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In these situations, you can try to refresh their memories with tangible proof such as pictures or ornaments. Keep your responses short and sweet by diverting their attention, or responding in ways that make them feel safe and understood.
It is advisable to not provide lengthy explanations because it will only lead to greater confusion and frustration on your side as you repeat yourself excessively.
3 useful tips for more effective communication
Communication is a two-way street and requires effort from both parties. Developing an empathetic and open mind when dealing with your dementia parents is key to establishing an effective conversation.
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In June 2021, the U.S. Food and Drug Administration approved Aduhelm for treating patients with Alzheimers disease. Aduhelm is the first new drug approved to treat the disease since 2003 as well as the first to specifically target amyloid-beta – the protein researchers widely believe to play a role in the development of Alzheimer’s.
Things Not To Say To Someone With Dementia
Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.
For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.
1. Youre wrong
For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.
Instead, change the subject.
Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.
2. Do you remember?
Instead, say: I remember
3. They passed away.
Instead
4. I told you
Instead, repeat what you said.
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Deal With Personal Hygiene And Incontinence
Urinary tract infections, incontinence, constipation these are just some issues the elderly have to deal with. Add to that the tendency to forget the need to go to the toilet or even where the toilet actually is, and a person with dementia has even more trouble. Prominently signpost the toilet with a board of some kind, keep the door open for easy access, and ensure the person with dementia has clothes that are quickly removed using a zipper instead of buttons helps. When it comes to personal hygiene, the fear of falling or becoming disoriented might keep someone from washing regularly. Some patients may allow a caregiver to help with this or be present when they are bathing.14
The Three Stages Of Dementia
After dementia is diagnosed, it usually follows a three-stage, downward trajectory.
In mild dementia, people may have difficulty remembering words and names, learning and remembering new information, and planning and managing complicated activities such as driving. They may also be experiencing sadness, anxiety, loss of interest in once pleasurable activities, and other symptoms of major depression.
In moderate dementia, judgment, physical function, and sensory processing are typically affected. This can cause problems with personal hygiene, inappropriate language, and wandering. This stage — when your loved one is able to get around but has poor judgment — is physically and emotionally challenging for the caregiver.
“My dad went from being Mr. Nice Guy to Mr. Obsessed. And things were always worse at night. He was energized and I was physically exhausted,” says Robert Matsuda, a Los Angeles musician who worked full-time and cared for his father with Alzheimer’s Disease for three years before recently placing him in a nursing home.
As a patient moves from mild to moderate dementia, some home modifications that may include removal of throw rugs, installation of locks and safety latches, and the addition of a commode in the bedroom often need to be made.
This is also the time when the palliative care team should be brought in to support the caregiver and help manage behaviors.
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Tips For Those Affected By Dementia
If you have recently been diagnosed with dementia, it is normal to experience a wide range of emotions, such as denial, anger, fear, loneliness, frustration, loss, and/or depression.
Here are some things to keep in mind in order to manage the disease in a way that benefits you and your family:
A diagnosis of dementia does not mean that life is over. It means that there will be challenges ahead, and thinking about those challenges now will help prepare those close to you and benefit all of you in the long run.
Other Factors That Can Affect Behavior
In addition to changes in the brain, other things may affect how people with Alzheimers behave:
- Feelings such as sadness, fear, stress, confusion, or anxiety
- Health-related problems, including illness, pain, new medications, or lack of sleep
- Other physical issues like infections, constipation, hunger or thirst, or problems seeing or hearing
Other problems in their surroundings may affect behavior for a person with Alzheimers disease. Too much noise, such as TV, radio, or many people talking at once can cause frustration and confusion. Stepping from one type of flooring to another or the way the floor looks may make the person think he or she needs to take a step down. Mirrors may make them think that a mirror image is another person in the room. For tips on creating an Alzheimers-safe home, visit Home Safety and Alzheimers Disease.
