Supporting Daily Activities Archives - DementiaHub.SG https://www.dementiahub.sg/loved-one-has-dementia-category/my-loved-one-has-dementia/supporting-daily-activities/ Singapore’s One-Stop Resource Portal on Dementia Wed, 15 Apr 2026 07:47:46 +0000 en-US hourly 1 https://www.dementiahub.sg/wp-content/uploads/2022/06/fav.png Supporting Daily Activities Archives - DementiaHub.SG https://www.dementiahub.sg/loved-one-has-dementia-category/my-loved-one-has-dementia/supporting-daily-activities/ 32 32 PAL Series: Supporting Persons Living with Dementia at a Planned Level https://www.dementiahub.sg/living-well-with-dementia/pal-series-supporting-persons-living-with-dementia-at-a-planned-level/ Sat, 28 Feb 2026 00:25:18 +0000 https://www.dementiahub.sg/?post_type=dementia&p=80322 Discover how to meaningfully engage people living with dementia using the PAL Tool.
Learn how to create enriching, personalized activities that support independence, dignity, and joy.

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The Pool Activity Level (PAL) Instrumental Tool1 is a framework designed to support individuals living with dementia. This article is the second installment to the PAL Series that discusses how to support persons living with dementia in the mild stages of dementia, who are usually in the Planned stage of the PAL tool. Learn more about tailoring activities for your loved ones’ cognitive and functional abilities.

  1. Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia  
  2. Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia  
  3. Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195  
  4. Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/  
  5. Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6  

What is the Planned Level

The Planned Level of the PAL tool describes those at the earliest stage of dementia. At this Level, persons living with dementia can still carry out well-rehearsed tasks and routines with structure and support, but they need prompts and environmental cues to stay on track.  

For instance, they can go to the market or coffee shop to buy their daily meals. However, if there are changes to the shop, such as its location, they may face difficulty orienting themselves.  

Below is an example of how to identify if your loved one is at the Planned Stage: 

Level
Person Living with Dementia
Example (Getting Dressed)
Role of Caregiver
Planned Level
Plan and carry out familiar tasks independently
Plans what to wear; selects own clothing from cupboard; dresses in correct order 
Encourage autonomy with minimal guidance 

What should Caregivers Do?

The following shares how, as a caregiver, you can support your loved one living with dementia at the Planned Level: 

1. Provide Structure and Routine

  • Stick to a familiar schedule to reduce confusion and anxiety. Consider providing an activity schedule or timetable for your loved one to know what is expected throughout the day. Place it in an area visible and frequented by your loved one. 
  • Engage them in activities that follow established patterns, such as making a cup of Milo, folding laundry, or gardening. 
 
  • Use step-by-step instructions, repeating as needed. Provide 2-3 steps instruction, giving verbal promptings if required. For example, “Pour the powder in the cup” (pause) “Let’s add the water now.” 

2. Use Environmental Cues

  • Label cupboards and rooms with pictures and simple words. 
  • Keep commonly used items in consistent, visible places that are easy to reach, such as a low cabinet. 
  • Use visual aids or colour codes to indicate steps.
    • For example, using matching colors on keys and the items they unlock.

3. Offer Guided Participation

  • Let them initiate the activity, when possible, and try to join in as a collaborator rather than an instructor. 
  • Use verbal prompts, gestures, or demonstrations when they hesitate or forget what to do next. 
  • Encourage independence with supervision, intervening only when necessary. 
    • For example, if the person living with dementia has been regularly cooking, caregivers can make sure their loved one is within sight during that activity to ensure safety and intervention when required. 

4. Choose Familiar and Purposeful Activities

  • Select tasks they used to do regularly, such as setting up the table, sorting items, or simple craftwork such as knitting or sewing. 
  • Focus on the process of doing the activity, rather than completing it perfectly. 
  • Social activities like taking a walk in the park or sensory and creative activities like sing-along sessions and gardening are ideal. 

5. Communicate Simply and Positively

  • Speak slowly, clearly, and use simple, familiar words. 
  • Offer praise and encouragement, reinforcing their effort and participation. 
  • Avoid correcting or criticising — redirect gently if they are off track. 

Use familiar words

”Its time to eat now”

”We can go soon”

Praise and encouragement

”That looks great, you are a good painter. Thank you for helping me”

Avoid correcting or criticising

”I like the design, why don’t we try a different method for the next one?’

6. Minimise Distractions

  • Create a calm, clutter-free environment. 
  • Reduce distracting background noise and unnecessary sensory inputs such as glaring lights to help them focus. 

Matching support to your loved one’s current cognitive abilities may preserve dignity, promote engagement, and reduce frustration or behavioural challenges for your loved ones. At the Planned Level, the goal is to empower them to continue participating in meaningful tasks/activities. 

Activities for Planned Level

Activities should be person-centered and adapted to their past interests, preferences, and current abilities. When supported appropriately, individuals at the Planned Level can still find joy, purpose, and connection through these daily experiences. 

