Saturday, 21 September 2013

Review: Day clocks for people living with dementia

On my other blog about creating a day clock for dementia using a digital photo frame, there have been quite a few comments regarding day clocks for people living with dementia. I’d therefore like to take the opportunity to review some of the various types of day clocks available.

The concept of the day clock is nothing new. Long case clocks (grandfather clocks) have had sun and moon phases for quite some time, and the basis of a day clock is exactly that.

Before we had clocks, we had sundials, from a basic stick or stone in the ground, to the more complex gnomon based variety. These would give a fairly accurate indication of the time of day, whilst the sun was visible – morning, afternoon and evening. Night was quite naturally the absence of the sun altogether.

Thus the entire concept of the day clock can be traced back to when man first pushed a stick into the ground, and started to measure the time of day, from the shadows cast by the sun.

With the likes of Stonehenge, the whole concept took on a completely different purpose, but it would still measure time.

Night and day is quite easy to define (unless you are located nearer to the North or South poles, and within the Arctic or Antarctic circles), although each part of the day lengthens or shortens, depending upon the time of the year.

We are all used to the concept of day and night, and have been for millions of years. Yet, within our modern world, with electric lighting, we can extend or shorten these periods to suit our needs. For someone living with dementia, this can cause problems.

Therefore another way of indicating the time and period of the day, may, and I reiterate the word MAY, be helpful.

There are a number of day clocks aimed at people living with dementia, including my own free version for use with digital photo frames. The principle is similar in all cases.

There are analogue versions, some of which are essentially a modern version of the long case clock, showing night and day phases. These are easily recognisable, but their usefulness is questionable, especially as the clock face, unless illuminated, is not visible at night.


Other analogue versions have only one hand, and rotate on a weekly basis, showing the day of the week, and the day subdivided, in most cases, into day and night. The problem with these is that they have to be “learned”, they don’t follow the basics of a normal analogue clock. Again their usefulness is questionable.

Then there are analogue “digital” clocks with an alphanumeric display, showing time, day and often month. These are essentially analogue “digital” clocks re-marketed as dementia clocks, in order to try to enter a perceived, yet un-researched, market.

There are also true digital versions of the same clocks, either with an LED or LCD display, yet again, these are standard clocks remarketed to try to enter the “dementia” market.

Other day clocks

The first I will mention is that developed by BIME. Essentially, like my version, it is based upon a digital photo frame, in this case adapted to be used specifically as a dementia day clock. The display is basic, with a simple text message such as “Now it’s Tuesday Afternoon”, in white on a black background. BIME claims that “Now it’s” proved to be the best understood message.

Feedback from my own blog, would tend to indicate that “Now it’s” or as in my version “It is now” are actually superfluous, so I will be producing a simpler set of files in the very near future.

Another clock, somewhat dubiously marketed as a clock suitable for people living with dementia (DayClox), is in essence a standard digital clock, based upon a digital photo frame, and providing no further information than that found on any other standard digital or indeed analogue clock.

Finally, there are two further versions. My own, and that of Zeezap. Both use text and images to indicate the period of the day. My own uses, and earlier versions of Zeezap used, real images to portray the period of the day. Zeezap however, has now moved to simplistic, almost nursery type images, spoiled by the overuse of Photoshop effects in order to get the message across.

I’m trying not to be overcritical of Zeezap, in favour of my own system, however, the use of all upper case letters decreases legibility of the message, especially for older people with visual impairment.

As a graphic designer, I’m only too aware of the importance of the use of upper and lower case lettering when it comes to legibility, and would refer to the designs of Jock Kinneir and Margaret Calvert for British motorway signs, where legibility at high speed was important. They used upper and lower case, a standard which, including the typeface, has since been adopted in many parts of the world.

Many claims have been made regarding day clocks for people living with dementia, and many of those clocks marketed as such can prove to be an expensive waste of time. My own version works for my Mother, and may indeed work for others.
If you are a carer/caregiver for someone living with dementia, then try one of these clocks by all means. It may well prove helpful, especially where there are cases of sun-downing. I would however recommend that a certain amount of experimentation is carried out first, especially before spending money on something that may prove to be totally useless. Not one person living with dementia is the same as another, however, the companies marketing these devices would have you believe otherwise.