If you dont know what is causing the problem, call the doctor. It could be caused by a physical or medical issue.
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Do Not Ignore Physical Abuse
As much as one needs to be tolerant, kind, forgiving, and patient with older adults who have dementia, it does not mean that they have to excuse the patients when they become physically aggressive and allow the abuse to continue. It is not to be accepted, and if it happens, it is best to alert your doctor who will work on the solution to make sure it stops. It will keep both the patient and caregiver in safety.
From physical manifestations to angry outbursts, taking care of an individual with dementia may not be easy. However, working with the tips above can help caregivers and loved ones to get through it. Remember that there are plenty of treatments, interventions and special care providers who can help therefore, you should never be shy about getting help when you need it.
Ask Very Simple Questions
Any questions you ask should be easy to understand and answer. Instead of saying, Hi Richard, We were wondering if you might want to take a walk before going to eat your lunch this afternoon? try Richard, can we go for a walk? or Richard, its time to eat. Always address them with their name and allow them a moment to process and react or answer the question. You dont want to overwhelm them with long-winded questions or by asking too many at once.
A great way to continue to promote independence and self-autonomy even as dementia progresses is to offer simple choices. For example, Julio, would you prefer to wear your green shirt or blue shirt today? When you give simple choices, you offer a supportive environment that allows your loved ones with dementia to still have some control over their life.
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Common Changes In Behaviour
In the middle to later stages of most types of dementia, a person may start to behave differently. This can be distressing for both the person with dementia and those who care for them.
Some common changes in behaviour include:
- repeating the same question or activity over and over again
- restlessness, like pacing up and down, wandering and fidgeting
- night-time waking and sleep disturbance
- following a partner or spouse around everywhere
- loss of self-confidence, which may show as apathy or disinterest in their usual activities
If you’re caring for someone who’s showing these behaviours, it’s important to try to understand why they’re behaving like this, which is not always easy.
You may find it reassuring to remember that these behaviours may be how someone is communicating their feelings. It may help to look at different ways of communicating with someone with dementia.
Sometimes these behaviours are not a dementia symptom. They can be a result of frustration with not being understood or with their environment, which they no longer find familiar but confusing.
Make Sure Physical Needs Are Taken Care Of
Sometimes what seems to be the issue is really a symptom of another, underlying problem. If your loved one is experiencing physical discomfort but isnt sure how to tell you , their agitation could turn into aggression. Dr. Beatrice Tauber Prior of Harborside Wellbeing explains, There are many illnesses that can lead to an increase in aggressive behaviors.
If you notice that the usual things that work to calm your loved one are not working, make an appointment to see their medical professional to rule out a physical reason/illness that may be causing the aggressive behaviors, she recommends.
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Try Diverting The Conversation
Keep a photograph album handy. Sometimes looking at pictures from their past and being given the chance to reminisce will ease feelings of anxiety. It might be best to avoid asking questions about the picture or the past, instead trying to make comments: ‘That looks like Uncle Fred. Granny told me about the time he….’
Alternatively, you could try diverting them with food, music, or other activities, such as a walk.
Caregiving In The Late Stages Of Alzheimers Or Dementia
As Alzheimers or another dementia reaches the late stages, your loved one will likely require 24-hour care. They may be unable to walk or handle any personal care, have difficulty eating, be vulnerable to infections, and no longer able to express their needs. Problems with incontinence, mood, hallucinations, and delirium are also very common.
In your role as caregiver, youll likely be combining these new challenges with managing painful feelings of grief and loss and making difficult end-of-life decisions. You may even be experiencing relief that your loved ones long struggle is drawing to an end, or guilt that youve somehow failed as a caregiver. As at the other stages of your caregiving journey, its important to give yourself time to adjust, grieve your losses, and gain acceptance.
