Staying healthy with dementia

Expert reviewer Dr Rahul Bhattacharya, Consultant Psychiatrist
Next review due January 2023

Staying physically and mentally healthy is an important part of living well with dementia. Support from loved ones can help. Having regular appointments with a GP (or another health professional) to keep an eye on any changes is important too.

How can a person with dementia stay healthy?

Some key ways that a person with dementia can stay well include:

• having a regular routine
• having prompts that minimise the need to remember, such as signs on doors, or clocks that show clearly what time of day it is
• having easy access to help and support, whether that’s from medical professionals or family members
• having a plan or system in place to avoid forgetting to do important things, for example paying bills by direct debit
• a dementia-friendly home environment
• taking medicines as prescribed and keeping up with medical appointments
• keeping physically active and socially engaged
• eating and drinking well, and getting enough sleep

Taking dementia medicines

Remembering to take medicines that doctors have prescribed is important. Loved ones can help by setting reminders, through phone calls or visits. You’ll need to make sure you have enough medicines and ask for new prescriptions before medicines run out.

A dosette box from your local pharmacy could help with storing and managing dementia medications. Your pharmacist can also help if you have questions about the medicines.

Medicine diary for carers

If you are caring for someone with dementia and helping them take their medicines, downloading our medicine diary for carers could help you keep track of things. You can use it to:

• remind you what medicines need to be taken and when
• record what medicines have been taken each week

You can print off a new copy for each week. It may help to keep it somewhere where you’ll remember to check it, such as on your fridge or on a door.

Emotional support and dementia

Dementia can limit many things you are able to do. But it doesn’t change that you have feelings and need emotional support, just like anyone else. People with dementia say they can feel powerless, afraid, guilty or embarrassed because of the effects of the condition.

Having an awareness that you are forgetting things, finding thinking more difficult and less able to manage can be frightening. Thinking about what the future holds can also be upsetting.

Being reminded of what you can do and accomplishing tasks – no matter how small – can be an important part of feeling better. It can give a sense of control and satisfaction.

If you’re the relative or partner of a person with dementia, you can support your loved one by:

• spending time with them
• encouraging them
• listening to their distress
• acknowledging their fears and worries
• empathising with fears about the future
• encouraging them to be positive and focus on the present moment

Mindfulness

Mindfulness has been tested in people with dementia and their carers. In one study, they were taught mindfulness techniques and then practised them for up to an hour a day. Mindfulness proved to be particularly helpful for lessening worry about the future. Other benefits that many people with dementia and carers had were:

• feeling less stressed
• coping better with stress
• sleeping better
• less anxiety

Mindfulness isn’t difficult – it just takes a bit of practice. If you’re caring for someone with dementia, you might find it relaxing and enjoyable to do with your loved one.

Taking part as a carer may well have benefits for you and may also help you to encourage your loved one to keep it up.

There may be local dementia support groups in memory clinics or community organisations. Admiral Nurses are nurses who specialise in the care and support of people with dementia. They can listen to how someone is feeling and give them a chance to talk.

The benefits of mindfulness have been better researched for:

• people with early dementia, or with mild cognitive impairment
• people caring for someone with dementia
• carers and people with dementia doing mindfulness together

Psychological therapies and dementia

There may be times when a person with dementia needs more support than relatives and friends can provide. Depression and anxiety are common in people with dementia, and talking therapies with trained professionals could help. Your GP can advise you on what’s available and they may be able to refer you to a local service.

Counselling

Someone who’s been diagnosed recently may find it helpful to have counselling, either on their own or in a group.

Cognitive behavioural therapy

People with early dementia may find cognitive behavioural therapy (CBT) helpful for depression and anxiety. CBT is a way of re-learning behaviour that has become a habit. In very simple terms, it comes down to ‘stop, think and do differently’. If someone with dementia has negative thoughts that are upsetting, CBT can help them to become aware of doing this, stop themselves, and try to think calming thoughts instead. Of course, this takes practice, and they may need the support of their loved ones.

But research into CBT has shown that people with dementia can successfully learn these new skills. Carers may also benefit from CBT.

Cognitive stimulation and reminiscence therapy

Cognitive stimulation means ‘mental exercise’ – enjoyable social and mental activities that are aimed at improving thinking, concentration and memory. This can include reminiscence – encouraging people to think and talk about the past. For dementia, types of cognitive stimulation are often given in a group.

