Caring For A Dementia Patient At Home
The challenges families deal with when they care for a dementia patient are at times frustrating, confusing and heartbreaking. You may ask yourself how can we make this easier? What do I need to do at home to keep my loved one calm and safe? A clinical nurse educator and dietician with Chapters Health System and explain 10 important tips for family.
Shadowing In Alzheimers Disease
It is thought that the dementia patient does this because they have a fear of being alone. How do I know this? Because I have done this on many occasions. An out-of-proportion fear overwhelms me when my wife Phyllis June is out of sight.
You may read suggestions on how to stop shadowing, but thats all they are: suggestions. What you are essentially doing is trying to get a person with a progressive brain disease to realize that what they are doing is unnecessary and has to stop.
In short, good luck with that. Whatever behavior your loved one may be exhibiting, you can be sure that they are doing this unknowingly. In other words, it is likely completely involuntary. They do not wake up in the morning with a plan to follow you around all day. That simply does not happen. In order to do this, they would have to have the ability to plot and execute such a plan. Most dementia patients who display problematic behaviors no longer have these capabilities.
The very best advice I can offer caregivers who are struggling with dementia behaviors is to find a way to personally cope with the frustration. Changing your own perspective is within your control, trying to change these behaviors is nigh impossible. Please understand that Im strugglingits not just my behaviors. As a dementia patient, my whole world is beginning to feel completely out of my control.
Common Causes Of Aggression
Aggression can stem from:
- Confusion. When a senior is feeling disoriented and scared, they may act out with aggression.
- Physical pain or another unmet need. When a senior cant verbalize or address needs such as hunger, thirst, or pain, its common for frustration to build, Hashmi says.
- Emotional pain. Sometimes, agitation can be a sign that someone with dementia feels lonely, depressed, or isolated.
- Discomfort with a specific task. Does aggression come out specifically at bath time, bedtime, or while your loved one is getting dressed? These tasks may be triggers for aggressive behavior.
- Reactions to medications. Has your loved one recently changed medications? Do they experience difficulties with medication management? This might be interfering with their dementia diagnosis, leading to aggression.
- Vision or hearing loss. Issues with vision or hearing can compound the typical disorientation of dementia and can cause seniors to act out in confusion or as a cry for help.
- Sundown syndrome. Does your loved one become aggressive around sunset in particular?
- Fear. People often are confrontational when approached or touched by someone they dont know. For seniors with dementia, who may not recognize caregivers, doctors, and community residents, many daily interactions can alert a fight or flight response.
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Remember: Your Needs As A Caregiver Matter Too
Dealing with dementia behaviors can quickly wear out a caregiver or family member, causing caregiver burnout.
If your loved ones dementia behaviors have progressed to the point where you cannot manage them alone, help is available. Senior care options like home care or memory care can help relieve some of the caregiving burden while also helping to keep your loved one safe.
If you are feeling resentment, anxiety, or depression, seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.
Other families, other caregivers, are going through the same thing, Hashmi says. They have a lot of common challenges and common solutions to share. And often those are the most effective, because theyre going through exactly the same process.
Living With Dementia: How To Talk To A Parent With Dementia
Dementia is a condition that affects nearly 50 million people worldwide. This disease affects a persons ability to remember the people around them and prohibits them from communicating like they once did.
Not only does dementia affect the person that is inflicted with it, but their family members also suffer as well. If your parent has been displaying signs of dementia, you will have to find a new way of communicating with them.
Read below to find out more about how to talk to a parent with dementia.
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How To Handle Seemingly Manipulative Dementia Behaviors
A loved ones dementia-related behaviors can be frustrating and even hurtful for family caregivers to deal with. Its important to keep the following pointers in mind when caring for a senior with Alzheimers disease or another type of dementia.
Common Causes Of Sleep Problems In Dementia Patients
Troubled sleep is thought to be a dementia risk factor as well as a behavioral symptom. Here are some factors that may contribute to your loved ones sleep problems:
- Brain changes. Dementia patients have steeper changes in their brains sleep architecture and their circadian rhythms, causing sleep disturbances.
- Over-the-counter medications. Some over-the-counter medications labeled PM can disrupt sleep by making patients sleep for a bit but then making them more confused or sleepy at the wrong time, Hashmi says.
- Diet. Caffeine, excess sugar , and alcohol can disrupt sleep patterns, Hashmi says.