Conclusion

These activities provide your loved one living with dementia a sense of autonomy while playing to their strengths. 

References
  1. Pool, J. (2022). How to support people living with dementia at the Planned level. CaringTimes. https://caring-times.co.uk/feature/how-to-support-people-living-with-dementia-at-the-planned-level/
  2. Pool, J. (2012). The Pool Activity Level (PAL) Instrument. Jessica Kingsley publishers, London. https://www.dailysparkle.co.uk/wp-content/uploads/2022/04/PAL-Guide-for-Activity-Provision.pdf 

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]]> Using the Pool Activity Level (PAL) Tool to Engage Persons Living with Dementia https://www.dementiahub.sg/living-well-with-dementia/using-the-pool-activity-level-pal-tool-to-engage-persons-living-with-dementia/ Wed, 03 Sep 2025 05:40:12 +0000 https://www.dementiahub.sg/?post_type=dementia&p=72242 Engage persons living with dementia with the PAL tool to enrich engagement after their diagnosis.

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The Pool Activity Level (PAL) Instrumental Tool4 is a framework designed to support persons living with dementia. Developed by Dr. Jackie Pool, PAL focuses on tailoring activities to match the cognitive and functional abilities of each person, fostering meaningful engagement.  

This article is the first of four installments that discusses the benefits of PAL and how one can use it informally for persons living with dementia.  

  1. Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia  
  2. Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia  
  3. Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195  
  4. Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/  
  5. Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6  

What is Pool Activity Level Instrumental Tool (PAL)

The Pool Activity Level, or PAL in short, is an evidence-based tool for persons living with dementia. It was developed by Dr. Jackie Pool in 1999 to personalise activities for persons living with dementia.  

PAL is widely used across the community care sector in Singapore 1, such as dementia day care centers and nursing homes. It helps community care providers tailor activities to enhance the well-being and quality of life for persons with dementia, but it can also be used by individuals caring for their loved ones with dementia to scale activities for daily living and recreation. 

How is PAL Used?

Occupational therapists (OTs) often use the Pool Activity Level (PAL) Instrument to support persons living with dementia, by assessing their functional abilities and tailoring meaningful activities accordingly.  

The following describes how one can use the PAL tool in practice: 

Tips

One may observe whether a person can pick up a toothbrush and start brushing without being told, or if he needs help to get started.

1. Determine the PAL Level

​

There are four levels of PAL. To tailor the best activity for your loved one, you should know which level they fall under. 

Level

Planned Level

Persons Living with Dementia Characteristics

Plan and carry out familiar tasks independently.

Examples (Getting Dressed)

Plans what to wear selects own clothing from cupboard; dresses in correct order.

Caregiver Role

Encourage autonomy with minimal guidance.

Exploratory Level

Can follow simple instructions and learn by doing.

Needs help to plan what to wear but recognises items and how to wear them.

Use hands-on, step-by-step prompts. 

Sensory Level

Responds mainly to sensory stimuli (i.e music) 

Needs help to plan, and with order of, dressing, but can carry out small tasks if someone directs each step. 

Offer tactile, auditory or visual input.

Reflex Level

Reflexive, mostly involuntary responses (i.e massage) 

Totally dependent on someone to plan, sequence and complete dressing; may move limbs to assist.

Focus on comfort, position, and routine. 

2. Activity Planning and Grading

Based on the person’s PAL level, one should: 

  • Ensure activities are something the person enjoys (cooking, painting etc). 
  • Design or adapt activities to match cognitive ability. 
  • Ensure activities are safe, engaging, and doable. 
  • Adjusts task complexity, environment, and instructions. 

Tips

Example one:

For someone at the Exploratory Level, introduce a familiar baking task but break it down into single steps with demonstration. 

Tips

Example two:

For a person at the Exploratory level, offer hand-over-hand assistance to get the person to water the plants at a garden. 

Tips

Example three:

For a person at the Planned level, encourage full participation from planning to execution of a simple cooking task

i.e. cooking fried rice, providing verbal promptings when required. 

3. Review and Reassessment

It is advisable to continually:

  • monitor for changes in function or cognitive status; 
  • adjust the PAL level and revise activity plans as needed; and 
  • use PAL as a dynamic tool, not just a one-time assessment. 

Tips

When someone who was at the Exploratory level is now unable to perform a painting task with guidance, consider getting the person to run his or her fingers over textured surfaces.

These simple actions provide a strong foundation of understanding persons living with dementia. One can also speak to an OT and care staff to better understand their loved one’s abilities. 

Benefits of PAL for Persons living with Dementia

Research has supported the following areas where PAL can influence meaningful engagement and improve the quality of life (QoL) for persons living with dementia. 

Promotes Person-Centered Care

The PAL tool focuses on what the person can do, rather than their limitations. Activities are tailored to match a persons living with dementia’s current cognitive and functional abilities, making them feel respected, understood, and valued.2 This will boost their self-esteem and emotional well-being. 

