Over the past few months, our daily habits have changed drastically to prevent the spread of COVID-19: We have been advised to wash our hands frequently, sanitize everything we buy, stay 6 feet away from others and stay home.

But for those dealing with dementia, these new precautions can be confusing, frustrating and difficult to remember.

Individuals who have dementia or Alzheimer's disease rely on routine and can get easily agitated and paranoid when they are confused. Now faced with drastic changes to their normal schedules, such patients may be at higher risk of contracting COVID-19, as they may forget the guidelines intended to protect them. The Centers for Disease Control and Prevention has listed people age 65 and older — the same demographic Alzheimer's disease typically affects — as being at high risk of contracting the virus.

On Friday, the Alzheimer's Association was joined by Waterford and Groton Town police, Groton Senior Center and Groton Parks and Recreation Department for a virtual panel called "We're All In This Together" that offered tips and advice for those living with loved ones with dementia. U.S. Rep. Joe Courtney, D-2nd District, was supposed to join the call but couldn't because of technical issues.

Kris Sortwell, regional director of the Alzheimer's Association, said that caregivers for people with dementia should expect that their loved one may experience a range of emotions and behaviors as they try to navigate a "new normal" that they may not understand.

"Even for a person with a healthy brain, it's tough for us to remember and it's frustrating for us to have to wash our hands and wipe everything down," Sortwell said. "For individuals who have this disease that's breaking down their brain, it's going to cause frustration even faster — they will become frustrated that they need to wash their hands again when they just washed them, that they can't go to the store when they used to go every Thursday, that their grandchildren can't visit."

"As the structure breaks down, the confusion increases and with it come the outbursts, the paranoia and the frustration," Sortwell said.

The Alzheimer's Association recommends implementing more reminders, such as hanging up notes on important hygiene practices, including washing hands with soap for 20 seconds.

Whether an individual has always lived with their family, or has recently been pulled out of a nursing or retirement home to be in a safer environment during the pandemic, behavioral challenges can be just as frustrating for caregivers, according to the Alzheimer's Association.

Tomi Stanley from the Groton Senior Center said that individuals with cognitive issues might "shadow their loved ones" — or follow them around — when they are stressed or upset, because it helps them feel safe. This can be frustrating for a caregiver when they're trying to complete daily tasks.

Stanley said the best way to cope with this behavior is to have them join in. "Allow them to help, make breakfast together and let them stir the pancake mix," she said. "Let them pick out their own outfits in the morning."

Stanley advised that making activities more fun or enjoyable can help ease their loved one's stress.

"When they need to bathe, instead of a shower offer a bubble bath," she said. "And don't sweat the small stuff. If they want to wear mismatched socks, let them; it's not going to hurt anybody."

Stanley said that keeping a routine is very important — it helps a person be less confused if they eat and bathe at the same time every day. Regular fresh air and exercise are important ways to structure time outside and can reduce risks of wandering.

During a time when social distancing and staying home are vital to public safety, the risk of a person with dementia wandering off alone is even more concerning. Due to a stark change in routine, it can, unfortunately, be more likely.

"With this disease, the more confused someone gets, the more that they aren't using their brain," Sortwell said. "When they don't have structure and when they're confused, their risk for wandering increases."

If a person with dementia normally attends a day program that is shut down because of COVID-19, they may not understand why they aren't going to that program every day and wander out of the house because they're used to leaving at that time. If they have in-home caregivers who normally take them on walks, or to the park, they may walk off because they are used to that caretaker being with them. And when they're reprimanded for these behaviors that they conceive as normal and are told to stay inside instead, their confusion may manifest in a variety of emotions.

Over the last few months, Waterford and Groton Town police have implemented new programs that help families prepare for crises, such as a loved one with dementia wandering off or having an outburst. By communicating with police ahead of a crisis, caretakers will better prepare first responders to help in a way that will keep people with dementia safe and feeling secure.

Jessica Patterson, community outreach coordinator for the parks department, said the best thing caregivers can do is be proactive: Call your local police department ahead of time and make them aware of your loved one's cognitive issues. If you do have to call police in an emergency, the first thing you should do is alert them that your loved one has dementia, she said.

Officer Heather McClelland of the Groton Town police on Friday discussed the cognitive safety and awareness program that the department rolled out a few months ago, following the lead of the Waterford Police Department.

In addition to ensuring that first responders are trained in how to work with individuals who suffer from dementia, the program encourages a proactive approach for caregivers. Families have the opportunity to provide police with details about their loved one that might be helpful in an emergency.

"Doing that helps us in making sure officers responding have information about the person, whether it be a nickname or something in their past that might be a good connecting piece that we can use," McClelland said. "The more information we have ahead of time, certainly the better we are prepared."

Lt. Marc Balestracci of Waterford police stressed that it is helpful to call ahead of time instead of in a critical moment. If police are notified in advance, they can have a file prepared for the individual that tells responders how they should interact with them.

"You can provide details such as what triggers your loved one, what their diagnosis is and how they look at law enforcement, whether they like us or not," said Balestracci, who also suggested families have two recent photos ready to provide and something with a scent that is familiar to their loved one, like a pillow case.

Both departments agreed that if caregivers notice a family member with a cognitive issue has left home unattended, police should be alerted right away.

Even if a person with dementia doesn't wander, increased confusion still can put them at risk in their home — especially if they are staying in a new environment due to the pandemic.

Caregivers should take steps to make sure the environment is safe by securing tools and sharp objects; keeping medications in locked drawers or cabinets; and putting alarms on windows and doors.

Chemicals and cleaning supplies also should be secured, as people with dementia can often confuse safe and unsafe items with similar packaging, such as lemonade and lemon-scented cleaner, and all weapons and guns should be removed or disabled, as dementia can cause a person to think that a person familiar to them is an intruder.

During the pandemic, it is also critical that caregivers ensure the safety of their loved one by developing a "plan B" for an alternative caregiver in the event that the primary caretaker gets sick. Caregivers should a prepare a list of medications, doctors and routines available in case someone needs to take over, Sortwell said.

For those living in nursing homes or retirement communities, the Alzheimer's Association advises that family members ask what the facility's safety precautions are: ask if workers are wearing masks, how they're practicing social distancing and how they can keep in touch with loved ones through windows and on virtual calls. Families should expect loved ones with dementia to be overwhelmed by changes — they may wonder why everyone on television news is wearing masks or be overwhelmed by new technology and virtual communication. They may get upset and won't understand why visits take place through a window instead of in person.

Panelists on Friday reminded caregivers to reach out for help.

Navigating these changes and challenges can be stressful and guilt-inducing for caregivers, Patterson said. "Make sure that while you're staying physically distant that you're staying socially connected," she said, adding that that virtual support groups are available.

The Groton Senior Center is offering a variety of classes over Zoom to help people stay connected. The classes are being held twice a week and will include music, trivia and exercises, Stanley said.

Despite the restrictions in place due to COVID-19, the Alzheimer's Association is "still in full force, we are just as passionate," Sortwell said. "We are all here for you and your communities. If you could get it (a service) before, you can probably get it right now virtually, and if we weren't doing it before, we're open to doing it now."

The association offers a 24-hour hotline that provides help and resources to caregivers: 1 (800) 272-3900.

t.hartz@theday.com