Develop Helpful Daily Routines
Having general daily routines and activities can provide a sense of consistency for an Alzheimers or dementia patient and help ease the demands of caregiving. Of course, as your loved ones ability to handle tasks deteriorates, youll need to update and revise these routines.
Keep a sense of structure and familiarity. Try to keep consistent daily times for activities such as waking up, mealtimes, dressing, receiving visitors, and bedtime. Keeping these things at the same time and place can help orientate the person with dementia. Use cues to establish the different times of dayopening the curtains in the morning, for example, or playing soothing music at night to indicate bedtime.
Involve your loved one in daily activities as much as theyre able. For example, they may not be able to tie their shoes, but may be able to put clothes in the hamper. Clipping plants in the yard may not be safe, but they may be able to weed, plant, or water.
Vary activities to stimulate different sensessight, smell, hearing, and touchand movement. For example, you can try singing songs, telling stories, dancing, walking, or tactile activities such as painting, gardening, or playing with pets.
Spend time outdoors. Going for a drive, visiting a park, or taking a short walk can be very therapeutic. Even just sitting outside can be relaxing.
Dont Counter Aggressive Behavior
People with dementia and/or Alzheimer’s may become aggressive in response to the environment. Bath time is often when the aggressive behavior is displayed. The caregivers and/or family member’s approach may also play a part. Rushing, speaking harshly, or forcing a person may result in an aggressive response. When someone with memory loss displays aggressive behavior, it is a form of communication. It may be the only way a person has left to say, Pay attention to me! I don’t want to take a bath! When someone is communicating vigorously, it is the caregivers and/or family member’s job to respect that communication. Hitting, kicking, or biting are ways of saying, stop. The appropriate response is to stop. That doesnt mean not to try again in five minutes or a half an hour.
Resources For Carers Of Someone With Dementia
- an Aged Care Assessment Team â helps older people and carers work out whether they need home-based support or residential care and can provide information on suitable care options and arrange access or referral to appropriate residential or community care
- the Aged Care Information Line â gives support and assistance with queries about access to home and community care, respite fees, and bonds and charges
- Commonwealth Respite and Carelink Centres around Australia â provide information about the range of community-care programs and services available to help people stay in their own homes
- the Carer Advisory and Counselling Service â provides carers with information and advice about relevant services and entitlements.
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Determining The Cause Of The Behavior
Taking the time to listen and assess the situation can help pinpoint the source of anxiety and intent of the behavior. Is there a pattern to the behavior? Has anything changed in the patient’s health, environment, treatment plan, or daily routine?
Ask these kinds of questions when determining the cause of violent behavior and remember: Don’t take it personally. It may seem like the dementia patient is attacking you, but really they are anxious and you happen to be around.
When behavioral disturbances occur, give the person space you may need to leave the room until you’re both calm, according to the Alzheimer’s Society. Showing your anxiety may make the dementia patient more agitated, so make sure you can approach them calmly. Tell the person you can see they’re upset.
Make Time For Reflection
At each new stage of dementia, you have to alter your expectations about what your loved one is capable of. By accepting each new reality and taking time to reflect on these changes, you can better cope with the emotional loss and find greater satisfaction in your caregiving role.
Keep a daily journal to record and reflect on your experiences. By writing down your thoughts, you can mourn losses, celebrate successes, and challenge negative thought patterns that impact your mood and outlook.
Count your blessings. It may sound counterintuitive in the midst of such challenges, but keeping a daily gratitude list can help chase away the blues. It can also help you focus on what your loved one is still capable of, rather than the abilities theyve lost.
Value what is possible. In the middle stages of dementia, your loved one still has many abilities. Structure activities to invite their participation on whatever level is possible. By valuing what your loved one is able to give, you can find pleasure and satisfaction on even the toughest days.
Improve your emotional awareness. Remaining engaged, focused, and calm in the midst of such tremendous responsibility can challenge even the most capable caregivers. By developing your emotional awareness skills, however, you can relieve stress, experience positive emotions, and bring new peace and clarity to your caretaking role.
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Dont Ask A Person With Short
A patient and/or loved one can construe even the simplest of conversation starters as a real question, but they honestly dont know the answer to it. This can be embarrassing and can send them back into a fogthey try their best to give an answer that makes sense to them and often produce immediate physical concerns: I’m having a lot of pain, for example. A caregiver and/or family member might ask, What did you have for breakfast? and the person with memory loss doesn’t remember at all. They might say earnestly, I haven’t had anything to eat for weeks, . So these are questions to avoid because it causes fear for the person, that they have failed. But there things you can talk about
Tips For Communicating With Your Parent
- Avoid power struggles. Dont push, nag or harangue your parents. Making ultimatums will only get their backs up, and yelling, arguing or slamming doors could seriously damage the relationship. Laura Ellen Christian, 15 Expert Tips for When Your Aging Parents Won’t Listen, The Arbor Company Twitter:
- Ask about your loved one’s preferences. Does your loved one have a preference about which family member or what type of service provides care? While you might not be able to meet all of your loved one’s wishes, it’s important to take them into consideration. If your loved one has trouble understanding you, simplify your explanations and the decisions you expect him or her to make.