There is consistent research evidence that this can help to improve thinking and understanding for people with mild-to-moderate dementia. So, doing word games, puzzles, talking about interests and even practical activities such as baking and gardening can have a positive effect on memory and quality of life. These activities can also help to improve communication and social skills.

It’s not surprising that this type of dementia therapy can help. It is in line with the general view that our mental abilities are more likely to decline if we don’t get enough mental stimulation. If you’re caring for a person with dementia, it’s encouraging to know that activities and pastimes you organise for your loved one are helpful and could effectively be part of their dementia treatment.

If you’re looking for day-care or groups for a person with dementia, try to find one that offers this type of therapy. They may not call it ‘cognitive stimulation’, but if they’re arranging enjoyable activities that stimulate thinking and encourage people to interact, there’s a clear benefit.

Eating and drinking well

Eating a healthy, balanced diet and drinking enough to stay hydrated are important when you have dementia. Not eating well could lead to weight loss, tiredness and a higher risk of infections. Dehydration could cause problems such as headaches, extra confusion, urinary tract infections or constipation.

Dementia can make it more difficult to recognise or communicate hunger or thirst. So if you’re a loved one of someone with dementia, regularly offering them food and drink (aim for about eight glasses of fluid a day) is important. If other family members and friends are around, you could make sure you keep each other updated about when your loved one eats and drinks.

If your loved one is losing weight, or if you would like advice about their diet, speak to your GP. They may be able to refer you to a dietitian, who can give advice that is tailored to your loved one’s needs.

People with dementia also often have practical difficulties with eating and drinking; for example, with holding cutlery. We have more information about caring for a person with dementia at home.

Being physically active

Being physically active can help people with dementia to stay fit and healthy. Even everyday household activity, gardening or walking around the shops can make a difference.

Exercise may be a way for people living with dementia to keep independence and gain confidence; it may be a chance to start a new hobby. Being active could also protect against other health problems, and help with getting a better night’s sleep. When people living with dementia exercise, it has also been found to make things a bit easier for their carers too.

Recent studies have suggested that exercise doesn’t help with slowing cognitive decline in people with dementia. It’s also important for people not to over-exercise.

We have more information about keeping active and engaged with dementia.

Eyesight and hearing

Problems with eyesight and hearing are very common in later life. But a person with dementia may not realise when these changes happen. Having sight or hearing impairments can add to their sense of confusion and may mean they need more help in everyday life. Helping them to have regular hearing and sight examinations can pick up any problems early on.

Sometimes problems that seem to be about sight or hearing are actually caused by changes to the brain. For example, a person may seem not to see something because their brain is not processing what they’re seeing correctly. Or they may appear not to have heard what's been said because of changes to their brain, rather than to their hearing. On the other hand, the opposite can also happen – where poor hearing can make a person appear more forgetful than they actually are. If you’re unsure about what may be causing the problem, help your loved one to make an appointment with their GP or dementia specialist.

Dental care

Dental care can help someone with dementia to be more comfortable, as well as avoiding behavioural changes caused by tooth pain or an infection.

It may be easier for someone with dementia to use an electric toothbrush, or a toothbrush with a handle that’s easy to hold. Over time, they may need a loved one to brush their teeth for them. A dentist or hygienist can give carers guidance about doing this and about general dental health.

Managing other health conditions

Most people who have dementia are likely to be living with at least one other health condition. This is partly because dementia generally affects people later in life. Common examples include:

• heart problems
• high blood pressure
• diabetes
• problems with muscles, bones or joints

Having dementia may make it harder to manage other health conditions independently.

If your loved one has dementia, they may rely on your help, for example, with taking multiple medicines or with coordinating their appointments. When you attend GP or hospital appointments with your loved one, make sure the health professional knows you are their carer. Knowing this, they should involve you in decisions and give you information about how you can help. You should also make sure the health professional knows when there is more than one health problem – ideally this information should be passed between services, but unfortunately this doesn’t always happen.

GPs can be a good source of advice about managing multiple conditions at the same time. It’s important to attend regular check-ups for long-term conditions, which should include a review of medicines being taken. If you have questions about how different medications might interact and how to take them together, your local pharmacist should also be able to help.

Dementia can make it harder for someone to fight off infection. For this reason, it’s important for people with dementia to have the flu jab each winter. GPs can also advise on vaccines that will reduce the risk of infection, such as a pneumonia vaccine.

Providing dementia support to someone with several health problems can be very stressful. Don’t forget to look after yourself too.