Sep 7, 2011

The Comfort of Familiar

A familiar routine is just another one of the “treatments” or therapies for the person with memory loss.

By Monica Heltemes

The Comfort of Familiar
As many other children around the country, my kids started back to school this week. We attended a school open house last week in preparation. My younger daughter returns to the same teacher and classmates, so for her there will be little change. My older daughter, however, will have a new teacher and new classmates. Her nervousness about this new situation started at open house and will probably last a week or two into the school year.

Her situation made me think back to my own “new” situations - and the feelings that accompanied! Do you remember your first day back to school…first day on a new job…first gathering in a new neighborhood?

Remember the feelings? For me, it would involve a lot of pre- planning and a restless night beforehand. When the actual time came, it would be nervous jitters, pep talks by self or family, and a quick prayer that I could make it through this “first”.

Once I had a few days or encounters under my belt, I would feel more at ease and soon slip into a routine. According to the Merriam-Webster dictionary, routine means “a regular course of procedure”. A regular course, knowing what will come next. Routine is familiar and familiar is comfortable.

For the person with Alzheimer’s or other forms of dementia, when they have lost the ability to structure their own day and remember one moment to the next, they have no routine. Therefore, they have no familiar, and can be left feeling frustrated, restless, scared, and unable to rest. That is unless the people around them help to put a routine and a structure into place.

Caregivers can help the person with dementia function at their highest capacity by instituting a routine. Of course, no routine is ever set in stone and remaining flexible should also be part of the care approach. But a general routine that will be followed each day can immensely help the person with dementia. This routine will provide comfort for the person with dementia and help their day move more in a rhythm. There will likely still be bumps in the road, but at least you can set off the day on a good path.

Routine includes the person’s daily self-cares, such as dressing and showering.

For instance, is the shower first thing in the morning or in the evening – or is it a bath instead? Try to stick to a similar routine that the person followed when they could do these things themselves.

Routine also includes meals, hobbies, and rest time. Do they have coffee first then breakfast later or do they both come at the same time? Does the person like to have music playing on the radio in the evening? Is there a nap after lunch?

At-home family caregivers usually know the person’s preferences and historical routine. Professional caregivers working in facilities do not have this advantage. But knowing how beneficial routine is for the person with memory loss should prompt both staff and family to work together to make this information known.

It is up to staff to help incorporate this routine.

For example, for the person who has always been more of a night owl and then slept in the next day, staff should not try to impose a new routine of early to bed and early to rise. They will be fighting the persons’s routine, their familiar, and, therefore, can cause upset and agitation.

For us without cognitive deficits, routine is a matter of choice. Some of us like to buck routine and try new things often.

But, for the person with Alzheimer’s or other form of dementia, it should not be an option.

The caregiver putting into place a familiar routine is just another one of the “treatments” or therapy for the person with memory loss.


Monica Heltemes is a practicing occupational therapist and owner of MindStart™. MindStart designs hobby-style items, such as games and puzzles, specifically for persons with memory loss. They keep persons with dementia active, while giving support to caregivers, and are quick and easy to use. Visit MindStart (Activities for Persons with Memory Loss) to learn more.

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Original content Monica Heltemes, the Alzheimer's Reading Room