More than 400,000 Australians live with dementia, and around two thirds of them live in the community rather than in residential care. Staying at home is what most people want, and with the right approach it is achievable for much longer than families often expect. This article shares the strategies our support workers and nurses use every day.

Communication that reduces distress

Dementia affects memory and language, but feelings remain intact. The tone of a conversation is remembered long after the words are forgotten.

Approach from the front, make eye contact and say your name before you start.
Use short sentences and one idea at a time. Wait for a response.
Avoid quizzing. “Do you remember who I am?” creates anxiety. “It’s Mei, your daughter, I’ve brought lunch” does not.
Do not argue with a mistaken belief. Acknowledge the feeling behind it and redirect gently.
For people who learned English as a second language, the first language often returns as dementia progresses. A Mandarin or Cantonese speaking worker becomes essential, not optional.

Routine as a scaffold

A predictable day reduces confusion. Keep waking, meals, bathing and bedtime at the same times. Put a large-print daily schedule and a clock showing the day and date where they will be seen. Introduce new activities in the person’s best hours, usually the morning.

Making the home safer

Remove rugs and clutter from walkways, and add night lights between bedroom and bathroom.
Label cupboards and doors with words or pictures.
Fit a stove safety switch or induction cooktop, and check smoke alarms.
Store medicines, cleaning products and car keys out of sight.
Consider a personal alarm or GPS device if wandering becomes a risk.

An occupational therapist can assess the home and recommend modifications that funding will cover.

Managing changes in behaviour

Agitation, repeated questions or refusal of care are usually communication. Ask what the person might be feeling: pain, hunger, a full bladder, boredom, too much noise. Meeting the need is more effective than managing the behaviour. Keep a diary of when difficult moments happen; patterns usually emerge.

Looking after the carer

Dementia caring is a marathon. Carers who use respite, join a support group and keep their own medical appointments sustain care far longer than those who try to do everything alone. Dementia Australia’s helpline on 1800 100 500 offers advice and counselling, including in Chinese through interpreters.

Specialist dementia support at home

Avida Care’s team is trained in dementia care, with Chinese-speaking support workers, registered nurses and allied health across Box Hill and Melbourne’s eastern suburbs. Call 0477 399 714 or 0421 986 841, or contact us to talk about what support at home could look like for your family.

Dementia Care at Home: Practical Strategies for Families