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Physical Health and Dementia
While the mental parts of dementia are the most well-known, an often-overlooked consequence of dementia is physical health.
Dementia is much more than memory loss, and you need to make sure that you attend to all aspects of your loved one’s well-being when providing them with their much-needed care.
Unfortunately, as your loved one’s dementia progresses, so too does the deterioration of their physical health. It’s important to know what changes to expect and what you can do to better their physical health and overall quality of life.
Physical Health Difficulties Caused by Dementia
The extent of your loved one’s physical health decline depends on how severe their dementia is. Each person will experience physical health difficulties that are unique to them, though these are some of the most common types of physical health difficulties that you can expect:
It’s common for your loved one to experience movement difficulties, especially if they are in the later stages of dementia. Some movement difficulties that you can expect are:
- Difficulty balancing
- Poor coordination
- Stiff muscles
- Weak muscles
- Uncontrollable jerking
- Difficulty standing
- Difficulty sitting up in a chair
- Slow walking with feet shuffling
- Slower overall movements
- Repeated falls
Though most of us take it for granted, swallowing the food and drink that we eat is actually a very complicated process that requires a lot of concentration and oral muscle movement. It makes sense that your loved one may experience swallowing difficulties and complications such as:
- Inhaling food
- Difficulty chewing
- Difficulty swallowing
- Poor appetite
- Weight loss
- Chest infections
Though no one really likes to talk about it, incontinence is a significant area of frustration for people with dementia, and it’s one of the more debilitating physical health effects of dementia. Here are some difficulties you can expect:
- Bladder incontinence
- Bowel incontinence
- Urinary tract infections (UTIs)
I’ve written a full-length article on this topic which you can read here.
Because of its effect on the brain, dementia can cause communication difficulties that impair your loved one’s ability to use and understand language, as well as with their speech itself. Unfortunately, speech and communication difficulties are common, and you can expect any of the following:
- Verbal communication difficulties
- Non-verbal communication difficulties
- Speech impediments
- Poor comprehension (receptive aphasia)
- Difficulty with expression (expressive aphasia)
- Impaired ability to communicate what they want
- Weak oral muscles
- Difficulty coordinating oral muscles
If you’d like to learn more about aphasia, then you can watch this video.
Sometimes, you might find that your loved one becomes more active at night and has great difficulty sleeping. This activity worsens as your loved one’s dementia progresses, and is medically called “sundowning.” Here some other sleep difficulties that you can expect from your loved one:
- Periods of being alert or drowsy
- Confusion\Changes in temperament
- Abnormal sleep patterns
- Night-time wandering
- Altered mood
Something I learned with my Grandpa is that the best way to target your loved one’s movement difficulties is to incorporate functional movement activities into their daily routine. The key is to make exercising not feel like exercising.
Fine and gross motor coordination exercises are great for maintaining your loved one’s independence and inspiring them to get up and do more. I’ve found that simply cutting out pictures with my Grandpa for scrapbooking and throwing a ball back and forth can yield fantastic results.
You should keep the movement activities light and simple and make sure that they are challenging enough for your loved one without causing them to become frustrated.
Get creative and make sure you include movement activities that your loved one enjoys. Some people love to dance while others prefer chair yoga. You know your loved one best, and you are the most qualified to brainstorm which activities they would enjoy the most.
The way your loved one eats is very much dependent on the stage of their dementia and other physical issues that they may have.
I’m lucky in that my Grandpa is still able to eat alright, though we have to make sure all his food is soft because he doesn’t really like wearing his dentures.
The best thing you can do for your loved one when it comes to eating is to ensure that their mealtimes are regular, relaxed, and unhurried. You should choose a calm setting that has very few distractions and noise for their mealtimes.
Finger foods are an excellent idea to help your loved one maintain a level of independence, especially if there are particular finger foods that they enjoy. Avoid mixing foods together too much, and talk about the different foods that they are eating.
You may have to consult with a nutritionist and/or speech therapist if your loved one has specific feeding difficulties that need to be addressed. By consulting with these professionals, you can ensure that your loved one gets all the nutrients that they need.
The first and most important thing you need to do when managing your loved one’s incontinence is to ensure that no underlying issues are causing their incontinence and that you maintain their bladder health. A simple doctor’s visit and change in diet can be all it takes to get them back on track.
If this doesn’t work, then you may need to consider providing your loved one with pads and pull-up pants to absorb any accidents that may happen. As mentioned in my article about incontinence, TENA has a great range of products for both men and women, and a wide selection of products can be found on Amazon.
Be supportive and communicate with your loved one and learn to notice the signs and symptoms that they display when they need to go to the bathroom. My Grandpa tends to get restless and moody when he needs the bathroom, and knowing this helps me prevent accidents from happening and encourage better communication between us.
Communication is vital for us as human beings, and yet it is one of the main areas that people with dementia have trouble with.
There are many ways that you can encourage and assist your loved one when it comes to communicating. Here are some tips which seem to deliver the best results:
- Be clear in your communications
- Speak clearly and concisely
- Use short sentences with one idea
- Adjust your volume if you need to
- Set a positive mood
- Get their attention softly
- Make sure that they understand your questions
- Use “yes” or “no” questions if necessary
- Diminish environmental distractions
- Break your communication down if they don’t understand
- Maintain your humor (and theirs)
- Redirect them if they get off-topic
- Be patient
- Show affection
- Listen thoughtfully
- Don’t point out their mistakes
- Don’t put them in stressful situations
- Wait patiently for them to respond
If your loved has trouble sleeping, then it may be necessary to consult with their doctor and consider providing them with some form of sleeping medication. There are both pharmaceutical and herbal options available, but it’s essential to adhere to the guidance of a medical professional.
Try and get your loved one into a routine and implement sleep hygiene as far as possible. Calming them down before bed and making sure they don’t eat or drink too close to bedtime can do wonders for helping them get better sleep. Just make sure that they don’t become dehydrated!
Using devices like nightlights, photos, and other familiar objects can help your loved one feel more secure in their environment and enable them to sleep better by reducing their anxiety. Being “grounded,” calm, and reassured are three essential requirements for healthy sleep.
This fantastic infographic by Daily Caring summarises these points nicely:
And there you have it!
You’ve officially survived my crash course on physical health and dementia. I know it’s a lot of information to take in, but always remember that you are never alone when caring for your loved one with dementia.
When in doubt, follow your loved one’s lead and take their responses to your assistance into account. You can’t go wrong when you do this, and it’ll help ensure your loved one’s quality of life and the continued growth of your relationship with them.