Caring For A Loved One With Dementia During Ramadan

You’ll know Ramadan as a time of fasting for Muslims, but it is more than that. It’s about family, community, faith, giving back, learning, and being thankful. However, caring for a loved one with dementia during Ramadan can be challenging.

Ramadan is one of the five pillars of Islam. It’s the holiest month lasting thirty days and means you abstain from eating or drinking from sunset to sunrise. The elderly, the young, ill, travelling, pregnant or menstruating etc are exempt. The same applies to someone living with dementia. But it does depend on your loved one, whether they choose to abstain or not. 

Balancing Act

Our loved ones with dementia may experience difficulties like confusion due to changes in routine and disrupted eating patterns. As a dementia caregiver, our role is to minimise changes and help our loved ones whilst at the same time balancing the physical and emotional demands of caregiving during Ramadan.

Too Fast or Not To Fast!

Fasting is an act of worship and, for most Muslims, a lifelong practice. So your loved one with dementia will want to fast with you, but 

• Check with your doctor if any risks of fasting
• Are there medical conditions that mean fasting isn’t an option? Mum’s a diabetic and can’t, as she’s on medications to manage it. Fasting would cause her blood sugars to go too low. Some people can still fast, check out Diabetes UK factsheet on Ramadan & Diabetes  
• Are they taking medications that need food to be absorbed and therefore can’t fast?
• Is hydration a major issue? e.g in mum’s case she becomes very confused if not properly hydrated, susceptible to UTI, and catheter blockages, so no fluid for most of the day wouldn’t be an option
• A contentious one is whether to tell your loved one that it is Ramadan, I say this with a heavy heart as mum with her health conditions needed to eat/drink but once we mentioned it was Ramadan, she flatly refused, repeating that she was fasting for hours until sunset putting herself at risk last year . Some memories are ingrained so she didn’t forget for that whole day. 

Every loved one with dementia has different needs and capabilities for nutrition and hydration. Assessing these your loved one needs and capabilities is crucial for caregivers to ensure that they meet their nutritional requirements. This may involve considering factors such as the stage of dementia, swallowing difficulties, and dietary restrictions. 

Things to Consider Caring for A Loved One With Dementia During Ramadan

1. Safety – if your loved one does fast, who will support them to make sure they eat, drink and take medications during non fasting hours. Get up at night to eat their predawn meal? Who will monitor them for signs of exhaustion, dehydration and ensure that they rest?
2. If your loved one isn’t fasting, it’s important to maintain their normal eating and drinking schedules. Getting them involved in prepping food and drinks for themselves and for those fasting can help them feel engaged.  
3. Leaving healthy snacks out and drinks for them to help themselves (your loved one may forget they are fasting, so it’s helpful to have items ready) 
4. Going to prayers – do they pray at home or go to the mosque? Risks of falls or confusion increase from dehydration, so ensuring a loved one accompanies them is crucial.  Use technology like Alexa or Islamic Prayer clock to remind them of prayer times.
5. Changes in daily routines increase confusion, so ensure that daily activities are planned, engaging and non taxing. Be aware that increased activity in the evening as you prepare to break your fast could have an impact on sundowning.  Having a quiet room available as you may have more visitors than normal as you break fast
6. Keep an eye on sleep patterns, if like Mum you have disrupted sleep patterns and deal with hallucinations, getting up for the predawn meal may result in sleep problems developing.

Caring for a loved one with dementia during Ramadan requires careful consideration and adjustments to ensure their well-being and comfort. By customising fasting plans, maintaining regular nutrition and hydration schedules, and adjusting daily care routines, you can provide the necessary support to your loved one whether they participate in Ramadan or not.

Things to Consider as a Dementia Caregiver during Ramadan

1. Plan and organise caregiving tasks in advance to ensure that both caregiving and religious obligations are met. Make a checklist of important activities (if like me you get brain fog from low energy in the first few days this can help).  
2. Focus on the essentials daily activities, leave things like cleaning etc & strenuous activities to after you break fast
3. Meal Prep meals will make life easier to break your fast with a nutritious meal at the end of the day, rather than having to cook each day. Meal prep and freeze meals, or cook ahead elements of a meal that can be thrown together, like slow cooked onions, tomato sauce, soups, roast meat/chicken and of course, samosas. I intend to meal prep each week to last for 3-4 days at time, and freeze the extra for the following week. It also means that if your loved one with dementia is not fasting, then they’ll have a healthy meal ready to go. 
4. Shopping – take advantage of home delivery options and save yourself time and energy that can be used on your loved one. Buy the rainbow of foods for hydration and nutrition. Lots of fruits, veg, and carbohydrates to keep your energy up.
5. You’re going to be tired, have less energy & may be frustrated at the beginning.  So make sure to get help from family members or friends to share caregiving responsibilities and provide support during fasting periods.  
6. It’s a great time for self care, as you reflect & become more spiritually aware, make sure that you do take that time to relax.  This is the time to get respite, so take advantage of it. Make sure you’re eating and drinking enough to face each day.

I’m writing this from my experience, and for me the first week is always the most difficult. After that your body and mindset change and accommodate the fasting period. Some people even experience higher energy levels.  Whatever you do, be mindful of your own wellbeing. You can encourage your loved one with dementia to take part in Ramadan activities in a modified manner that works for them.  It doesn’t have to be perfect. Remember that!