Caregiving for a relative with dementia can be a hazardous occupation, and it is no wonder that it has been referred to as feeling like a “36 hour day.” While there’s no question that caregiving has its positive elements, and that for the patient themselves, living at home with a relative is usually the optimal condition, the cognitive, behavioural and physical challenges that result from dementia often threaten to overwhelm even the hardiest of caregivers.
Having said that, there are many potential avenues of intervention and assistance that can ease the journey for the caregiver and lead to an improvement in quality of life for the patient with the dementia. One of the best interventions that I recommend for all my patients and their caregivers, is to attend a dementia day program.
What is a dementia day program?
Dementia day programs take place in a variety of locations in the community and are run by a number of providers including government, charitable organizations, and Alzheimer’s Associations. The programs are delivered to groups of people with dementia. While some facilities stream by level of cognitive impairment (mild, moderate and/or severe), many include patients with the full spectrum of impairment.
Activities vary by organization but can include exercise, often chair exercises or walking groups, some programs offer discussion groups or music appreciation, which may involve singing and dance. Other activities include: pet therapy, arts and crafts and sports activities – all geared specifically to people with cognitive impairment.
Different providers offer different schedules for programming. I have patients attending programs varying from half a day a week, to full days, for seven days a week.
Meals are often available depending on the timing of the programs. Costs vary with some programs being fully subsidized and other programs requiring a fee for participation. Some programs provide transportation to and from the facility.
Related post: The positive aspects of caregiving for dementia
Reluctant to send a relative to a dementia day program?
Many caregivers are reluctant to send their relatives to these programs. Caregivers will often say: “My husband will refuse to go – he won’t leave my side”; “My wife was never a ‘joiner’ or a group person”; “My husband was a professor – there’s no way he’s going to enjoy playing cards or doing arts and crafts”; or “My wife will become distraught if she’s put in a program with severely impaired individuals.” My first response to these concerns is always, “Try sending him/her to the program a couple of times before you pass judgement.”
When people with dementia are welcomed by the warm, empathic and experienced staff of a day program, this is often enough to overcome the initial reluctance to leave their caregiver. When someone with a cognitive impairment participates in non-threatening, seemingly simple activities, it can help provide the person with a sense of accomplishment and mastery, regardless of their previous professions and whether they had been physiotherapists, physicians or physicists.
Caregivers may be concerned about how their relative with dementia will react if he or she is less impaired than other day program participants. I typically recommend caregivers tell the person that they are going to a facility to act as a volunteer to help older, frail, individuals. This therefore becomes a “job” and responsibility for these individuals, which can help to improve their self-esteem.
Discussing caregiver concerns with the staff at the program prior to starting, and even attending the first session or two, is often sufficient to allow the person with dementia to adapt and incorporate the program in their structured daily life routine.
Benefits of dementia day programs
Some of the benefits of day programs for the person with dementia include socialization, mental and physical stimulation, encouraging a sense of mastery, improvement in mood and potentially problematic behaviours like agitation and apathy. Participants sleep and appetite will often improve as a result of increased physical and mental activities.
While attendance at a day program is occasionally resisted by the person with dementia, I often recommend trying again every few months. Behaviours, likes and dislikes often change dramatically over the course of the illness. The potential benefits of day programs are overwhelmingly worth the effort to ensure their attendance.
How caregivers benefit from dementia day programs
When a person with dementia attends a program, it allows the caregiver to have personal time for their own needs such as shopping, work, leisure, time with friends. Dementia day programs can offer the benefit of a break, even for a little while, to help give caregivers an opportunity to focus on themselves.
Please consider a dementia day program for your relative with dementia. Discuss this with your family physician and speak to your local Alzheimer’s Society representative for a list of programs in your area. Visit the program, with or without your relative with dementia, and sign up for a trial. It will likely be the most helpful intervention offered to you and your relative over the course of the illness.
