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The Comforts of Structure and Routine

The Comforts of Structure and Routine Dec 31, 2012
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Structure and routine creates benefits for both an in-home caregiver and their loved one with dementia.

“If the person with dementia is enjoying the comfort, safety and security provided by a predictable routine, the caregiver is making their job easier by avoiding the behavior challenges that come from unexpected events or erratic schedules,” M. Barbara Betts Swartz, a Program Director for the Alzheimer’s Association (www.alz.org) said. “Routine for the person with dementia also allows for predictable periods of time the caregiver can use at his or her discretion.”

There are also medical reasons that structure and routine can help the person living with dementia.

“As dementia progresses in a person, the world they experience becomes less and less familiar and increasingly uncomfortable,” Betts Swartz explained. “Due to brain changes with the disease, a person is actually seeing and hearing a different world. Familiarity and routine become very important to the person with dementia. The rhythm of the day and the consistency of that rhythm becomes highly valued, and in some cases, critical.”

This can be the structure of the day or the layout of the living room.

“The familiarity with his or her environment becomes paramount for the person with dementia. Even small changes can be upsetting, such as moving furniture or personal belongings,” Betts Swartz said. “Although the person with dementia most likely cannot identify what comes ‘next’ in the order of their day, the predictability of a routine or schedule is something that provides comfort, safety and security.”

When it comes to creating structure or routine for someone with dementia, Betts Swartz recommends taking into account the lifestyle and preferences and remaining abilities that person has at their disposal. This might mean allowing the person with dementia to dress himself or herself in the morning if they are still able – even if it takes them a long time.

“Having mealtimes, an exercise schedule, chore time, and quiet time at similar times each day becomes a predictable comfort to the person with dementia,” she said.

As important as the routine is, it will change as the disease progresses.

“Caregivers watch for things that work and things that don’t, and try to work them into or eliminate them from daily routines,” Betts Swartz said. “Keeping the person with dementia content, involved, and feeling safe and secure is one of a caregiver’s most significant challenges and a routine can help.”

For more help, you can visit Homewatch CareGivers’ dementia care tips page or read our Guide to Living with Dementia.

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