Professional Comment

Getting Routines Right for People Living with Dementia

By Bernadette Mossman, Healthcare Director at Vida Healthcare (https://vidahealthcare.co.uk)

Amidst 55 million global dementia cases and 10 million new diagnoses annually, emphasising specialised care routines is essential for care home operators and staff when it comes to providing exceptional care for people living with dementia. Bernadette Mossman, Healthcare Director at Vida Healthcare, shares expert insight on how to implement routines for people living with dementia and why they are so important to contribute to physical and mental wellbeing.

Vida Healthcare is the UK’s leading provider of specialist dementia care. The company currently operates three outstanding-rated care homes which provide bespoke care, including residential and nursing, for over 200 people living with dementia.

Why are routines important?
Living without a daily routine can cause increased stress and anxiety, lack of concentration and even exacerbate feelings of distress. This is even more important for people living with dementia, who require stability to maintain independence and wellbeing.

Daily routines serve as a foundation for specialist care, by ensuring consistency and management of the unique needs of each individual living with dementia. Care homes across the board will understand the importance of implementing daily routines for their residents to support crucial activities, such as taking medication on time and getting enough sleep. However, it can be tricky to understand how to establish a routine for people who may find it challenging to vocalise their needs, such as those living with dementia.

Setting routines not only creates a sense of familiarity, but also ensures structure and predictability which can, in turn, promote independence and wellbeing. Therefore, providing care home staff with the right skills to undertake effective routines is fundamental for holistic and effective dementia care.

This becomes more essential as people progress on their dementia journey and their care needs change. For example, some people living with dementia may lose the ability to carry out everyday routines by themselves over time, such as getting dressed in the morning, eating, communicating or understanding their surroundings. This will often cause confusion, embarrassment and require increased assistance from others. Introducing routines as early as possible when a person moves into a care home can support these functions and help to maintain independence for longer.

Starting the day
Incorporating cues and reminders can be a useful tool in starting a daily routine for someone living with dementia. If a resident has always started their day by getting a shower, it is important to maintain consistency with this pattern to avoid stress or anxiety. Simple cues, such as leaving a person’s toothbrush and clothes out can make a significant impact, and foster independence for longer.

Daily activities
When devising a daily routine for an individual living with dementia, a fundamental aim should be to cater it to their personal preferences and past experiences as much as possible. Upholding even small or seemingly ordinary activities within their daily schedule can yield positive results, such as helping them continue to do things independently for longer. These routines may include leisure activities such as a post-lunch walk, making a cup of tea or sitting down at a certain time of day to watch a favourite TV programme.

Dining
For residents living with dementia, excessive distractions and stimuli can cause residents to become overwhelmed during mealtimes, emphasising the need for a calm and welcoming environment which residents feel comfortable in.

The menus a care home offers should be diverse and visually appealing. Providing traditional and nostalgic meals is often well-received. Involving residents in setting the table like they would do at home can be a useful routine, as it fosters a sense of purpose and inclusion. Creating a calming dining experience will help maintain good nutritional intake which in turn, ensures residents are sustaining a good quality of life.

Bedtime and circadian rhythms
Residents living with dementia frequently experience disturbed sleep and Circadian Rhythm Disorders (CRDs). Establishing a safe and comfortable bedtime environment can help ensure the individual has uninterrupted sleep throughout the night.

Vida Healthcare’s care homes cater to the specialist needs of dementia residents by incorporating specially selected decor and sensory features to help alleviate confusion. Vida Court, the newest of Vida Healthcare’s three homes, has integrated circadian lighting, which aims to reduce agitation amongst residents whilst maintaining routine.

Implementing a routine for people living with dementia is instrumental in providing predictability, structure and a sense of safety. However, caring for individuals living with dementia can pose challenges for care home operators in determining how best to support them. Encouraging routines can promote independence and, ultimately, positively influence their overall quality of life and general wellbeing for as long as possible.