Home-based care strategies amid COVID-19 Pandemic for Dementia Patients

Here are some tips to make it easier for Dementia patients and their caregivers

1 .Control of the infection

  • Stay at home to reduce the risk of infection
  • Keep home as a clean zone
  • Prevent visits from high-risk persons, for example, those with fever or who have had contact with COVID-19 cases
  • Have home-members self-sanitize (e.g., wash hands, change clothes, take a bath) and cleanse personal belongings (e.g., cell phones, handbags) upon returning home; clean the bags of delivered goods, etc.; leave footwear outside the house before entering home

2. Care for basic needs

  • Maintain home support in personal needs (e.g., bathing) or chores (e.g., preparing meals)
  • Nursing care (eg: wound dressing, changing of urinary catheters or feeding tubes) should be continued
  • HCP providing home care should be trained in infection control, wear appropriate PPE. and have regular COVID-19 testing
  • Make use of online services (e.g. grocery shopping, meals delivery)
  • For day care centres that remain open during the outbreak, advice on infection control measures during travels should be given to patients/caregivers or transports should be arranged for them to visit the centres; these centres should implement strict infection control measures

3. Calm down challenging behaviours

  • Ask trained HCPs to provide simple tips (e.g., identify potential triggers to avoid) to caregivers in handling behavioural problems, online training videos on management of behavioural problems
  • Get consultation via phone or videoconferencing if required
  • Video-record the challenging behaviours (e.g., using smartphone) and send it back toHCP for advice
  • Dial emergency health-care numbers for tackling more severe behavioural problems (e.g., any form of violent or suicidal behaviour)
  • Remember delirium/confusion may be a manifestation of COVID-19 among older people

4. Comprehensive cognitive enhancement

  • Replace previous outdoor routines with home-based activities, including maintaining simple exercises (eg, walking, stretching) or cognitive stimulating activities comprising reading, playing card games, or arts and crafts
  • Ask to arrange for videoconferencing with individuals or groups of people with dementia/caregivers for activities including exercises, recreational activities, educational talks
  • Ask to deliver cognitive and physical rehabilitation programs via videoconferencing which are tailored i according to patients’ disabilities (a.g., balance/gait training or stretching exercise for those with concurrent parkinsonism)
  • If outdoor walk/exercise is allowed, avoid crowded areas or maintain physical distancing

5. Managing medical and cognitive problems at home

  • Get educated to monitor simple vital signs like B.P., pulse, temperature, blood glucose, and/or oxygen saturation at home; B.P. monitoring may be particularly important in limiting further vascular contributions to dementia; oxygen saturation may detect desaturation due to pneumonia/COVID-19
  • Secure arrangement for medical doctors could make home visits if deemed necessary, but they need to follow infection control measures and put on proper PPE for home visits
  • Refill and be compliant to prescribed medications: get home delivery of medication if possible
  • Discuss in advance patients and caregivers wishes with respect to receiving life-sustaining treatment including hospitalization, resuscitation, and ventilatory support in the event of respiratory failure due to COVID-19


6. Self care for caregivers

  • Regularly screen for anxiety, stress and depression and prompt treatment when there is emerging/significant psychopathology
  • Have regular home-based exercise, recreational activities, and other ways to relieve stress (e.g., listening to music)
  • Ask the trained HCP (e.g., psychologists) to deliver/teach relaxation methods (e.g., mindfulness meditation) via videoconferencing
  • Discuss a contingency plan in caring for the patients in case the caregivers become sick

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Dr V.T Haridas

Senior Consultant Neurophysician at Elite Mission Hospital

Dr V.T.Haridas is a Senior Consultant Neurophysician at Elite Mission Hospital, Thrissur, Kerala. He received his medical degree from the Thrissur Medical College and had his two years Post Graduate Training in General Medicine at the Kottayam Medical College. He completed his DM Neurology training at NIMHANS, Bangalore, Dr.Haridas has also received DNB degrees in General medicine as well as DNB neurology. He was a rank holder during his Graduation and his area of interest is Neuro-rehabilitation.

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