How to Care for Those With Cognitive Impairments

Tips for Supporting Your Loved One

A cognitive diagnosis can be a painful experience, but those tasked with caregiving may feel uncertain about how best to support their loved one.

For those who have found themselves in a caregiving role, we’ll take a look at the steps you can take to care for your loved one — and yourself — during this life phase.

Maintain a Consistent Routine

Confusion is a common symptom of cognitive disorders. Do your best to maintain a consistent schedule for your loved one; routine activities like meals, baths, dressing and exercise should happen at roughly the same time every day, giving your loved one something concrete to hold onto.

Your living space should also be reliably comfortable and consistent. Avoid redecorating or repositioning furniture more than necessary, and take steps to create a calming environment. While individual comfort needs will vary — and you should take the time to learn what your loved one will find most soothing — consider using low lighting, reducing clutter and introducing plant life into your home.

Create a Safe Living Environment

Those with advanced cognitive decline are at higher risk for accidental harm. It’s important to run a safety check on your home and take the necessary steps to minimize potential hazards.

Consider the following:

• Secure all medications, cleaning supplies and other potentially harmful substances
• Attach handrails to bathrooms, showers and other areas to protect against falls
• Remove knobs from stoves and other appliances to minimize accidental burns and fires
• Keep sharp objects like knives, needles and scissors out of reach
• Remove or secure objects like hoses, tools, furniture or carpets that may cause a slip
• Ensure neighbors are aware of your loved one’s condition so they can exercise caution

In Massachusetts, reporting a driver with cognitive impairment to the Registry of Motor Vehicles is voluntary; it may be made by the individual, a family member or health care provider who has reasonable cause to believe that the impairment affects safe driving. Once a report is made, the RMV may request a medical evaluation of the person's ability to drive safely.

Communicate With Patient and Compassion

As your loved one’s condition progresses, they may lose the ability to communicate as effectively as they used to. Your communicate style may need to adjust with them.

• Use short, simple and clear instructions
• Avoid arguing or correcting misstatements
• Redirect conversations rather than confront
• Validate emotions, even when the facts being discussed are inaccurate
• Identify and minimize triggers for agitation

Care for the Caregiver

Caregiving can be a major life challenge, and its unique stresses may put the caregiver at higher risk for adverse mental health conditions like depression.

If you’ve become the caregiver in a loved one’s life, make sure self-care continues to be a core part of your daily responsibilities. Not only will this make you better able to provide the care your loved one needs, it also helps ensure you won’t suffer your own health consequences as a result.

Try incorporating the following into your self-care routine:

• Eat nutritious, well-balanced meals that consist of lean proteins, fresh fruits and vegetables, whole grains and healthy fats.
• Exercise regularly. The Centers for Disease Control and Prevention recommends healthy adults aim for at least 150 minutes of moderate-intensity exercise per week.
• Get consistent, high-quality sleep. Aim for between seven and nine hours of deep, uninterrupted shuteye every night, including on weekends.

Caregiving can be a lonely experience that many people, even friends and other family members, will struggle to understand.

But it doesn’t have to be you against the world.

Resources like respite care, adult day programs and in-home support services are available and can provide valuable relief as you navigate life as a caregiver.

You might also consider joining a support group with other caregivers. This will give you the space to share your experiences, receive advice and build community with people on the same journey as you. You may also benefit from counseling, mindfulness-based interventions, caregiver education programs and behavioral management training, depending on your individual needs.

Understand Your Loved One’s Plans and Priorities

As your loved one’s condition progresses, they may lose the ability to engage in long-term planning (including estate planning, end-of-life arrangements and care preferences). It’s important these issues are discussed and put into writing while your loved one is still able to communicate their wishes.

Encourage them to write a will. Organizing their finances and other affairs can help reduce conflict between family members later; it can also promote patient autonomy by allowing individuals to actively participate in decisions about their future care and finances.

They should also take time to identify and name a health care proxy. This is the person who will make care decisions on their behalf if they are no longer able to. Their proxy should be someone they trust who understands their values and preferences so the decisions they make align with their wishes.

This may be a challenging chapter in your life, but by maintaining a consistent schedule, planning for the future and caring for your own needs, you can help your loved one achieve the best possible quality of life.