Saturday, 7 September 2013

Dementia - eating and drinking

Many of us know how hard it can be, trying to persuade someone living with dementia to eat and drink sufficiently. It’s been quite a few months now since Mum came out of hospital after a serious UTI, but during those months, I’ve experimented with a wide variety of foods, from ready-meals to full blown home-cooked dishes.

The results have been quite conclusive, and ready-meals hardly feature at all. I’ve tried finger foods, but Mum is easily distracted, and tends not to eat as much as she should.

Knives and forks are out, as food ends up all over the place, and not in her mouth. Her co-ordination with any form of eating utensil is clumsy to say the least.

Persuading someone with dementia to drink is also a problem. The solution here is simple - foods with a high liquid content. Cereals, with plenty of milk, for breakfast, and soups or other high liquid content foods for lunch. I tend to opt for the higher fibre soups containing beans or lentils, although I also use Baxter’s Mediterranean tomato soup, which has a high tomato and vegetable content. Food with a higher fibre content, aids digestion, and helps to avoid constipation.

Heinz now produce a five bean version of baked beans, in their Snap Pots range, and these have proved very successful alongside soups. Beans, as we know, are high in protein and fibre, and the Heinz Snap Pots Five Beanz contain Kidney beans, Haricot, Pinto, Borlotti and Cannellini beans.

OK, so we’ve sorted breakfast and lunch, but what about dinner? After many months of experimenting, I’ve started to compile a list of home-cooked dishes that Mum will eat, with no problem. I have to add at this point, that due to co-ordination issues, I generally spoon feed.

Nasi Goreng

I have produced a concise list (more will be added later) of dishes that Mum will eat, with little or no encouragement. Wherever possible, I try to avoid the use of prescription food supplements such as Fortisip or Calogen. The dishes are varied, and quite cosmopolitan, offering a variety of ingredients and flavours. Thus far, the list consists of the following:

1. Cottage Pie – this is the one and only ready-meal to feature as, to be honest, it’s easier and cheaper in this form - served with a variety of fresh vegetables, primarily broccoli, spinach, cabbage or Brussels sprouts, and gravy.
2. Bangers (sausages) and mash, again with a variety of vegetables, and onion gravy.
3. Chilli con Carne with rice, and plenty of red kidney beans.
4. Spaghetti Bolognese, with added tomatoes and basil.
5. Bauernfruhstuck – Farmer’s Breakfast, a sort of German bubble and squeak, made up of diced potato, bacon or ham, onions, eggs and parsley.
6. Nasi Goreng – an Indonesian fried rice, containing meat (usually chicken, although, I often use bacon lardons), prawns, leeks and rice, using Sambal Oelek (Indonesian and Malay chilli sauce, although Thai Red Chilli sauce can be used as a substitute), topped with a fried egg.
7. Cheese and mushroom omelette.

Of course each individual has a personal taste and preference, but variety, as the saying goes “is the spice of life” (excuse the pun). Finding meals that are acceptable and enjoyable, as well as being nutritious is, of course, paramount.

By using meals that have a higher than average liquid content, helps overcome some of the drinking issues faced by care givers of those living with dementia. Without them realising, they are taking on more liquids, helping to counter their unwillingness to drink sufficient fluids.

Drinking is of course still to be encouraged, in order to avoid a variety of problems, including dehydration and potential UTIs. Again, it’s a matter of finding what they will and will not drink. Mum will often drink tea, but not always in sufficient quantities, she is, however, quite partial to apple juice and grape juice, so that helps. Ice cream (of the diabetic type if needed) and yoghurt are also useful for introducing extra fluids. Of the flavoured varieties of yoghurt, I generally favour the Raspberry flavour, as this tends to be higher in fibre than other flavours.

Getting someone living with dementia to eat properly can be difficult. Taking both nutrition and variety into consideration, and then experimenting can help both the caree and the caregiver. Mealtimes become less fraught and more enjoyable for both.

If you have other suggestions to offer, please feel free to share them here.