Homebased Supports for Adults with Alzheimer’s or Dementia During COVID-19

As we continue to live with the COVID-19 pandemic, many of us are trying to get used to our “new normal.” This can be especially difficult for older adults with Alzheimer’s disease and related dementias (ADRD), and their caregivers. The familiarity of a daily routine provides comfort and may be able to help a person with ADRD cope with short-term memory loss. Establishing a predictable pattern of events can help transfer the schedule of a daily routine into the long-term memory portion of the brain, helping a person retain their ability to perform activities of daily life.  

Many day programs nationwide have temporarily closed due to COVID-19. If a loved one is used to attending this kind of program, this disruption from routine can lead to restlessness, agitation or a growing sense of anxiety. If a loved one has found the transition to staying at home difficult, here are some things we can do to build a schedule and keep them engaged:

1. Schedule mealtimes

Regular mealtimes are crucial to the maintenance of other elements of daily routine like medication management. This could also allow the opportunity for socialization, relaxation or to just enjoy a cup of coffee. 

2. Make time to exercise

The recommendation of getting at least two hours and 30 minutes of aerobic exercise per week applies to everyone who can do so safely (DODD (2020) Having a Meaningful Day during Ohio’s Stay-at-Home Order).  A wide array of chair-based exercises are available online to help get the blood flowing. The CDC offers online resources to a variety of options including adaptive Tai Chi and Yoga. If safe to do so, we can take a loved one for walks around the block, or on accessible trails at nearby parks, to get some fresh air and sunshine. We should remember to check with a loved one’s doctor before having them engage in exercise.

3. Try music therapy

Music therapy can be an effective activity for loved ones, as it helps to stimulate remote memory, helping them reduce confusion of their current surroundings. Research suggests music helps reduce agitation in 70 to 90 percent of individuals in the advanced stages of dementia. A loved one can enjoy music on their own by listening to it on a personal device with headphones, or together with us, with added elements like singing, clapping, dancing or playing instruments. The development of personalized playlists can have added benefits for loved ones with dementia. According to neurologist Oliver Sacks, “Music evokes emotion, and emotion can bring with it memory… it brings back the feeling of life when nothing else can.” When paired with everyday activities, music can help those with memory loss develop a rhythm that will help them recall their day-to-day activities and improve their ability to do them over time (TruSense, 2018).   

4. Engage in hobbies

These challenging times can also be looked at as an opportunity to tap into existing capabilities and prior interests; or explore new interests, hobbies and ideas (DODD (2020). Arts & crafts are open-ended activities providing the option to try different projects such as stringing beads, making items, sculpting with clay/Play-Doh or using paint-by-number kits. Coloring, drawing and sketching are creative ways to flex one’s brain, and help express thoughts and feelings (n4a (2020) Create Connections Without Technology).

5. Explore technology

Zoos, amusement parks and museums across the nation have set up virtual tours and exhibits that we can share with a loved one and view and talk about together. Free video conference technology like Zoom, FaceTime and Skype can help a loved one stay connected, and see the person they are talking to. If the loved one we care for does not have access to the internet or smart phones, there are more traditional options to maintain social connections, including calling a family member or friend every day on the phone; writing a note; or making and sending a card (n4a, 2020).

6. Enjoy games and activities

Other low-tech options we might consider based on the abilities of a loved one include playing board games, building models or tackling jigsaw puzzles (DODD, 2020). We can try including them in common household activities such as folding towels, cleaning or cooking together with simple recipes. Gardening is another therapeutic intervention that engages the senses and provides loved ones positive emotions that they may no longer experience regularly (Sauer, A. (2016) Gardening Therapy Tips For People with Alzheimer's).

Of course, in the midst of this pandemic, it is important to follow CDC guidelines for heightened hygienic practices. We may need to consider posting handwritten notes or signs in the bathroom and elsewhere to remind a loved one to wash their hands with soap for 20 seconds. We may also need to demonstrate proper handwashing or use of alcohol-based hand sanitizer with at least 60 percent alcohol as a quick alternative to handwashing if a loved one cannot get to a sink easily. We should be sure as well to maintain a rigorous cleaning schedule, sanitizing high touch and common use areas.