I am a big fan of comfort care once someone with dementia is needing regular support, supervision, and guidance.  I see a lot of folks with advanced dementia being put through doctor’s appointments, procedures, tests, that they are no longer able to understand and that bring considerable discomfort to their days.  

I teach families that we should use the concept of “quality of life” as our guide.  Will a doctor’s appointment or a procedure contribute to an improvement in their quality of life?  Or will an appointment or procedure only bring them discomfort, confusion, or pain?  

There are some appointments, though, that remain important as long as folks remain up and about and out and about: appointments to trim toenails (and fingernails), clean teeth, and clean out ears and check hearing aids.

Let me explain.  I have seen far too many people living with dementia who have toenails that are unbelievably long.  Long toenails quickly become painful as they press against the toes of one’s shoes.  Long toenails are also likely digging into the sides of one’s toes, and probably digging in to toes on each side (I have seen all of this).  This is unacceptable.  But here’s the disclaimer….it can be tough to get toenails and fingernails trimmed with someone with dementia who is increasingly unable to recognize their long nails, while not being interested in help and not understanding that they need help.  So if your loved one’s nails are long, and you are having trouble getting them trimmed, please reach out to us.  These are the kinds of issues we specialize in.  We can help you in person, or via phone or zoom.

Teeth.  I have seen far too many folks living with dirty teeth and inflamed gums.  Research lets us know the importance of clean teeth and clean gums to our overall health, and it also makes sense that dirty teeth and gums end up as painful teeth and gums.  We must remember that our folks with dementia are becoming unable to interpret and analyze and decide what to do about issues such as pain.  So it is our job to try to prevent problems with oral health.  Again, this can become a tough issue when dementia is part of the journey; we are happy to help.

Ears.  Folks with dementia often forget to shower, let alone clean their ears.  They already struggle to hear and keep up with conversations, and if their ears are blocked by wax, this of course makes hearing and engaging in conversation even harder.  So regular ear checks for wax are important.  Hearing aids….if someone with dementia will continue to agreeably wear their hearing aids as part of their routine, then it is worth having the hearing aids checked, cleaned, repaired.  But often, hearing aids become forgotten and lost.  And that is ok; it’s certainly not worth a battle.  Please just remember that we will need to speak as loud as necessary so that our companion with dementia can clearly hear us.   

Comfort care is the kind way to do dementia care.  But please remember that trimmed nails and clean teeth and clean ears are an important part of helping our companions with dementia stay comfortable.

Happy to help,

Jill and the Better People Care Team