society of Ireland

Eating and Living With Dignity Source: Ministry of Health of Israel

AUTHOR BIO

Clarissa Tai, Senior Dietitian

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Swallowing Difficulties and Soft Diets

Difficulties With Swallowing

What You May Observe & Suggested Strategies to Prevent This

Coughing/choking

Holding food in their mouth

Food Refusal in Advanced Dementia

Artificial Nutrition

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1. Tracker with SOS and Geofencing Capabilities

2. Tracker with Call-and-Fall Detection Capabilities

3. Adapting Bluetooth Trackers

4. Adapting Tracking Through “Find My Device” Apps

5. CARA – Engaging the Community

6. Hyperlocal Dementia Search Networks

7. Tracking Public Transport History

8. Google Maps and Timeline

9. Location Sharing Through Chat Apps

10. Activating Family & Friends

Nutrition and Dementia
Source: Alzheimer’s Disease International

Eating Well with Dementia
Source: Alzheimer’s Society of Ireland

Eating and Living With Dignity
Source: Ministry of Health of Israel