Since the caregiving demands are so extensive in the later stages, it may no longer be possible for you to provide the necessary care for your loved one alone. If the patient needs total support for routine activities such as bathing, dressing, or turning, you may not be strong enough to handle them on your own. Or you may feel that youre unable to ease their pain or make them as comfortable youd like. In such cases, you may want to consider moving them to a care facility such as a nursing home, where they can receive high levels of both custodial and medical care.
Connecting in the late stages of care
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Create Time For Reflection
As you are planning activities, it is vital to have some time for reflection.
This is particularly important in the early stages when the person has been diagnosed with dementia since most people usually have a hard time accepting the new developments.
Alter expectations and be ready to deal with fresh challenges with each new stage of the illness. Caregivers also need to find the strength to celebrate successes and mourn losses.
Helping Someone With Everyday Tasks
In the early stages of dementia, many people are able to enjoy life in the same way as before their diagnosis.
But as symptoms get worse, the person may feel anxious, stressed and scared at not being able to remember things, follow conversations or concentrate.
It’s important to support the person to maintain skills, abilities and an active social life. This can also help how they feel about themselves.
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How To Deal With Aggression And Dementia
How To Deal With Aggression And Dementia
Aggression is one of the worst parts of caring for a parent or senior loved one with dementia, but youre not powerless. Having a number of strategies on hand to deploy whenever you need them gives you the means to handle a loved ones aggression any time it rears its head.
Learn more about how to cope with aggression and dementia.
Tips For Home Safety For People With Dementia
As a caregiver or family member to a person with Alzheimers or related dementias, you can take steps to make the home a safer place. Removing hazards and adding safety features around the home can help give the person more freedom to move around independently and safely. Try these tips:
- If you have stairs, make sure there is at least one handrail. Put carpet or safety grip strips on stairs, or mark the edges of steps with brightly colored tape so they are more visible.
- Insert safety plugs into unused electrical outlets and consider safety latches on cabinet doors.
- Clear away unused items and remove small rugs, electrical cords, and other items the person may trip over.
- Make sure all rooms and outdoor areas the person visits have good lighting.
- Remove curtains and rugs with busy patterns that may confuse the person.
- Remove or lock up cleaning and household products, such as paint thinner and matches.
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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!
Stage : Mild Dementia
At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:
- Difficulty remembering things about ones personal history
- Disorientation
- Difficulty recognizing faces and people
In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.
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What To Do If They Refuse To Let Go Of The Idea
Sometimes, your older adult will refuse to let go of the idea of going home, no matter how much you try to soothe or redirect.
If that happens, you might need to agree to take them home and then go for a brief car ride.
Experiment with how long it takes before you can take them home without protest. Or, suggest a stop at the ice cream shop, drugstore, or grocery store to distract and redirect.
If its not possible to actually take them out or get into the car, even going through the actions of getting ready to leave can still be soothing. This will shows that you agree with them and are helping to achieve their goal.
Meanwhile, the activities of getting ready give you more chances to distract and redirect to something else.
Keep in mind that not everything you try will work the first time. And even if something works once, it might not work the next time.
Do your best to stay calm, flexible, and creative this technique gets easier with practice.
How To Deal With Manipulation
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. These symptoms can be especially difficult for a caregiver to handle, as it may feel like a complete change in personality. In fact, a person with dementia may not realize theyre lying.
Manipulation is often the root behavior for trust, control, and security. Sometimes, it can even be a cry for help.
- Set limits when possible.
- Remain aware of your personal responses. Do you feel angry, hurt, or frustrated? Acting on these emotions can bring more distress to an already stressful situation.
DONT:
- Hold dementia behaviors against your loved one.
- Bring up events to prove or disprove statements.
- Use accusatory language such as youre lying or youre being manipulative.
- Engage in heated arguments.
Dealing with dementia behaviors can quickly wear out a caregiver or family member. If you care for a person with dementia and are feeling resentment, anxiety, or depression, dont hesitate to seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.
Although there are no treatments to stop dementia behaviors in the elderly, there are medications, dementia therapies, and memory care communities that may help.
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