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Caring for someone with Alzheimer’s disease can be rewarding but also time-consuming and stressful. Often, a relative provides care, but there are other options.

The Centers for Disease Control and Prevention (CDC) notes that about 2 in 3 dementia caregivers are women, and around 1 in 3 are ages 65 and older. In addition, about a quarter of dementia caregivers also care for children under 18.

Getting outside help and support can make caring for your loved one more enjoyable and less stressful. It can improve quality of life for both of you.

Alzheimer’s disease is a progressive illness, and caregiver responsibilities typically increase as the disease advances.

Responsibilities can include making important health decisions for a loved one, so setting up a care plan early is important.

Here’s how to prepare for the future:

  • Discuss your loved one’s wishes in the early stages of the disease. This allows them to express their end-of-life care wishes, such as the type of medical treatments they want.
  • Get permission to speak with their healthcare team. Before AD progresses, complete a HIPAA authorization form. This allows you to discuss a loved one’s medical history with their doctors.
  • Consider legal matters. You’ll need authorization to make medical decisions on their behalf. Contact a family lawyer for assistance with creating a medical power of attorney. Also talk with your loved one about advance care directives, which outline their wishes in the event of a medical emergency. For example, it may cover how they feel about life support.
  • Consider financial matters. You can also become their financial power of attorney. This allows you to make financial decisions on their behalf. Also, read their insurance policies to understand their coverage (health, life, supplemental care, etc.). It would help to also discuss their funeral and burial wishes.

The type of care a person needs will depend on the severity of their symptoms. Types of care available for AD include:

  • In-home care. The individual can receive care in a familiar environment. Family members or friends can share responsibilities with a home health aid to help take some of the pressure off.
  • Adult day centers. Sometimes, caregivers are busy with work or other responsibilities during the day and can’t provide dedicated care during those hours. In these cases, adult day centers can provide a safe and active environment for their loved ones. Some centers provide structured activities, as well as transportation and meals.
  • Long-term care. As the disease progresses, some individuals require long-term care. This includes care in a nursing home or an assisted living community. Both options offer 24-hour care or assistance.
  • Respite care. This is short-term relief for caregivers. The length varies but can range from 1 day to several weeks.
  • Hospice care. This occurs when a loved one approaches the end of their life. This care can take place in their home or at a long-term care facility. Hospice care provides comfort and care in a person’s last months of life.

Here are a few tips for caring for someone with AD.

1. Educate yourself

Learn about your loved one’s condition. This can improve communication with your loved one, and it can help you cope with their changing behavior. Attend medical appointments and ask questions.

2. Set a daily routine

Simple daily routines can help a loved one cope with short-term memory loss. For example, aim for them to bathe, get dressed, and eat at a set time each day.

3. Keep them physically active

Being active and exercising regularly can slow cognitive changes. Movement exercises the joints, muscles, and heart too. This can improve their mood — and yours.

4. Keep them mentally active

Mental activity also helps slow cognitive changes. Let your loved one perform some tasks themselves, if possible. This includes bathing, brushing their teeth, and doing household chores.

You can also encourage reading and other activities like puzzles.

5. Promote nutritious eating

Your loved one might lose interest in food, but it’s important to maintain balanced nutrition when possible. This slows cognitive changes as well.

When preparing meals, include foods with cognitive benefits. These include:

  • green leafy vegetables
  • berries
  • whole grains
  • fish
  • poultry

Try to limit:

  • red meat
  • sugar
  • fried foods

6. Offer choices

A person with Alzheimer’s may not be able to ask for what they want, but they can often make choices.

Keep the choices simple, for instance, ask them to choose between two outfits, pasta or rice, whether to sit outside or indoors, and so on.

7. Promote good hygiene and grooming

Low self-esteem can affect their mood, so help maintain the person’s hygiene and grooming habits. This includes a daily routine of:

  • bathing
  • brushing their teeth
  • combing their hair

If they feel good about their appearance, they might feel better overall.

8. Be patient

It might take your loved on longer to complete certain tasks like bathing and eating. Try your best to be patient and not get frustrated.

The inability to care for themselves can be upsetting or embarrassing. You can maintain their dignity by respecting their comfort level. For example, allow them to bathe or shower alone (if it’s safe).

9. Focus on communication

A person with Alzheimer’s may be unable to find the words to express themselves. This can lead to anger, frustration, and inappropriate care, if they cannot say how they are feeling. The tips below can help you communicate with an individual with Alzheimer’s.

Tips for communicating with someone with Alzheimer’s disease

Do’s

  • Do keep responses and instructions simple and short.
  • Do give them time to process information.
  • Do be patient, and if necessary, repeat instructions.
  • Do redirect conversations to avoid arguments.
  • Do use humor to break tension.
  • Do learn their nonverbal cues.

Don’ts

  • Don’t argue or become overly irritated. Leave the room if necessary.
  • Don’t insist they complete a certain task.
  • Don’t take their actions personally. AD can affect mood and behavior.
  • Don’t belittle them.
  • Don’t yell.
  • Don’t ask open-ended questions. Give options instead.

10. Be prepared for sundowning

Sundowning refers to restlessness, irritability, and confusion that worsens in the late afternoon and early evening hours.

Your loved one might wander around the home or pace during the night. This can be challenging for caregivers because sundowning often prevents sleep.

To manage sundowning, maintain a predictable bedtime routine. You can also increase their activity during the day and limit daytime napping and caffeine before bed.

11. Ensure the home is safe

If you’re caring for a loved one at home, take steps to prevent falls and other accidents. For example:

  • Place carpet or grip strips on stairs.
  • Place latches on cabinet doors.
  • Place covers over electrical outlets.
  • Remove small rugs.
  • Place handrails and mats in the shower.

Depending on the severity of the person’s cognitive symptoms, you may not want to leave them unattended in the shower or tub or allow them to cook by themselves.

12. Get help

It can be hard if you’re the only caregiver. Don’t be afraid to open up with family and friends about your experience, as they may be able to help, whether by dropping in for a chat to sharing experiences or even looking after your loved one while you take a break.

Check out local community support, online groups, and other options.

The Alzheimer’s Association has useful resources, including an online chat facility and 24/7 helpline.

13. Sort out the admin

It can be hard to think of this, but while your loved one is still able to make decisions, it’s essential to ensure you arrange for various formalities, including the following:

  • enduring power of attorney
  • advance directive, or power of attorney for healthcare
  • a living will
  • a standard will
  • any necessary financial arrangements

While things don’t always go as planned, it might be worth discussing with the person what they currently think they would like in terms of future care.

14. Engage in self-care

It’s important to take care of yourself, too. Caregiving can be physically, emotionally, and mentally exhausting. If possible, take advantage of respite care.

Try to maintain a balanced diet and get plenty of physical activity. Go for a walk and enjoy the fresh air. Get involved in activities that bring you joy.

Also, you can look into local or online caregiver support groups.

The cost of Alzheimer’s care varies. According to the Alzheimer’s Association, estimated costs for various services may include:

  • home health aide: $28 per hour
  • adult day centers: $83 per day
  • long-term facility: $4,500+ per month

Health insurance (Medicare, retiree group plan, or private) can cover some costs. Talk with your loved one about any supplemental plans or long-term care insurance plans to reduce the out-of-pocket expense.

Check with your loved one’s insurance provider to understand their benefits.

Alzheimer’s disease is a progressive illness, and the rate of progression varies from person to person.

Some people are caregivers for only a few months, while others provide long-term care. It’s important to set up a short-term and long-term plan for medical care and financial and legal matters.