Caring for someone with mid-to-late stage dementia can be challenging to say the least. Progressive dementia is full of life-altering changes, and everyone experiences them differently. When people experience confusion, communication difficulties, or the loss of memories, challenging behaviors may arise as they struggle to cope with a new normal. When someone you love is exhibiting unusual or difficult behavior, it’s helpful to know how to respond. Here we will review the most common behaviors and the do’s and don’ts for handling each.
You may notice that your senior is having difficulty making good decisions when it comes to spending money or completing tasks such as balancing a checkbook.
Don’t: question their ability to handle the task at hand. Doing so can cause feelings of embarrassment or frustration and could lead to aggression and anger.
Do: offer structure and supervision. Help by offering solutions. One example would be a senior who has issues with spending money. They may give donations to every charity that calls or say yes to a home repair company when asked if a new roof or windows are needed. In a case like this, it may be necessary to change phone numbers or block unwanted calls. Another solution could be to arrange with the credit card company to decline sales over a certain amount. It is helpful when a person other than a family member is telling them the sale is not approved and the purchase won’t happen that day, leaving time for a discussion to be had.
A person with dementia may repetitively ask the same question. Chances are they are looking for some comfort or to relieve stress they are feeling about the situation. The Alzheimer’s Association offers some good insight as to the causes of repetition and how to respond with care.
Don’t: get angry or show resentment.
Do: practice patience and redirect the conversation. For example, if your senior is repetitively asking your name, you could answer the question a few times. However, if it’s the third time being asked, you may say something like “You know, I often have a hard time remembering people’s names too. Sometimes, my friend’s name is on the tip of my tongue, but I can’t remember what to call her.” You may be able to offer some reassurance they are looking for and be able to have a very positive conversation about it. Redirecting the conversation is a good way to keep the frustration to a minimum.
Time and space disorientation
Perhaps your senior is talking as if someone that has passed is coming to visit or as if they are reliving their childhood. Sometimes your senior may mistake you for someone from their past, such as their daughter or their mother. Another common space disorientation is that they want to go home. However, the place they are in isn’t registering that it is their home.
Don’t: correct them by insisting on the reality.
Do: enter their reality, not necessarily in a way that is deceitful, but by talking about the person, they are remembering. For example, instead of saying “Dad’s been gone for 20 years.” You could say “Dad’s such a great storyteller, what’s your favorite one?” If they are insisting on going home, perhaps taking them out of the situation for a moment would help. Take a walk outside or into another room, or to the kitchen for a snack—then when they come back to the more familiar living room, they may recognize it as home. The disorientation will pass. Arguing with them could move them into feelings of frustration and anger.
Aggression and mood swings
Communicating with someone who has dementia can be uncomfortable if they are expressing signs of aggression or mood swings.
Don’t: engage in an argument or correct everything they say to you. Remember it is not the accuracy of the statement that is important; it is the feelings they are trying to communicate.
Do: remain calm and offer a distraction. When someone is displaying signs of aggression or hostility, prevention is the best cure. Learn to recognize the triggers and avoid them. Sometimes all it takes is just leaving the room briefly. We had a client once who became angry and said he was going to leave. When he sat down to put on his shoes, we quietly left the room. A few minutes later we returned to find he had one shoe on and one shoe off. He had become distracted by the TV and had completely forgotten what he was doing. We asked him if he wanted to put his feet up since he was taking off his shoes. A distraction is often helpful when someone is going into an angry state.
Caring for someone with dementia can be confusing and sometimes frustrating, and it requires compassion. Knowing the right strategies to use, and which to avoid, can make your experience and your loved one’s experience much easier and delightful. At Shepherd’s Staff In-home Care, we train our caregivers on the best way to handle clients with dementia, and we can counsel family members, as well. To discuss the particulars of your loved one’s care, please contact us today and speak with one of our staff members.