Caring for Adults with Cognitive and Memory Impairment
This article was updated on: 09/09/2018
Caring for a loved one can be challenging under the best of circumstances, but caring for someone with cognitive impairment can be especially challenging. People with cognitive impairment may have certain conditions or injuries that have affected their normal brain functions.
Certain conditions and injuries like Alzheimer’s disease, Parkinson’s disease, stroke, or a brain injury can cause cognitive impairment and affect memory, reason, and perception. This can make even simple daily tasks difficult. If you’re a caregiver for an individual with cognitive impairment, these tips may help you as you move forward.
Tips for caregiving for those with cognitive impairment
Individuals with conditions that cause cognitive impairment often display behavioral issues that can make caregiving especially challenging. For example, patients with Alzheimer’s disease may have the following behaviors and issues:
- Communication problems
Many caregivers find these aspects of caring for someone with cognitive impairment to be among the most stressful. It’s important to note that every person is different, and your loved one may display some, all, or none of the above behaviors. You may find that some days are better than others.
If your loved one suffers from behavioral issues, it might be a good idea to consult a doctor to be sure there are no hidden medical conditions such as vision or hearing problems, infections, or pain that are causing or exacerbating his or her behaviors.
The Alzheimer’s Association offers the following non-medication options that may be helpful if you’re caring for someone with cognitive impairment, such as:
- Maintaining a calm environment, since new or external stress factors may worsen symptoms. Look for potential environmental factors that may be the cause of the behavior and make appropriate changes (for example, adjusting room temperature or minimizing excessive noise).
- Addressing your loved one’s physical needs, such as hunger, thirst, or bathroom needs.
- Making sure your loved one gets regular exercise and adequate rest.
- Implementing a home safety plan.
If caregiving becomes increasingly difficult and you’ve consistently applied non-medication therapies, you may consider asking your doctor whether prescription drug treatment could help your loved one manage behavioral issues. This might include medications such as antidepressants or antipsychotics.
How to communicate with someone with cognitive impairment
Effective caregiving relies on good communication between you and your loved one, something that’s difficult to achieve when he or she has cognitive impairment. The Family Caregiver Alliance recommends these strategies to improve your ability to communicate:
- Be sure you have your loved one’s attention before you begin talking, and speak at eye level, if possible, to increase engagement. Start sentences with his or her name and pause to give time for a response.
- Use simple, direct words and ask—don’t command—when possible. For example, “Mom, can you sit so I can untie your shoes?” is better than “Sit down now so I can take your shoes off.”
- Understand that your loved one may have trouble remembering simple words or need to use gestures to help him communicate. If you aren’t able to understand the specific words he’s trying to convey, be receptive to the feelings or emotions behind them. If he seems pleased about something he saw on a walk, for example, say, “It sounds like you really enjoyed your time outdoors.” If he’s agitated, try “I can tell you’re upset by that.”
- Give yourself time to listen to your loved one. Showing interest is an important part of caregiving, and even if you don’t understand everything, simple nonverbal gestures like taking her hand or gently stroking her arm tell her you’re paying attention.
How to prepare yourself to be a caregiver for someone with cognitive impairment
It’s important to get a complete diagnosis and medical assessment from your loved one’s care team. Find out what medications he is taking and what to watch for at home. Find out everything you can about your loved one’s disease; join a support group if one is available in your area.
The HealthinAging website suggests that you develop a care plan in advance that addresses essential needs, including:
- Personal care
- Household management if your loved one will live at home
- Health care
- Social and emotional support
Consult your local Area on Aging or hospital’s social work department for recommendations and help finding resources in your community. If you haven’t already done so, you may want to talk to an attorney about estate planning and legal documents, such as living wills and advance directives, to ensure your loved one’s wishes are respected and financial matters are protected if the cognitive impairment progresses.
Finally, be intentional about caring for yourself. Look into respite care and talk to other family members and friends who can support you. Schedule time for exercise and pursuing your own hobbies and interests, even if it’s just 20 minutes a day spent walking outdoors or reading a favorite book, and make sure you get enough rest. Caregivers are at an increased risk for depression and chronic health conditions, so be sure to get regular checkups and preventive care.
Does your loved one have Medicare coverage? For help navigating plan options that might be a good fit, you can use the links below to get an email with personalized plan options or set up an appointment to speak by phone. If you’d rather get started browsing right away, just click the Compare Plans button on this page.
For more information on caring for someone with cognitive impairment:
Family Caregiver Alliance: National Center on Caregiving, “Caring for Adults with Cognitive and Memory Impairment,” accessed February 17, 2017, https://www.caregiver.org/caring-adults-cognitive-and-memory-impairment