Supports Cognitive Engagement

Activities designed at the appropriate PAL level help to stimulate the brain without overwhelming the person living with dementia. It helps to maintain cognitive function for as long as possible by promoting participation in structured, familiar, or sensory-rich tasks. 

Improves Emotional and Psychological Well-being

When tasks are too complex, persons living with dementia may feel distressed, agitated, or helpless.6 PAL ensures tasks are matched to ability, reducing the risk of behavioural challenges and increasing cooperation. This can lead to smoother caregiving interactions. 

Maintains Independence and Functional Skills

PAL preserves daily living skills. It empowers individuals to do as much as they can, with just the right level of support. It also encourages autonomy in personal care, mobility, and leisure where possible. 

Even simple tasks like folding towels or sorting items can reinforce purpose and control for persons living with dementia.  

Enhances Quality of Life Through Meaningful Activity

Activities under the PAL framework are emotionally and socially meaningful, tailored to personal preferences and history.3 PAL promotes occupational engagement based on the interest of the persons living with dementia. Individuals often display improved mood, better sleep, and more stable routines.

 

For example: A person living with dementia who was previously a teacher may find familiarity and engagement in grading papers or word searches compared to other activities. 

Improves Safety

PAL helps therapists and caregivers identify risks based on cognitive level (e.g., poor problem-solving skills, impulsion). Activities and environments can be modified (e.g., simplifying tasks, removing hazards) to prevent injuries.  

Supports Relationships and Communication

Caregivers who understand how PAL works can interact more effectively with persons living with dementia by using appropriate prompts and managing expectations. It reduces miscommunication and preserves the emotional bond between the caregiver and their loved ones.  Additionally, the PAL tool is effective for persons living with dementia with hearing or visual impairment.5 This helps caregivers adapt activities for sensory loss, making it easier for their loved ones to stay engaged.

Track Progress or Decline

PAL can be re-administered over time to monitor changes in abilities. This supports timely adjustments to care plans and interventions.  

Conclusion

The PAL tool is beneficial in enhancing the quality of life for persons living with dementia. Using a structured approach to understanding a person’s activity level, the PAL tool enables caregivers to tailor care that is meaningful and engaging. It contributes to a greater sense of well-being for persons with dementia. 

References
  1. Agency for Integrated Care (2016). Dementia Care Competency Framework 2016. Agency for Integrated Care. https://www.aic.sg/wp-content/uploads/2023/06/Dementia-Competency-Framework-Assessment-Criteria.pdf 
  2. Groenendaal, M., Smaling, H. J. A., Achterberg, W. P., & Caljouw, M. A. A. (2022). Maintaining meaningful activities for persons with dementia during transitions of care: A systematic review. Geriatric Nursing, 44, 176–183. https://doi.org/10.1016/j.gerinurse.2022.01.017 
  3. Han, A., Radel, J., McDowd, J. M., & Sabata, D. (2015). Perspectives of people with dementia about meaningful activities: A synthesis. American Journal of Alzheimer’s Disease & Other Dementias®, 31(2), 115–123. https://doi.org/10.1177/1533317515598857 
  4. Pool, J. (2012). The Pool Activity Level (PAL) Instrument. Jessica Kingsley publishers, London. https://www.dailysparkle.co.uk/wp-content/uploads/2022/04/PAL-Guide-for-Activity-Provision.pdf 
  5. Wenborn, J., Challis, D., Pool, J., Burgess, J., Elliott, N., & Orrell, M. (2008). Assessing the validity and reliability of the Pool Activity Level (PAL) Checklist for use with older people with dementia. Aging & mental health, 12(2), 202–211. https://doi.org/10.1080/13607860801984375

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]]> FINGER Model – Prevention of Cognitive Decline https://www.dementiahub.sg/living-well-with-dementia/finger-model-to-prevent-cognitive-decline/ Mon, 04 Aug 2025 03:59:10 +0000 https://www.dementiahub.sg/?post_type=dementia&p=71612 FINGER model is a holistic approach that focuses on lifestyle changes rather than medication. It has gained prominence as a proactive measure against cognitive impairment, underlining the significance of lifestyle interventions in maintaining brain health. Its development has paved the way for a shift in how we perceive and address cognitive decline, embracing a more integrated and preventive strategy.

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The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) model is a holistic approach that focuses on lifestyle changes rather than medication. It has gained prominence as a proactive measure against cognitive impairment, underlining the significance of lifestyle interventions in maintaining brain health. Its development has paved the way for a shift in how we perceive and address cognitive decline, embracing a more integrated and preventive strategy.

Understanding Cognitive Decline

Cognitive decline refers to the gradual loss of cognitive abilities, which can affect one’s memory, reasoning, and problem-solving skills. Some cognitive decline is expected with age, but significant cognitive decline can indicate mild cognitive impairment or more severely, Neurocognitive disorders (Dementia). The symptoms often start subtly, like forgetting appointments or struggling with problem solving, but can eventually impact one’s daily life and independence.

