Redirecting a Loved One With Dementia

Alzheimer's disease and dementia, which affect memory and other cognitive abilities, can create anger, anxiety, confusion, and fear for a person living with the disease. It doesn't help that explaining and reasoning with a person with dementia probably won't ease their frustration.

An approach called "redirection" frequently helps. Redirection is a technique that is used to shift a distressed person's attention away from the situation that is causing anger, anxiety, fear, or dangerous and unsafe behavior to a more pleasant emotion or situation.

How to Redirect

It's happening again. Even though you've explained many times to mom, who has dementia, that she can't call her sister Marie, who passed away five years ago, mom insists on calling her right now.

To make matters worse, she's become agitated, even paranoid. "What have you done with Marie? Why won't you let me call her?" mom asks. At this point, you are at a total loss as to what to do to calm her down.

When a person has dementia, he or she is unable to process information like they used to. That's because dementia's impairments aren't restricted to memory loss. Those diseases also compromise the "executive functioning" capabilities of insight, judgment, and reasoning. As a result, your loved one with dementia can be incapable of telling the difference between a hallucination and reality. Trying to explain why that person's perceived reality isn't true is pointless. Such an explanation can escalate already strong emotions.

Steps to Consider When Redirecting

It is possible to find ways to still stay connected to your loved one with dementia so they don't feel that you're trying to bully or push - which can easily backfire. Instead, try to understand that your loved one's anxiety, fear, or other emotion probably stems from frustration or feeling out of control. For example, a person with dementia may ask the same question again and again because they have trouble processing the answer.

Fortunately, redirection can sometimes alleviate frustration for both the person with dementia and their family caregiver.

The following tips provide advice on how to redirect a loved one with Alzheimer's or dementia:

• Assess the environment. Is the room too hot or cold, but your loved one can't find the words to express that? Is the space calm and comforting or noisy? Sometimes, it's the environment itself that needs redirection.
• Don't try to explain or reason. If mom keeps pushing furniture against a door and insists that someone is trying to break in, explaining that no one is attempting to get in probably won't ease her fear. Instead, try responding to the emotions behind the actions. You don't have to say, "I believe this is happening," but you can say, "I'm so sorry this is happening to you." You might also say, "Mom, I really want you to feel safe. How can I help you feel safe?" In this scenario, you realize what is causing your loved one's agitation and redirect her feelings from a place of insecurity to one of security because she feels like you finally believe her and are on her side.
• Go outside. Try to step outside for some fresh air and a change of environment if you can. Light and sunshine are healthy and help redirect the brain.
• Keep it simple. Try to keep conversations simple and direct. For example, if the person resists bathing, instead of saying, "I need you to come to the bathroom so you can take a bath and shave and I can wash your hair," a simple "Dad, we're going to the bathroom" is easier to comprehend. Asking for one thing at a time helps keep things simple.
• Use bridge phrases to put the focus back on the person. If Mom won't eat and says she's not hungry, you don't have to push. Instead, try a 'bridge phrase' that moves the conversation to a different place. For example, you can tell Mom how much you always loved her fried chicken and ask her if she remembers how the house used to smell while it cooked or how she prepared the meal. Then a little later, maybe return with, "hey, how about we both have a bite of this sandwich?"
• Use touch to calm and focus.
  Not everyone with dementia feels comforted by touch. However, if the person is okay with it, touching that person's arm or shoulder or gently hold their hand can be comforting and grounding. With redirection, keep in mind that one technique may work fine one time but not the next, so it's a good idea to have several options on hand. The whole idea of redirection is that you want the person to feel cared about and listened to and make sure they're in a safe situation.

Need more advice? Our professional memory care team can answer your questions and help you navigate your situation.

Learn about our Alzheimer's, dementia, and memory care services in Eau Claire.