Expert warns: Covid must not disrupt routine for those with dementia

Dementia patients have been hard hit by the COVID-19 pandemic said a foremost expert in this field Dr Charles Scerri. Citing statistics from the UK he said that 25% of COVID deaths were dementia patients. He said that Malta while not having the same statistics, was probably spared the brunt of the deaths in the first wave due to its rapid and scientific intervention. Dr Scerri said that in the first wave, keeping the virus away from the care homes in Malta was crucial.

“These people [with dementia] are the most vulnerable among the vulnerable. The nature of their condition, dementia, makes it difficult for these individuals to understand what is going on around them. They also find it even more difficult to keep to the guidelines issued by the authorities,” said Dr Scerri. Social distancing, sanitizer use and avoiding unnecessary contact may be beyond the recall of those with this condition. He warned however that dementia has several stages even if people normally focus on the final and most acute stage. Dr Scerri said that those in the early stages of dementia normally do take the precautions and follow rules. “As the condition deteriorates, with recollection coming increasingly under threat in the brain, problems of understanding and communication will arise and this will affect the understanding of the situation,” said Dr Scerri.

Timetables and routines

Dr Scerri stressed the importance of getting persons with dementia outside, emphasising that the contact with nature, the fresh air will help these persons keep calm. Warning that certain activities, such as gatherings were not recommended in the pandemic, the emphasis with dementia should be on the maintenance of a routine. “Routine is essential for persons with dementia,” said Dr Scerri, adding that this is constantly advised to carers and families. Meal and snack times should be kept to their normal time as much as possible. “If the person with dementia is used to following a mass on TV, keep that going so that the disruption on the outside of the home will be kept from disrupting the routine within the home. This is most essential,” emphasised Dr Scerri. So, while a person with dementia may not remember having a cup of tea, they will remember that the time for a cuppa would have been missed. Dr Scerri said that no memory trigger should be missed, including memories accrued through the senses of smell, touch, and hearing.

The human touch

Over 80% of persons with dementia in Malta live in their homes and, Dr Scerri said, these actually got to see their relatives more since the families were confined to their homes. He warned of carer burnout advising all carers to make sure that they carve out time for themselves on a daily basis. “Carers are the keystone in this arch. If the keystone collapses so will the arch,” said Dr Scerri. For those with relatives in homes, technology such as Skype, Zoom or any other visual long-distance means of technological communication should be used to bridge the gap of loneliness.

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