It is crucial to prevent cognitive decline to maintain quality of life, allowing individuals to engage fully in personal and social activities. By focusing on prevention, we can delay or even avoid the onset of severe cognitive impairments, ensuring a more vibrant life as we age.

Core Principles of the FINGER Model

The FINGER model is built upon five core components: 

  1. Nutrition: A balanced diet that is rich in fruits, vegetables, whole grains, and lean proteins, which supports cognitive function. 
  2. Physical Activity: Regular activities, such as walking, can improve blood flow to the brain and the growth of new neural connections.
  3. Cognitive Training: Activities like puzzles and memory games can keep the brain active and engaged.
  4. Social Engagement: Such engagement provides mental stimulation and emotional support, which are essential for maintaining cognitive health.
  5. Monitoring Risk Factors Related to Cardiovascular Disorders: Controlling of cardiovascular risk factors like blood pressure, cholesterol, blood glucose, and body weight is also important for brain health.

Each of the above components play a vital role in promoting brain health and preventing cognitive decline.

Implementing Lifestyle Measures to Maintain Social Relationships and Keeping the Brain Actively Engaged

Integrating the FINGER model into daily life does not have to be daunting or reinventing one’s daily routine. One can start with small, manageable changes. For instance, including more fruits and vegetables into meals, or frequent brisk walks. These simple steps can make a significant difference over time.

In addition to mental and social activities, integrating physical exercise into one’s routine is crucial in maintaining overall wellbeing. Regular physical activity does not only improve cardiovascular health it also enhances cognitive function by increasing blood flow to the brain.

Whether it is a brisk walk in a park, a yoga session, or a dance class, find an activity that you enjoy and commit to it regularly. Exercise releases endorphins, which can improve mood and reduce stress level, further supports cognitive health. One should aim for at least 150 minutes of moderate aerobic activity each week, as recommended by health experts.

A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats provides essential nutrients your brain needs to function optimally. Foods high in antioxidants, like berries, and omega-3 fatty acids found in fish, such as salmon, are particularly beneficial.

Staying hydrated is equally important, as mild dehydration can affect your concentration and cognitive abilities. One should consider consulting a nutritionist to tailor a diet plan that meets one’s specific needs and preferences, fuelling both your body and mind effectively.

Integrating these lifestyle changes lays a strong foundation for long-term cognitive vitality.

A Promising Approach for Local Dementia Care

Although the FINGER model emerged from Finland, it has been implemented in various studies worldwide, including Singapore. Its adaptation signifies an encouraging trend, highlighting its potential to enhance Cognitive support care for individuals and families locally.

Author’s Bio

Hovi Care provides elderly and elderly and cognitive support care services designed to support seniors in achieving a high quality of life through active ageing and holistic wellness programmes. They combine cognitive, social and physical rehabilitation, to support and to meet individual’s needs.

Website: http://www.hovicare.sg/

  1. Alzheimer’s Society (2025). Anxiety and Dementia. https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/anxiety-dementia.
  2. Barrell, A. (2020). Stress vs. anxiety: How to tell the difference. Medical News Today. https://www.medicalnewstoday.com/articles/stress-vs-anxiety
  3. Dementia UK. (October, 2022). Managing anxiety and depression in a person living with dementia. https://www.dementiauk.org/information-and-support/health-advice/managing-anxiety-and-depression-in-a-person-living-with-dementia/

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]]> Supporting Instrumental Activities of Daily Living https://www.dementiahub.sg/living-well-with-dementia/supporting-instrumental-activities-of-daily-living/ Tue, 13 May 2025 01:11:43 +0000 https://www.dementiahub.sg/?post_type=dementia&p=68921 Discover practical tips for traveling with dementia, covering planning, packing, routines, and activities to ensure a safe and enjoyable journey for both caregiver and loved one.

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Instrumental Activities of Daily Living (IADLs) are often defined as activities that are learned as an adolescent and that one requires to be fully independent. IADLs often involve more complex tasks and are more cognitively-demanding compared to the basic activities of daily living.

  1. Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia  
  2. Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia  
  3. Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195  
  4. Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/  
  5. Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6  

What are Instrumental Activities of Daily Living?

Instrumental activities of daily living (IADLs) include:

  • Cooking
  • Shopping
  • Communication by phone or email
  • Managing finances
  • Transportation
  • Housekeeping

When a person carries out IADLs, they rely on coordination, judgement and other cognitive abilities that begin to change as dementia progresses. Thus, even in the mild stage of dementia when persons living with dementia are still able to perform other activities of daily living well, they are more likely to struggle with IADLs. It is important to note changes in your loved one’s ability to perform instrumental activities of daily living, as it is often an early indicator of whether your loved one has developed dementia. Prognosis for dementia is greatly improved with early diagnosis and treatment.

Supporting Your Loved Ones in Instrumental Activities of Daily Living ​

You can adapt these activities to suit your loved one’s needs and mobility level.

