My loved one has behaviors associated with Dementia! How do I handle it?
What are dementia behaviors?
A person with Alzheimer’s or another type of dementia may become irritable and even and sometimes aggressive without provocation. They may show some confusion and disorientation or manipulate others. Here are examples of dementia behaviors:
This behavior includes being mean, lashing out, or being non-compliant such as “I don’t want to take a shower!” or “I don’t want to eat that!” Sometimes it can escalate to physical violence.
This could mean saying phrases like:“I want to go home!”“This isn’t my house.”“When are we leaving?”“Why are we here?”It is normal for individuals to have some paranoia and frequent mood swings which often result from a person with dementia feeling confused.
This can include unfounded accusations such as “You stole my keys!” Struggling to balance a checkbook or forgetting to turn off the stove can be the result of dementia. Other examples include hoarding, and repeating statements and tasks.
Persons with dementia will sometimes use manipulation to get what they want. A person with dementia may say things like “You told me I could leave the house,” or use bargaining such as “If you let me use the car, I will take my medicine.”
Tips for dealing with dementia and difficult behaviors: Managing dementia behaviors may be difficult, but it’s not impossible. Your words, affect, and responses have the power to quickly deescalate difficult situations.
There are best practices for calmly and effectively dealing with these four common types of dementia behaviors:
1. How to handle an aggressive or combative loved one;
A lot of times, aggression comes from the underlying feeling of fear. It is very difficult for individuals with dementia to intepret events accurately or to understand and process their emotions and feelings. People with dementia are more apt to hit, kick, or bite in response to feeling afraid.
Do: The key to responding with care to aggression caused by dementia is to try to identify the cause. What are the underlying causes of this behavior? All behaviors have meaning. What is the person feeling to make them respond aggressively?
Is pain occuring?Is their mind wandering aimlessly?Is something in their environment triggering a behavior?This when it is good to remind yourself about who your loved one really is. You know your loved one, and you are aware of bothersome behaviors that set them off. Likewise, touching him or even to tring and hold his hand rub his arm or leg — might result in him taking a swing. The best course of action is to walk away and let him have the space he needs.
Don’t: The worst course of action you can do is force the issue that’s creating the aggression. Don’t try to forcibly restrain the person unless there is absolutely no choice.
2. How do I manage questions and confusion?
Do: The APA gives the following tips:Communicate with simple explanations. Use photos and other tangible items to help explain situations, remain calm and supportive, and don’t take their confusion personally. Use tools such as alarms, calendars, and to-do lists to help them remember tasks.Don’t: Trying to use lengthy arguements and lectures don’t work. Remember that the most important this you can do is help your loved one feel safe, even if that ends up being a lie. You can’t reason with someone who has Alzheimer’s or dementia. The disease affects parts of the brain that assist with reasoning. It just can’t be done. A lot of times, we’re receiving the response we’re getting because of the questions we’re asking.
3. How to help with poor judgment
The deterioration of brain cells caused by Alzheimer’s disease leads to poor judgment and errors in thinking. Some of these symptoms are apparent such as hoarding household items, accusing a family member of wrongdoing, or forgetting how to do daily tasks. These tasks can include balancing a checkbook or dressing appropriately.
Some signs are more subtle, making it difficult for your aging loved one to realize they’re struggling. You may need to do a little investigating to find out if your are curious. Take a look at the bills. Payments will often be delinquent, or bills aren’t being paid.
Do: A caregiver can often minimize frustration and embarrassment for dementia patients by:
Listening and offering help:Work together to fix a problemSimplifying a task or routine by breaking it down into smaller steps. If you can offer your ear to your loved one, they will often acknowledge they are having a difficult time and will often ask for some assistance. Go lightly initially, and assist in anyway they are willing to allow you to. From there, you will gradually be able to gain more control over assisting your loved one.
Don’t: Questioning the person’s ability pr reprimanding them isn’t helpful. You may risk alienating them. They may interpret your behavior as accussing or doubting their ability to handle their own affairs. This will lead to anger and put them on the defensive.
4. How do I deal with manipulation?In certain stages of the diagnosis, your loved one may have lost the ability to distinguish between truth and falsehoods, and they may no longer have a sense of morality around lying. As a caregiver, you may feel that you have lost all ability to deal with your loved one's personality changes. In fact, a person with dementia may not realize they’re lying. See manipulation as the root behavior for trust, control, and security. When your loved one is manipulating you, they are trying to use the coping skills left to get their needs met, in an albeit difficult way.
If you see manipulation, try to identify the person’s need and work together to find a solution. Perhaps the trigger is driving. If your loved one wants to drive but isn’t able to, try to find other ways to make them feel independent. Give them some kind of control, even if it is small and insignificant to you.
Remember that the behior is not your loved one. Separate the behavior from the person, and do not hold it against them. Set limits with your loved one when possible, communicate expectations clearly, and work together to find a resolution when you’re able to. Work to be mor conscious of your reactions and triggers. Do you feel angry, hurt, or frustrated? If so, do you act on these emotions around your aging family member? Acting out toward your family member can bring more distress to an already stressful situation. Don’t:
Try to prove a point to your loved one by bring up events to prove or disprove statements. Use accusatory language such as “you’re lying” or “you’re being manipulative”;Engage in heated arguments;Caregiving for a person with dementia can cause burnout and trauma. Don't hesitate to find a caregiver support group, counselor, friend, or family member can offer support and advice.
How to help someone with dementia'
Although there are no treatments to stop dementia, there are medications, dementia therapies, and memory care communities that may help. Written By Kert Kennedy LCSW with references to APA Article below Living Well With Dementia, American Psychological Assocation, https://www.apa.org/helpcenter/living-with-dementia