- Electronic screens. The blue light from a computer, portable electronic devices, and television screens can delay sleep and disturb sleep patterns, Hashmi says.
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Try And Identify The Triggers
When a person living with dementia is confronted with a triggering event, they may begin rummaging or hiding things. Perhaps they do it at a particular time every day when theyre bored or upset.
Adhering to a consistent everyday routine may be beneficial since it provides a flow to your day. In addition, this eliminates the fear and anxiety that might lead to such behaviors.
Identify patterns in their actions to see whether you can find out whats prompting them to hide things.
You might employ diversion techniques such as involving them in a fun activity or providing their favorite food or beverage.
The Effect On Emotions
Although there is a decline in cognitive abilities over time, there is no decline in depth of feeling or the range of emotions that people with dementia experience. Indeed, for many people, emotions appear stronger than ever, and they can express anger, joy, grief and excitement without difficulty. They are also likely to be aware of any emotions expressed by others around them .
Think about your own emotions when caring or providing support for a person with dementia. When you arrive at the home of a person with dementia, are you feeling stressed or rushed after a previous home visit? If so, pause before going into the persons home, relax and smile as you enter. The person will see from your body language and tone of voice how you are feeling. If you are calm, patient, positive and reassuring, you are more likely to be successful in providing help and support.
For more on these sorts of ideas, from the point of view of people with dementia themselves, go to the feature My life is changing because of dementia in the section Getting to know the person with dementia.
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Memory Loss And Distortion
People with dementia tend to have problems with short-term memory. They may remember things from long ago but forget what happened this morning. Memory distortions also occur. People with dementia may confuse people in their memories, or combine two or more memories. Sometimes, they think an old memory is a new one. Memory issues are an early sign of dementia.
Are Seniors With Dementia Capable Of Manipulation
Amanda Smith, MD, medical director of the Byrd Alzheimers Institute at the University of South Florida, estimates that one-quarter of the caregivers she interacts with have concerns similar to Bransfords. Adult children often ask Dr. Smith whether their cognitively impaired parents are being intentionally deceitful or manipulative.
Sometimes caregivers assume that their loved ones are being manipulative because they just cant believe their unusual behavior, explains Dr. Smith. But in reality, people with dementia arent able to think through the complexities required to manipulate those around them.
Eileen Poiley, MS, director of education at the Byrd Institute, notes that short-term memory is the first to go for dementia patients. However, its not uncommon for seniors to develop mixed dementia, which can affect several different areas of the brain and cause a unique combination of symptoms.
For example, with Lewy body dementia, a seniors memory can quickly fluctuate from moment to moment. Their fleeting lucidity may appear as selective memory to outsiders. On the other hand, frontotemporal dementia affects parts of the brain that control ones decision-making, behavior and personality. A senior with FTD may do or say things that are socially inappropriate because their ability to gauge right or wrong is impaired. This might explain why a loved one may lash out and make hurtful statements.
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Turning Points/triggers That Led To This Aberrant Behavior
Doris told her mother they were going to Church
She did not ask her. Martha may not have wanted to go to Church. Many patients with dementia, especially Alzheimer Dementia, prefer to avoid social gatherings or any activity during which they are likely to interact with other people. They are often unable to remember the names of people they know and not able to recognize people they should know. These interactions are often stressful because as far as the patient with dementia is concerned she will be meeting strangers who seem to know her, but she has no idea who they are. Avoiding social gatherings is often one of the earlier manifestations of Alzheimer Dementia, often before the memory impairment becomes obvious.
Could it have been avoided?
As much as possible, patients with dementia should be involved, or at least should feel involved, in the decision-making process. This will make them feel relevant, secure, and needed. Besides, had Martha been asked if she wanted to go to Church, chances are high she would have chosen to stay home and the entire situation would have been avoided.
Doris told her mother to get dressed. She has given Martha an order.
Patients with Alzheimer Dementia often have paranoid delusions. They may misinterpret the actions of others. Martha is annoyed. She feels Doris is ordering her and she does not like to be told what to do.
Could it have been avoided?
Could it have been avoided?
Could it have been avoided?
Could it have been avoided?
Boredom And Dementia Leads To Challenging Behaviors
Many family members who care for a loved one living with dementia experience difficult behaviors. Examples are struggling to get the patient to cooperate with eating and bathing, as well as sundowning-related problems such as agitation, paranoia, repetitive speech, and increased confusion in the afternoon or evening hours.