Using the Phone

Over time, changes to your loved one’s vision and short-term memory for information such as phone numbers may make it difficult for them to contact others over the phone. If they are using a smartphone, there are apps available which can be used to minimise visual noise on the screen display and increase text for easy reading, such as ONY phone. These are often referred to as ‘elder-friendly launchers’. You can also consider making a phone-book or wall poster with their contacts’ photos next to the phone numbers in suitably large font. There are also senior-friendly phones such as the Jitterbug or picture phones.

Picture Phone Dialer

Image: Picture Phone (Picture Dialer Phone Box from HQTelecom)

Managing Finances

Managing bills can be daunting for anyone. Cognitive decline affects judgement and calculation in people living with dementia differently. To support your loved one with this IADL, you can identify specific aspects of finances your loved one is struggling with. This could be forgetting to pay bills on time, overspending or forgetting important information like PIN numbers. You may consider signing them up for automatic bill payments, or setting withdrawal limits. Have a conversation with them to explore methods of working around these issues and affirm aspects of finances they have been managing well.

Managing Medication

Your loved one may have difficulty keeping track of whether they have taken their daily medication, especially if they have been prescribed medication to manage more than one ailment. You can find detailed tips on how to help them manage their medication here.

Housekeeping

Packing and cleaning the house will become more challenging for persons living with dementia over time. Problems with coordination, and the loss of bone density typical of older adult may make it unsafe for your loved one to handle the procedural tasks of housekeeping alone. They may also forget the function and location of housekeeping tools such as the vacuum cleaner.

You can make a list of which regular chores required in the regular maintenance of the house your loved one is still able to manage. You could also consider breaking these chores down into steps, and assist with the steps your loved one has difficulty managing. Identify and remove furniture and items in the house that may be obstacles to your loved one while they are cleaning and ensure hallways are well-lit. Planning a routine together can also help your loved one to keep track of chores they are in-charge of.

Cooking

Cooking may not be safe for persons living with dementia if their coordination and memory are significantly impacted. This may lead to forgetting to turn off the stove or leaving food unattended. Loose clothing like long pajamas may pose a safety risk of catching fire on hot surfaces.

You may gradually need to take over cooking and safety-proof your kitchen (i.e., switching off the gas regulator and using socket covers). If your loved one living with dementia considers cooking to be important or an integral part of their routine, try to keep them involved in the process by asking them to help with simpler tasks. This could include mixing ingredients and washing vegetables. Several senior-friendly or adaptive kitchen tools are designed to make such tasks easier for seniors. Some of these tools may have designs that feel unfamiliar to the person living with dementia (for example, tools that have multiple handles). As much as possible, pick items that resemble tools your loved one is already familiar with. You can also label your kitchen drawers and label tools according to their function to make locating them easier for your loved one.

Image: Chef Craft Measuring Cups with Large Print (Left), North Coast Medical Adjustable Gripping Tool (Center), OXO Good Grips Mixing Bowls (Right)
Shopping

In the mild to moderate stages of dementia, your loved ones may start to feel disoriented in their surroundings and have difficulty calculating change when making payment. If possible, accompany them while they are shopping. You can stay with them while letting them handle as much as they are able to.

It may help to visit shops that your loved one is familiar so that shopkeepers can recognise them, and plan visits for off-peak hours so the environment is less likely to be disorienting. If possible, get support from people living in the neighbourhood, including stall owners at your nearby hawker centre, to look out for your loved one when they are shopping. Try to make a simple shopping list and help your loved ones locate the items where necessary.

Transport

As your loved one’s dementia progresses, their executive function which also involves their ability to concentrate will decline. Driving involves several cognitive demands, such as remembering directions and interpreting traffic signals. Your loved one may be distracted by peripheral traffic or slowed judgement to different signals.  You can assess their comfort with driving and whether it may be necessary for them to seek alternative forms of transport. Find more information on how to aid your loved one in driving and taking public transport.

Conclusion ​

Your loved one may need more support from you and other family members as their abilities change with the progression of dementia. Avoid comparing what they were able to do in the past with what they can do now. Viewing the activity as something you are doing together with your loved one and affirming them when tasks are completed (even if they are not done perfectly) can help to maintain your loved one’s interest and feeling of agency over these tasks. This in turn builds their sense of accomplishment and confidence.

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]]> Tips for Travelling with Dementia https://www.dementiahub.sg/living-well-with-dementia/tips-for-travelling-with-dementia/ Fri, 20 Dec 2024 08:48:29 +0000 https://www.dementiahub.sg/?post_type=dementia&p=63075 Discover practical tips for traveling with dementia, covering planning, packing, routines, and activities to ensure a safe and enjoyable journey for both caregiver and loved one.

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Travelling can still be part of life after a dementia diagnosis. With thoughtful preparation and simple adjustments, persons living with dementia, and their caregivers can continue to enjoy the excitement and joy of a well-deserved holiday. Whether you are revisiting a favourite destination or discovering a new place together, read on for practical tips to help create a smooth and memorable journey for both persons living with dementia and caregivers.

This article also features practical tips and insights from Maya, a passionate traveller and caregiver to her husband, Din, who lives with mild dementia.

