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Dementia, Alzheimer's disease, and other cognitive impairments are caused by changes that happen inside the brain. Many of these changes and the symptoms they cause are not within the control of the person with cognitive decline. These symptoms include memory loss, confusion, disorientation, depression, feelings of anxiety, agitation, aggression, and apathy. These can be challenging to manage for clients as well as for caregivers.

For caregivers specifically caring for a client with dementia, it often involves a series of steps that can be broken down into a category of “The Three E’s.” For a caregiver to better understand and connect with their client, they must first empower, then encourage, and finally engage with them. 

Building trust can take time but with the proper tools, it can be done in a way that will inspire and provide more meaningful days for both the caregiver and their client. Read along as we break down the 3 E’s everyone caring for someone with dementia should know!

Empower

The first thing a caregiver can do to support their clients is to empower them. One of the hardest parts about getting older and aging, especially aging with dementia, is losing your independence and not being able to do some of the things that you used to be able to do when we were younger and healthier. It’s important for caregivers to recognize this and do things with their clients, not just for them.

Caregivers should allow the client to do what they can, for as long as they can, and then be there to help support them as needed. It's also important to stay present in their reality, even if their reality is inaccurate. Go with the flow and be beside them, as long as they aren’t hurting themselves. Caregivers can do this by:

• actively listening
• paying attention to what they're saying and their body language
• observing the emotion behind their words and actions

Empowering patients can help them to have a greater understanding of how to navigate their condition. With this knowledge, they can confidently ask for the help they need. This greater sense of self-awareness will help strengthen the relationship between caregiver and person being cared for.

Encourage

The best way to support clients with Dementia is by encouraging them, in whatever way that’s best for them. Spend as much time as possible building a connection based on trust. Though it takes time, it is key towards understanding the client’s unique needs which will allow them to trust the caregiver, since they can demonstrate an honest understanding for what the client is going through. 

Caregivers are often met with resistance and experience challenging situations, especially as dementia progresses. If met with resistance, follow these steps for a safe and efficient approach:

• Wait five minutes
• Take a step back
• Reapproach and then try that at least three more times

Words and actions matter in these situations so try to avoid using the words like “no” or “stop.” Refrain from disagreeing with or “quizzing” your client. This can often cause a person to feel and get defensive. It's best to offer your support. Try a friendly invitation or asking for permission. Remember, patience will only provide them with the comfort and reassurance that they need. 

Offering choices also proves to be very effective. When caregivers offer their client’s a choice, it allows them the opportunity to make their own decisions, and to be a part of their care and what's going to happen next. For some, it could be the last aspect of their independence they have left, so caregivers should aim to support them for as long as possible. For example, a caregiver can offer a person a choice of “either, or...”

• “Would you like something hot or cold to drink?” 
• “Would you prefer to take a shower before dinner, or after dinner?” 
• “Would you like to go for a stroll to the park this afternoon, or would you prefer to keep working on the word puzzle that we started together yesterday?”

Offering clients a choice in different ways throughout the day can make a difference for both the client and the caregiver. They may be more open and accepting towards the caregiver, which will in turn assure the caregiver that they are connecting with the client and genuinely helping them.

Engage

To support clients is to engage with clients. Caregivers should create purposeful days with meaningful things to look forward to, depending on what they’ve learned from their client. It's important to create routine and structure in the lives of those living with dementia. A structured, predictable environment helps relieve anxiety commonly known to trigger behavioral issues in those with dementia. Caregivers should always take some time to get to know personal things about their client such as:

• Who they are
• Where they're from
• What they did for a living
• What kind of music they like
• What foods they prefer
• What are some of their interests and passions

Keep in mind that having structured, physical activity at least once a day is important. Here are some examples:

• Going for walks
• Doing exercises for range of motion
• Doing something creative with your hands 
• Cooking together in the kitchen
• Playing a game of cards
• Folding laundry together
• Painting 

It’s also important to keep them creatively stimulated and ensure that they are connected socially and emotionally to friends and family, and things that they love. This will help inspire both the caregiver and client to have more joyful days filled with positivity. Some examples of creative and intellectual activities include:

• Painting and crafting
• Word games and jigsaw puzzles
• Bingo
• Interactive online games 
• Trivia
• Reading 

Summing it up:

For all caregivers feeling lost or discouraged about building relationships with those living with dementia, refer to these tips on how to empower, encourage, and engage your client. Many times, dementia patients cannot control what's happening inside their body and their brain so we shouldn't take it personally. Caregivers may often feel overwhelmed with information or emotions. If you have any questions or concerns about your client, please contact your nearest True Care office.