Dementia Care Do’s & Don’ts: Dealing with Dementia Behavior Problems

Dementia Care Do’s & Don’ts:  Dealing with Dementia Behavior Problems

Mid-to-Late stage dementia often presents challenging behavior problems. The anger, confusion, fear, paranoia, and sadness that people with the disease are experiencing can be very frustrating for other family members who are trying to cope as best they can.

While frustration can at times seem insurmountable, there are definite strategies that family members can implement when interacting with their loved ones involved with dementia.

Dealing with Dementia Behavior

Communication difficulties can be one of the most upsetting aspects of caring for someone with Alzheimer’s or another type of dementia — and it’s frustrating for those with the disease and for loved ones.

Although it can be hard to understand why people with dementia act the way they do, the explanation is attributable to their disease and the changes it causes in the brain.

Familiarize yourself with some of the common situations that arise when someone has dementia, so that if your loved one says something shocking, you’ll know how to respond calmly and effectively.

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Common Situation #1: Aggressive Actions or Speech

Examples: Statements such as “I don’t want to take a shower!,” “I want to go home!,” or “I don’t want to eat that!” may escalate into aggressive behavior.

Explanation: The most important thing to remember about verbal or physical aggression, says 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.

DO: The key to responding to aggression caused by dementia is to try 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. The biggest way to stop aggressive behavior is to remove the word “no” from your vocabulary.

Common Situation #2: Confusion about Place or Time

Examples: Statements such as “I want to go home!”, “This isn’t my house.”, “When are we leaving?”, “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 community. 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. 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.

One solution is to say as little as possible about the fact that your loved one has all of their belongings packed. Instead, try to redirect them by finding another activity like going for a walk, getting a snack, etc. If your loved one asks 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.” Every situation is different and you have to figure out what’s going to make the person feel safest, even if that ends up being a “therapeutic lie.”

DON’T: Lengthy explanations or reasons are not the way to go. In most cases, trying to reason with someone with Alzheimer’s or dementia is almost impossible and you may actually be triggering a negative response because of the questions we’re asking.

Common Situation #3: Poor Judgement

Examples: Unfounded accusations: “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 judgement 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 he/she is having trouble with things that they never used to think twice about.

DO: First you’ll want to assess the extent of the problem. As an example, if you’re curious and don’t want to ask, take a look at a heating bill. Sometimes payments are delinquent or bills aren’t being paid at all. You may also want to flip through their checkbook and look at the math or have them figure out the tip at the restaurant.

Try to be encouraging and reassuring if you’re seeing these changes happen. Also, you can often minimize frustration and embarrassment by offering to help in small ways with staying organized.

DON’T: What you shouldn’t do in these circumstances is blatantly question the person’s ability to handle the situation at hand, or try to argue with them. Any response that can be interpreted as accusatory or doubting the person’s ability to handle their own affairs only serves to anger and put them on the defensive.

An Introvert’s Guide to Senior Living Communities

An Introvert’s Guide to Senior Living Communities

Introverts Just Want to Have Fun: Alone

Are you or a senior loved one an introvert? If so, you’re probably misunderstood on a regular basis. That’s because people often misjudge an introvert as being aloof or even rude when really…all that person wants is some much-needed time to recharge.

Unlike extroverts, who gain energy from socializing, an introvert actually loses energy with too much special time. You know your drained cell phone starts making that beeping sound when the battery has no bars left? That’s what an introvert feels like after three lunch dates and a movie in one week.

So, to someone not big on socializing, all the activities and people in a senior living community may seem overwhelming. It doesn’t have to be that way though.

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Some time ago, a daughter that was touring The Classic at Hillcrest Greens indicated she was worried that her mother, a lifelong introvert, might be unhappy if her parents moved into an independent living apartment in a senior living community. Several months later, following a move to The Classic, mom is happier and healthier. She still has plenty of time to herself while also choosing to participate in low-key activities like sit-down yoga and Chef Steve’s “From the Kitchen” presentations. “People need to be open-minded,” says Dean Mathwig, Community Relations Director at The Classic. “You need to be open to the possibility that there could be some positive things that will add to your overall quality of life.” For an introvert, there’s no more fearsome image than a peppy activities director rapping on your door at 6 a.m. Fortunately, that’s not the way senior living communities work. “This is your home and communities like The Classic are very limited in what they can share when it comes to your privacy,” says Mathwig. “People have this idea of everything being scheduled as though you’re going to camp, but that’s not reality.”

Are You Searching for a Senior Living Community?

“Each community is different,” says Mathwig. “It’s really up to the person(s) looking to move into a senior living community to ask plenty of questions up front before making a selection. While this strategy is true for anyone, for an introvert, asking the right questions is especially important.” Senior living staff work with all types of personalities, so if you tend to be introverted, you’re most likely not the first they’ve come across. Most communities will typically have some type of policy in place to meet the needs of residents who prefer their time alone. However, it’s always a good idea to make sure of a few things before you sign up to live in a senior living community. “An individual who wants their care to be conducted in a certain way should voice their needs,” says Mathwig. “They can’t assume that the staff will not be able to accommodate their unique needs.” Mathwig recommends asking questions about potential problem areas for someone who’s not a fan of frequent socializing.

Questions to Ask:

  • How flexible is the dining schedule? If you don’t feel like getting dressed for dinner, can you ever have meals delivered to your senior living apartment? If so, is there an extra charge? If your apartment has a kitchen, there may be times you’ll want to prepare your own meals.
  • How can staff ensure my privacy? Find out the system for staff communication about your personal needs. Will staff call or just stop by your apartment? Will staff members ever knock on your door without notice? If any particular method makes you uncomfortable, find out if staff can tweak how they communicate with you to better suit your needs.
  • Is there assigned seating in the restaurant/dining area? Or, can residents sit wherever they wish?
  • What is the policy if I choose not to participate in activities? No introvert wants to be hounded to take part in activities. Assisted living communities offer many types of sessions and social, physical, and spiritual opportunities, but nobody should be forcing you to participate in anything you do not want to be part of.

Settling Into a Ready-Made Community

Some people may not be lifelong introverts but actually became more introverted as a result of isolating themselves after losing many of their friends. When a person is used to only a few social interactions within a social circle they’ve created, it can be challenging to adjust to a ready-made community. The key to making assisted living work for an introvert is establishing boundaries without coming across as discourteous. Try to appreciate how things such as not having to prepare your own meals may allow you more downtime. Keep in mind that you may actually find an activity you enjoy.