  1. Health Promotion Board. (n.d.). Let’s talk about Vascular Dementia. HealthHub. https://www.healthhub.sg/programmes/mindsg/vascular-dementia  
  2. Chiew, H. J. (2021, July 5). Young-onset dementia: Improving outcomes with early recognition at Primary Care. SingHealth. https://www.singhealth.com.sg/news/defining-med/Young-Onset-Dementia  
  3. Ng, Z. X., Yang, W. R. E., Seet, E., Koh, K. M., Teo, K. J., Low, S. W., Chou, N., Yeo, T. T., & Venketasubramanian, N. (2015). Cerebellar strokes: A clinical outcome review of 79 cases. Singapore Medical Journal, 56(03), 145–149. https://doi.org/10.11622/smedj.2014195  
  4. Ioannides K, Tadi P, Naqvi IA. Cerebellar Infarct. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470416/  
  5. Huang, J., Qiu, Z., Zhou, P., Li, J., Chen, Y., Huang, R., Li, C., Ouyang, X., Feng, H., Xu, H., Liu, D., Dai, Z., Zhu, J., Liu, X., Chen, H., & Jiang, Y. (2019). Topographic location of unisolated pontine infarction. BMC Neurology, 19(1), 1-6. https://doi.org/10.1186/s12883-019-1411-6  

Before Travelling ​

Discuss Travel Interest and Comfort Levels ​

Before making any travel arrangements, it is important to have an open conversation with your loved one living with dementia on how they feel about travelling. This discussion can help you gauge their comfort level and address any concerns they may have about new environments or potential anxieties.

By taking the time to understand their feelings, you can make informed decisions that prioritise their well-being and create a more enjoyable travel experience for both of you.

Consider asking your loved one these questions: 

  • How do you feel about going on a trip? 
  • Is there a particular place you would like to visit? 
  • Would you like to visit a familiar place or try somewhere new? 
  • Are there any activities you would like to do during the trip?  
  • Is there anything else you would like me to keep in mind while we travel? 

Plan Ahead ​

After you have both agreed on the decision to travel, it is essential to start planning. Keep the following aspects in mind to ensure a smooth journey: 

Destination Choice

Choose locations that feel manageable, familiar, or supportive. It is best to avoid overly- crowded or highly- stimulating environments, such as night markets, that might cause distress. Exploring new places can be a rewarding experience, especially when it is thoughtfully planned. Take time to research areas that are accessible, with convenient transport options and necessary amenities to make the journey easier for both you and your loved one.

Mode of Transport

Select the most comfortable and accessible mode of travel. Some might prefer shorter journeys or direct routes to minimise confusion and anxiety. Additionally, opting for straightforward travel options and avoiding complicated connections can help make the journey more manageable and less stressful.

Documents

Make sure you have all the necessary travel documents, such as passports, medical records, and emergency contacts with you.

Pre-Travel Medical Consultation

Consult a healthcare professional to confirm that the person living with dementia is fit to travel. They might provide specific advice on necessary vaccinations, medications, and any special considerations for the trip.

Maya's Tips

• Purchase travel insurance that covers pre-existing conditions.
• Travel with someone or a group of people who understand your loved one’s condition and can assist if needed. 

Packing Essentials ​

Pack a bag of essentials to ensure comfort and minimise anxiety. Consider including: 

  • Medications, with an extra supply if needed 
  • Comfort items, like a favourite blanket or photo 
  • A memory aid, like a written itinerary or visual guide of the trip 
  • A list of emergency contacts and any relevant medical details

Maya's Tips

• Make multiple copies of a formal medical letter or memo from your loved one’s doctor to present during immigration or security checks. This letter can help explain the condition and facilitate special accommodations, such as remaining seated during border crossings. 
• Prepare a comprehensive list of all prescribed medications, including dosages and schedules. Include both generic and brand names for easy sourcing  when needed. 

Whilst Travelling ​

Keep your loved one living with dementia updated

Keeping your loved one updated on where you are going and what you will be doing can help them stay oriented and feel secure. Visual aids or a simple written itinerary with photos can be helpful for reference during the trip. 

Try to maintain routines

Maintaining routines around mealtimes, bedtimes, and medication schedules can reduce stress and provide a sense of stability. Bring along any items that support these routines, such as a travel-sized alarm clock and a pill organiser.

Consider calming aids for travel

Busy or noisy places like airports can be unsettling. If you are travelling by plane, noise-cancelling headphones and familiar music can help provide comfort to your loved one living with dementia. 

Choose activities that are well-suited for your loved one living with dementia

When planning activities during the trip, it is important to choose those that match your loved one’s interests and abilities. Consider these key factors to make the activities enjoyable.  

Maya's Tips

• If you are on a flight, check with the cabin crew about accessible toilets or facilities for persons with special needs.
• Upon arrival, locate the nearest hospital or clinic to your accommodation to ensure you are prepared in case of an emergency.
• Take time to familiarise yourself with the area and transport options. For example, during her trip to Holland, Maya sat at the train station to assess whether it was suitable for Din, who uses a wheelchair.
• Keep your loved one informed during the journey by showing them photos or reminding them of past visits to familiar places.
• Try to maintain familiar routines. For instance, Din enjoys crossword puzzles and reading the Quran on a tablet, which Maya tries to include during their travels.

