Struggling to keep track of conversations, zoning out and forgetting what they were doing, finding it harder to focus on day-to-day tasks. No two people experience dementia in the same way, however, difficulty concentrating is a challenging symptom that most people share.
As dementia progresses, the attention someone can give to a task, a topic, or goal-orientated behaviour (such as finishing all the dishes, or counting out the correct money), reduces.
At first, people may seem more distracted doing tasks they used to breeze through, such as finishing their favourite crossword or planning a journey. In the later stages, people may find it hard to engage in the most basic of tasks; such as dressing themselves, or making a cup of tea.
While it's upsetting to see someone's concentration decline, there are ways in which you can help your loved one feel more at ease with the changes dementia brings. And while there's little evidence that brain exercises slow the decline, being aware and prepared will help both the person you love and your family feel better placed to deal with the effects pro-actively.
Why do people with dementia have trouble concentrating?
Dementia-related illnesses attack parts of the brain. With Alzheimer's, this damage tends to start in an area called the hippocampus, an area responsible for holding new memories and learnings. So, when damage occurs to this vital part of the brain, people can experience trouble recalling recent thoughts, holding conversations and generally sense a growing brain fog blurring their ability to concentrate fully.
How to be more prepared for the decline in concentration
Since the progression of dementia will generally see someone's concentration lessen over time, there are ways that you as a loved one or caregiver can help ready yourself for the changes that can happen.
Build a routine – One of the keys to helping maintain some focus in your loved one, is to build them a calm environment and put in place a routine they both trust and recognise. Try to make sure this routine contains all the things they used to enjoy and love, rather than something entirely new. It could be as simple as waking and napping at the same time of the day, watching a favourite program, taking a walk, or even having a slice of something special with a cup of tea in the afternoon.
Do some safety checks – If your loved one is in the early stages of dementia, it may be a good idea to install some safety equipment around the house to help prepare for dangerous lapses in concentration. For instance, walking away from boiling pans, leaving the door wide open, or falling asleep while in the bath etc. Make sure fire-alarms have full batteries, doors have an automatic closing function or alarm, and agree to regular phone calls to make sure that everything’s OK.
Cognitive exercises – Memory games, word-based activities and simple brain exercises are all great ways to interact with your loved one. And while there's no concrete evidence that cognitive exercises slow the decline, some carers reported positive effects on concentration levels, as well as being a great way to get conversations going.
At Live Better With, have a selection of brain-based recalling and sensory games that all aim to help maintain concentration and memory. Or you can make your own by drawing pictures, words or colours on cards and asking your loved one to arrange, match or link the cards to help get their brains more engaged.
Ask opinion, but limit choices – A wardrobe filled with hundreds of clothes can loom over someone with dementia, whereas, a selection of two outfits laid out on the bed can be freeing. With decision making, you must never make someone with dementia feel as if you've taken away their control and autonomy. But, at the same time, be aware that too many choices can hamper concentration, and even make someone feel overwhelmed and agitated.
Use aids to help trigger concentration – In the early stages of dementia, Post Its, diaries, calendars, phone reminders and appointment books can all help keep some chaos at bay.
Conversation and concentration
Talking with your loved one, especially with those in the later stages of dementia, can become difficult for both of you. It can be frustrating and upsetting when conversations unravel as they lose its thread, forgetting questions, changing the subject or repeating facts.
Try to be patient. It's important to keep engaging your loved one, so that they feel secure and grounded to their sense of self. To help make conversations between you more fruitful, and less fragmented, try to keep outside stimulation to a minimum. Talking and music coming from other rooms, loud traffic noises from an open window, people bustling around, and flashing television screens are sure-fired ways to confuse and distract.
If possible, try to eliminate as many external factors as possible, so it's easier for them to give you as much attention as they can. But, before doing so, explain what you're doing, and make sure you have their permission if you're changing things in their space – such as closing windows and turning off the television.
To help conversations flow more smoothly, you can use conversation prompt cards, that your loved one can hold and keep referring back to if they lose track of what they were talking about. These could contain special memories that you both hold dear, or simply random words to help trigger conversation.
A note on taking time…
Witnessing your loved one’s concentration ebb away over time can be deeply upsetting, especially if you’re used to them being razor-sharp, witty and full of life. While lack of concentration can be very disrupting to daily life – especially if things get damaged, or people hurt themselves – you must remain patient. Getting cross or irritated by lack of concentration is easy, but remember, the person has no control over the changes to their brain, and needs your reassurance and patience more than ever.
Related article: Dementia and feeling confused