In a lot of cases, these challenging behaviors are a direct result of the persons unchecked needs surrounding boredom and loneliness, which must be addressed in order to improve their quality of life. Lets review some ways to feed these emotional needs.
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Why Do Dementia Patients Hide Things
Whether you are new to caring for someone with dementia or not, it is fairly well known or will quickly become apparent that they have unique tendencies and behaviors. For many, there is a reasonable explanation, but not for all of them. Hiding things is a common behavior for dementia patients and in this blog post we will explain more about why that behavior exists and what you can and should do to help.
Dont Forget The Children And Teens
With so much focus on the person who has dementia, sometimes younger family members donât get the attention they need, or the illness is not explained in a way they can understand.
Children often experience a wide range of emotions when a parent or grandparent has Alzheimerâs disease. Younger children may be fearful that they will get the disease or that they did something to cause it. Teenagers may become resentful if they must take on more responsibilities or feel embarrassed that their parent or grandparent is âdifferent.â College-bound children may be reluctant to leave home.
Reassure young children that they cannot âcatchâ the disease from you. Be straightforward about personality and behaviour changes. For example, the person with Alzheimerâs may forget things, such as their names, and say and do things that may embarrass them. Assure them that this is not their fault or intentional, but a result of the disease.
Find out what their emotional needs are and find ways to support them, such as meeting with a counsellor who specializes in children with a family member diagnosed with Alzheimerâs disease. School social workers and teachers can be notified about what the children may be experiencing and be given information about the disease. Encourage children and teens to attend support group meetings, and include them in counselling sessions.
Here are some examples that might help you cope with role changes within the family:
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Most Common Symptoms Of Dementia
Dementia is a group of conditions that impact memory, thinking, and social skills. To be diagnosed with dementia, a person’s symptoms have to impede routine functioning and reflect a drastic decline in mental capability. Early diagnosis may help slow the speed at which the condition progresses, but there is no cure for dementia. Treatment and medication may help reduce the intensity of symptoms, but their effect is usually minor.
Household Chores / Everyday Activities
You might assume that household chores are tedious, but for dementia patients, they are rewarding. They help the senior gain a sense of accomplishment and independence. In fact, the person may get agitated if you leave them alone to take care or essential household tasks such as laundry.
If so, try finding ways for the dementia patient to help with the following:
- Folding laundry
- Playing with paperclips
- Shuffling and arranging a deck of cards
The activities above might not always be performed up to your standard by the dementia patient, but he/she will enjoy feeling helpful.
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How Relationships Change
Alzheimer’s disease does not change a personâs need for love and affection, but it changes many aspects of a relationship. You may lose the companionship of someone who has been close and important to you. Youâll need to find different ways to express your feelings.
Alzheimer’s disease can also affect the sexual relationship of partners. It can change a person’s interest in sex, either increasing or decreasing it. This may create a problem. For example, the person may put demands on you for more sex than is wanted.
A person with dementia may be overly affectionate at the wrong time or place. If this happens, explain the disease and its effects to the people involved to help them understand.
You may also find your role in your relationship has changed. Perhaps the person always looked after the familyâs finances and this task has now fallen to you. Making decisions about financial and legal matters may be overwhelming. You may need to ask family members, friends or professionals to help you.
The Alzheimer Society can help donât try to do this alone!
Finding The Right Words
Another impact of dementia is increasing difficulty in finding the right words for things and to express oneself in a clear way. Over time this can result in speech becoming very limited. If by the time you get to meet someone with dementia they have lost a lot of speech, then getting to know them becomes more of a challenge.
If someone you are caring for is struggling to speak or find the right words, listen carefully, be patient and give them time to communicate. Think about what the person is doing or trying to do, the theme of any conversation that has been taking place and look for clues as to what the person is trying to tell you . It is important to be clear about what the person is saying or indicating and not just assume what word or words they are trying to express.
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Bake Their Favorite Dish Or Dessert
People with dementia commonly suffer from depression because they dont know what is going on around them, even forgetting that their loved ones are still there for them. Cooking or baking together can be one of the most therapeutic things to do together, plus allow you to make some old favorite recipes that theyll really enjoy. Or you can bake their favorite dessert or treat that they can smell and taste and have those memories rush back.