Conclusion ​​

Travelling with dementia requires extra consideration, but it can still be rewarding and enriching. With open communication, careful planning, and adaptability, persons with dementia and their caregivers can make meaningful memories together while keeping comfort and safety in mind.

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]]> Creating a Life Story for Persons with Dementia https://www.dementiahub.sg/living-well-with-dementia/creating-a-life-story-for-persons-with-dementia/ Thu, 20 Jun 2024 13:03:20 +0000 https://www.dementiahub.sg/?post_type=dementia&p=52654 Listen Min Read Discover the powerful impact of life story work in dementia care. This article explores how gathering and reflecting on personal narratives

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Discover the powerful impact of life story work in dementia care. This article explores how gathering and reflecting on personal narratives enriches identity, deepens empathy, and fosters meaningful connections for persons living with dementia and caregivers alike.

What is a Life Story?

Everyone has their own, unique life story. Our life experiences, beliefs, likes and dislikes, shape us as individuals. Life story work is an activity in which a person living with dementia is facilitated by family members and/or healthcare professionals to gather and review their past. The process of engaging in life story work helps the person to share their stories and enhance their sense of identity1.

Persons Living with Dementia and their Life Story

As dementia progresses, persons living with dementia can experience problems with communication and memory loss. Incorporating personal narratives and biographical knowledge while caring for a person living with dementia has been shown to increase caregiver’s empathy and uphold person-centred care2.

What is the Purpose of a Life Story Resource?

  • Provide a guide for family members and/or care staffs to discover the person;
  • Celebrate life achievements, special events, holidays, and other occasions that have been historically important to the person; 
  • Promote and support mental stimulation; 
  • Provide emotional comfort and pleasure; 
  • Help engage the person in meaningful conversations about the past where memories are more vibrant and clearer; 
  • Encourage social interactions between the person living with dementia, family members, and caregivers; 
  • Provide meaningful interaction to calm the person living with dementia if overwhelmed by other people, events, and noises in the environment; 
  • Use as a refocusing tool to support the person living with dementia in new and unfamiliar surroundings (e.g. hospital, moving to nursing home, changing rooms, etc.)3.  

Making a Life Story Resource

Information Gathering

Gather information about the person living with dementia from family members, care staff, case files, or directly from the person living with dementia themselves.

Preparation of Materials

Prepare materials to create a life story, including old photographs, keepsakes, thick files, colored papers, decorative items, colored pencils, paint, glue, scissors, and clear plastic folders.

Topic Selection

Suggested topics to include in a life story: 

  1. About me – personal bio
  2. Favourite food  
  3. Occupation
  4. Home 
  5. Childhood
  6. Favourite Idols
  7. Travel
  8. Retirement
  9. Relationships – Significant relationship with family and friends
  10. Legacy 

 

If the person living with dementia  has experienced sad or traumatic events that would cause great distress, you may want to avoid revisiting these life events. However, it may be helpful to explain these on a separate document that can be given to family members or other caregivers so that they can identify whether changes in behaviours are related to a specific events that have happened in the past.  

What Does a Life Story Look Like?

When developing a life story with a person living with dementia, one of the following formats, or a combination of formats, can be considered:  

  • Book 
  • Collage 
  • Video recording 
  • Memory box 
  • Personal profile document 
  • Mobile phone application 

The life story can be designed in any way that is meaningful to the person living with dementia. Those who prefer to do this virtually can do so using CARA, a lifestyle and community digital platform that provides easy access for persons living with dementia and caregivers to connect to an ecosystem of solutions via a mobile application. CARA has introduced a Care Circle feature, which allows family caregivers to collaborate on shared notes and create Memories, honouring and celebrating the life of their loved one with dementia. These Memory records can be used as personalised content, making every interaction throughout the dementia journey a meaningful one. Find out more about Care Circle here.

However, if you are looking for a more structured template, you can refer to the following resources:

dementia-uk-my-life-story-template_page-0001 (1)

Life Story Template
Source: Dementia UK

Dementia UK’s Life Story template is a practical tool for capturing personal histories, particularly for those with dementia. It offers customisable sections and a straightforward approach for easy documentation. Get started on your story today.

Download Template
this_is_me_1553_page-0001 (1)

This is Me Template
Source: Alzheimer Society

This is me serves as a tool for life story work, helping caregivers record important details about the background, preferences, and significant life events of the person living with dementia. By using This is me,  health and social care professionals can provide more personalised and attentive care based on a deeper understanding of the person living with dementia. 

Download Template

How Do You Engage Persons Living with Dementia in Creating a Life Story Resource?

