Looking After a Person with Dementia During Lockdown

The current government guidance states that people who are ‘clinically extremely vulnerable’ (i.e. people over 70 and those with specific health conditions) should stay at home and avoid contact with others (known as ‘shielding’). 

People with dementia are not included in the ‘clinically extremely vulnerable’ list. However, patients with dementia may be over 70 or have specific medical comorbidities which would classify them as ‘clinically extremely vulnerable’. In these instances, these individuals should continue to stay at home and avoid contact with others and adhere to the government advice for ‘clinically extremely vulnerable’ people.

Helping a person with dementia adapt to lockdown

The measures put in place within society to help fight coronavirus require us to all adjust to a  ‘new norm’. Many patients with dementia struggle with changes to their usual routine (1), so adjusting to lockdown life could be especially difficult for them. 

Good hand hygiene

Maintaining good hygiene is an important public health measure for preventing the spread of coronavirus (2). Dementia patients may require frequent prompting to help them adapt to and adhere to the requirements of lockdown life. You could put up signs around their home reminding them to frequently wash their hands with soap and warm water for 20 seconds. Verbal promoting could be useful too.

Daily exercise

If the person you are caring for is able to exercise, they should be encouraged to get some daily physical activity. However, they may require frequent, simple reminders about social distancing (i.e. the importance of staying at least two metres apart from individuals). Many residential and care homes have put strict social distancing measures in place. However, if you are caring for a person with dementia at home and they are going out in public for their daily exercise, you may wish to choose a quieter walking route and avoid busy times. 

Maintaining social relationships

You can help a person with dementia to maintain good social relationships by setting up frequent phone and video calls with their friends and relatives. Seeing a loved one’s face as well as hearing their voice can help a person with dementia to feel connected. Many care homes use specific technology platforms (i.e. zoom or skype), so get in touch with staff to see what is preferred and if they can help to facilitate calls.

Supporting from a distance

Friends and relatives can also provide care from a distance for those who live alone or in care homes. Sending flowers, photographs and cards is a great and safe way to remind the person that you’re thinking of them. Letters and emails are personable and can be read by care home staff, if needed. You could also send CDs of their favourite songs or their favourite movies to help provide comfort and support their wellbeing.

Hopefully, by now, systems will be in place to ensure that the person you care for is receiving a regular supply of food and necessities. If the person you care for usually does their own food shopping, try asking for support from friends, family, or neighbourhood volunteer groups to get their groceries delivered to their doorstep. Many supermarkets are also allocating online shopping slots for vulnerable customers. If the person that you care for is classified as ‘clinically extremely vulnerable’, you can stillregister them to receive support from the government. 

Managing disruption to routine

Keeping busy will help to combat boredom, which often leads to restlessness and agitation in people with dementia. Try to set up different ‘boredom buster’ activities in a variety of rooms around the home. Here are some ideas: 

• Play favourite films on the TV
• Switch on the radio or create playlists of favourite music for them
• Set up jigsaw puzzles or crafts like drawing or knitting
• Get some daily fresh air - perhaps some light gardening (if you have one)
• Keep up regular phone calls with loved ones 
• Have a quiet zone in the house where the person with dementia can go to calm down if they’re feeling overwhelmed 

Eating well at home with dementia

Dementia presents many nutritional challenges and these may be exacerbated by the restrictions of lockdown. To help maintain good nutritional status, you may want to consider the following:

• Stick to normal mealtime and snack routines as much as possible – this can help to provide comfort and familiarity when many other things are changing.
• Provide regular opportunities and prompts to eat, as people with dementia may forget to eat. Ensuring an adequate protein and energy intake can help avoid malnutrition, which is commonly associated with dementia (3).
• Present food in a way that is easy to eat – people with dementia can sometimes struggle to use cutlery or crockery. Providing finger foods can remove barriers to eating. Some examples of suitable high-energy, high-protein finger food includes:
• Small sandwiches or crackers with soft cheese
• Cocktail sausages or cut up pieces of chicken or fish
• A hardboiled egg (quartered)
• Biscuits and small cubes of cake

• If you’re concerned about poor appetite or reduced food intake: 
• Considerfortifying foods with additional energy and/or protein. For example, you can add cream, butter, or cheese to cooked dishes.
• Choose full-fat versions of dairy products like milk and yoghurts.

• Encourage regular fluid intake and look out for signs of dehydration (i.e. confusion, dry lips, and infrequent urination (4).)
• Create a calm and relaxing eating environment i.e. avoid background noise distractions
• Encourage some physical activity prior to mealtimes to stimulate appetite – dementia patients often experience a lack of appetite (5).
• Try to stay positive and keep spirits up – although easier said than done during lockdown, low mood and depression is common in people with dementia and has been associated with malnutrition (6).

Look out for yourself too

It’s important to ensure that you’re also looking out for your own wellbeing. If you have concerns relating to caring for someone with dementia during lockdown (and beyond), you can reach out for support from Dementia UK or the Alzheimer’s Society.

What to do if you’re still concerned about the person you’re caring for

Support services for caregivers and people with dementia continue to operate during lockdown. Charitable organisations and healthcare services actively encourage individuals to get in touch if they require support throughout lockdown. We have listed some useful resources below. If you’re still concerned about a person with dementia, speak to a healthcare professional. 

Useful resources:

1. Dementia UK, Coronavirus (COVID-19): information for families looking after someone with dementia:https://www.dementiauk.org/get-support/coronavirus-covid-19/
2. Alzheimer’s Society, Coronavirus: Information for people affected by dementia:https://www.alzheimers.org.uk/get-support/coronavirus-covid-19#content-start
3. NHS, Who’s at higher risk from coronavirus: https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk-from-coronavirus/whos-at-higher-risk-from-coronavirus