Support for Patients with Dementia During Isolation

by Sherie L. Friedrich, PsyD

Our residents with dementia will require special attention during this difficult time as they are isolated from family and friends and experience disruption to daily routines. Changes in the environment can be incredibly stressful for individuals with cognitive deficits.

Here are some strategies to consider for providing support to your residents with a dementia diagnosis:

• Adhere to routine whenever possible
• Pay special attention to assigning familiar staff
• Provide residents with security items to decrease loneliness (examples include baby dolls, stuffed animals, or picture albums)
• Offer meaningful activities that can be done in solitude
• Avoid providing too much information as it may unnecessarily overwhelm
• Keep explanations simple and consistent
• Create a calm environment
• Sleep, balanced meals, and physical exercise are essential for mental health
• Take time just to listen
• Facilitate calls with family when possible
• Protect residents from frightening and overwhelming news (limit exposure to news, an upsetting conversation between staff, etc.)

Creating memory “touchpoints” may help overcome the disconnection that residents diagnosed with dementia may experience when interacting with providers. This is especially important when once familiar caregivers now look physically different due to wearing appropriate PPE. Taking time to create small daily rituals that help define residents’ interactions may help combat feelings of isolation and disconnection.

• Staff should announce themself and remind residents of their role: “Hi again. It’s your Nurse Beth. I am here to deliver your afternoon medications”.
• Acknowledge precautions and provide straightforward rationale: “It’s Rob here to help get you ready for the day. I am wearing this silly mask to keep us both healthy. How are you feeling today?”
• Use cues to help foster recognition: “Good morning, it’s Carol here. Remember me? I’m the one always admiring your lovely plants”.

These small rituals can help maintain a connection between resident and caregiver when our patients are most likely to feel isolated. Keep in mind that emotional and non-linguistic communication are often preserved with dementia, so residents are likely to interpret and respond to body language and tone correctly. Especially in times of stress, set the tone of the interaction by speaking slowly and calmly, maintaining an open and relaxed posture, smiling and showing kindness, and responding thoughtfully.