Involving the person living with dementia as much as possible makes the life story more likely to reflect the person’s wishes and preferences and encourages a sense of ownership. The person living with dementia may also have very different views about the purpose of their life story resource. Respect their wishes about what goes into the life story and who will see it, now and in the future.  

Engage and  help them where needed, and write or type the information gathered so that they can see the story forming, with you. Try not to overload them with questions. It may be easier to start the conversations with open-ended questions. For example, you might say, “Can you share more about where you grew up?”.  

Learn more about effective communication with persons living with dementia here.

Creating  the life story may take days, weeks, or even months.  Remember that you can always add more information to it later and check in with other family members and friends to provide key information if needed. Remember to also be sensitive as reflecting on one’s life can be emotional.  

Conclusion

A life story resource does not stop here. It is retold and remains unfinished. It is also more likely to be successful if life story work is initiated early in the dementia journey. Do continue to add on to the stories and information as conversations with persons living with dementia continues.   

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References

  1. Thompson,R. (2011). Using life story work to enhance care. Nurs Older People. 23(8): 16-21. doi: 10.7748/nop2011.10.23.8/16.c8713.
  2. Doran, C., Noonan, M., Doody, O. (2019). Life-story work in long-term care facilities for older people: An integrative review. J Clin Nurs. 28(7-8):1070-1084. doi: 10.1111/jocn.14718. 

  3. Dementia UK, (n.d). Creating a ‘Life Story’ Caring for someone with dementia (n.d.). Retrieved from: https://www.dementiauk.org/wp-content/uploads/dementia-uk-creating-a-life-story.pdf  

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]]> Location-tracking Technology in Dementia Caregiving https://www.dementiahub.sg/living-well-with-dementia/location-tracking-technology-in-dementia-caregiving/ Mon, 27 Nov 2023 06:42:30 +0000 https://www.dementiahub.sg/?post_type=dementia&p=41831 Location-tracking technology offers a way to empower a person living with dementia to remain active in the community while caregivers monitor safety from a distance.

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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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References

1. Agrawal, A. K., Gowda, M., Achary, U., Gowda, G. S., & Harbishettar, V. (2021). Approach to Management of wandering in Dementia: ethical and legal issue. Indian Journal of Psychological Medicine, 43(5_suppl), S53–S59. https://doi.org/10.1177/02537176211030979 
2. Wolfe, S. E., Greenhill, B., Butchard, S., & Day, J. (2020). The meaning of autonomy when living with dementia: A Q-method investigation. Dementia, 20(6), 1875–1890. https://doi.org/10.1177/1471301220973067 
3. Howes, J., Denier, Y., & Gastmans, C. (2022). Electronic Tracking devices for people with dementia: Content analysis of company websites. JMIR Aging, 5(4), e38865. https://doi.org/10.2196/38865 
4. https://alzheimer.ca/en/help-support/im-caring-person-living-dementia/ensuring-safety-security/tracking-devices 
5. https://gethapn.com/resources/whats-the-difference-between-bluetooth-and-gps-tracking/ 
6. Cefai, J.F. (2023). Use of Tracking Technology Among Persons Living with Dementia: Raises Significant Ethical Concerns About Privacy and Autonomy, https://timesofmalta.com/articles/view/use-tracking-technology-among-persons-living-dementia.1030874 
7. https://www.alz.org/help-support/caregiving/safety/technology-101 
8. Tech Able: https://techable.enablingvillage.sg  

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]]> 10 Ideas for Outdoor Monitoring https://www.dementiahub.sg/living-well-with-dementia/10-ideas-for-outdoor-monitoring/ Wed, 15 Nov 2023 09:17:13 +0000 https://www.dementiahub.sg/?post_type=dementia&p=40103 This article offers a list of outdoor monitoring solutions and alternatives that may be helpful for caregivers to explore with their loved ones.

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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 ​

Tack GPS

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 ​​​​

CARA Dementia Singapore

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:

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:

 

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:

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.

Google Timeline

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

Location Sharing in 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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References

  1. Dementia Alliance International Global Report (2021), Link: https://dementiaallianceinternational.org/assets/documents/DAI-Global-Report-2021_Valuing-the-advocacy-of-people-with-dementia-moving-dementia-out-of-the-shadows.pdf
  2. Jason Weetch, Siobhan O’Dwyer & Linda Clare (2021) The involvement of people with dementia in advocacy: a systematic narrative review, Aging & Mental Health, 25:9, 1595-1604, DOI: 10.1080/13607863.2020.1783512

The post 10 Ideas for Outdoor Monitoring appeared first on DementiaHub.SG.

]]> Tips to Improve the Shower and Bath Experience https://www.dementiahub.sg/living-well-with-dementia/tips-to-improve-the-shower-and-bath-experience-for-persons-living-with-dementia/ Thu, 09 Feb 2023 06:15:42 +0000 https://www.dementiahub.sg/?post_type=dementia&p=20495 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.

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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. 

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?

Your paragraph text

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.

Click here

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.

Read Next

  1. Supporting Activities of Daily Living 
  2. Tips for Communicating with Persons Living with Dementia

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