Over the past year, we have worked with many families at Homewatch who are caring with a loved one with Dementia and Alzheimer’s. In our work, we have identified a few common themes related to care challenges and their loved one’s behavior that I wanted to share with you here. And more importantly, provides some helpful “Dementia Care Do’s & Don’ts”.
COMMON SITUATION #1: AGGRESSIVE SPEECH OR ACTIONS
Examples: Statements such as “I don’t want to take a shower!”, “I want to go home!”, “I don’t want to eat that!” may escalate into aggressive behavior.
Explanation: The most important thing to remember about verbal or physical aggression, according to the Alzheimer’s Association, is that your loved one is not doing it on purpose. Aggression is usually triggered by something—often physical discomfort, environmental factors such as being in an unfamiliar situation, or even poor communication. “A lot of times aggression is coming from pure fear.”
DO: The key to responding to aggression caused by dementia is to identify the cause—what is the person feeling to make them behave aggressively? Once you’ve made sure they aren’t putting themselves (or anyone else) in danger, you can try to shift the focus to something else, speaking in a calm, reassuring manner.
DON’T: “The worst thing you can do is engage in an argument or force the issue that’s creating the aggression.” Don’t try to forcibly restrain the person unless there is absolutely no choice. This is so important! Most professionals agree the best way to stop aggressive behavior is to remove the word ‘no’ from your vocabulary.
Common Situation #2: Confusion About Time or Place
Examples: Statements such as “This isn’t my house,” “When are we leaving? Or “Why are we here?”
Explanation: Wanting to go home is one of the most common reactions for an Alzheimer’s or dementia patient living in a memory care facility. Remember that Alzheimer’s causes progressive damage to cognitive functioning, and this is what creates the confusion and memory loss.
DO: There are a few possible ways to respond to questions that indicate your loved one is confused about where he or she is. Simple explanations along with photos and other tangible reminders can help, suggests the Alzheimer’s Association. Sometimes, however, it can be better to redirect the person, particularly in cases where you’re in the process of moving your loved one to a facility or other location.
The better solution is to say as little as possible about the fact that they have all of their belongings packed and instead try to redirect them–find another activity, go for a walk, get a snack, etc., suggest the experts. If they ask specific questions such as ‘When are we leaving?’ you might respond with, ‘We can’t leave until later because…’ the traffic is terrible / the forecast is calling for bad weather / it’s too late to leave tonight.”
DON’T: Lengthy explanations or reasons are not the way to go. You can’t reason with someone who has Alzheimer’s or dementia. It just can’t be done.
COMMON SITUATION #3: POOR JUDGMENT OR COGNITIVE PROBLEMS
Examples: Unfounded allegations: You stole my vacuum cleaner! Trouble with math or finances: I’m having trouble with the tip on this restaurant bill. Other examples include unexplained hoarding or stockpiling and repetition of statements or tasks.
Explanation: The deterioration of brain cells caused by Alzheimer’s is a particular culprit in behaviors showing poor judgment or errors in thinking. These can contribute to delusions, or untrue beliefs. Some of these problems are obvious, such as when someone is hoarding household items, or accuses a family member of stealing something. Some are more subtle, however, and the person may not realize that they are having trouble with things that they never used to think twice about.