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Dont Answer Questions Of Patient/loved Ones Regarding Bad Memories
People with Alzheimer’s often ask difficult questions, mostly about people who have passed away years ago. Its not helpful to remind the patient and/or loved one that a person theyre asking about has passed away. Rather than avoid the subject, you can say, He/shes not here right now, but tell me about him/her. Often the person with memory loss is looking for the sensation and security that they would have if their loved one was around.
Caregivers and/or family members should be helping patients and/or loved ones comfortable, safe, and protected. Elderly women, for example, who have had children commonly ask, Where are my babies? This question will often come up at meal time, when feeding the children was an important part of motherhood. Find a way to soothe their concern. You could say, The babies are sleeping.
As stated earlier, trying to bring a person with Alzheimer’s the present-day reality is not effective. Caregivers and/or family members should adapt to the patient and/or loved ones reality. Its ok to go anywhere in any time period in order to communicate.
What Is Anosognosia In Dementia
Anosognosia is a condition that causes someone to be unaware of their mental health condition and how it affects them. Its common in some conditions, including dementia.
So, someone who has been properly diagnosed with dementia, but has anosognosia, doesnt know or believe that they have dementia.
However, anosognosia symptoms may vary significantly from person to person, change over time, and might even fluctuate within a day.
The person might sometimes understand whats happening and other times firmly believe that theyre completely fine.
And other people might only be partially aware that theres something wrong.
The unawareness of cognitive impairment can be related to memory, general thinking skills, emotions, or physical abilities.
They might have occasional difficulty with language skills, like finding words, but they can explain away these situations with excuses about forgetfulness or fatigue.
And even if they forget to bathe, miss appointments, or burn food on the stove, theyre still likely to insist that they dont need help.
Theyll probably also insist that theyre absolutely capable of living independently despite clear evidence that things are going wrong.
If someone reminds them of their cognitive impairment, someone with anosognosia may get angry and defensive because in their mind theyre 100% convinced that there is no problem.
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Grief And Loss Experienced By Carers
Grief is an emotional response to loss. The loss could be the loss of a relationship, moving house, loss of good health, divorce or death. If someone close to us develops dementia, we are faced with the loss of the person we used to know and the loss of a relationship.
People caring for partners are also likely to experience grief at the loss of the future they had planned together. Grief is a very individual feeling and people will feel grief differently at different times.
S To Managing Difficult Dementia Behaviors
1. REASSURE the person
The hard truth: the person with dementia cant change the way he or she is. You have to change your reaction and the environment or situation.
So putting the person first in your thinking as you react is paramount.
Reassuring brings anxiety, upset, or other stress down a notch. It communicates Im on your side. I take you seriously. Not feeling understood makes anyone more distressed. For someone with dementia, you create a floor to what must feel like bottomless uneasiness.
The catch: To reassure someone else, we first have to collect our own feelings. This can be hard because these are almost always emotionally charged situations!
Its easy to feel annoyed when your parent is about to drive off yet another caregiver with false accusations. Or scared when your spouse lashes out or hits. Or embarrassed when Moms blouse comes off. Or worried Dad will fall or get lost. We want to REACT!
Showing emotional intensity only makes things worse. It puts the other person on the defensive and adds to their instability . Also, people with dementia tend to be very sensitive to others moods, mirroring their demeanor. If youre upset, theyre apt to continue to be upset or become more upset. If youre calm and reassuring, you have a much better chance of transmitting that state.
How to reassure:
Approach slowly and from the front. Youre less likely to startle, confuse, or provoke.
2. REVIEW the possible causes
How to try to understand the WHY:
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Do Try And Identify The Trigger That Causes Behavior Change
After spending some time with a patient who has dementia, caregivers may be in a position to identify some of the things that make dementia sufferers yell, get physical, or change their mood. For some, it may be something simple such as taking a bath or even getting dressed.
The best approach to handle this is not to force the patient to do something that they do not want to do. Try and distract them with something else that allows them to relax and calm down. Once they are not a danger to themselves or anyone around them, try going back to the subject, but this time reassuringly and calmly.
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Supporting A Person With Dementia
The way a person with dementia feels and experiences life is down to more than just having the condition.
There are many other factors aside from the symptoms of dementia that play a huge role in shaping someone’s experience. These include the relationships the person has, their environment and the support they receive.
Personal relationships and someone’s social environment are central to life, regardless of age or mental ability. People can recognise this by being as supportive as possible. Carers, friends and family, can help a person with dementia to feel valued and included. Support should be sensitive to the person as an individual, and focus on promoting their wellbeing and meeting their needs.
When supporting a person with dementia, it can be helpful for carers to have an understanding of the impact the condition has on that person. This includes understanding how the person might think and feel, as these things will affect how they behave.
The person may be experiencing a world that is very different to that of the people around them. It will help if the carer offers support while trying to see things from the perspective of the person with dementia, as far as possible.
Each person is unique, with their own life history, personality, likes and dislikes. It is very important to focus on what the person still does have, not on what they may have lost. It is also important to focus on what the person feels rather than what they remember.
Dealing With A Parent Who Denies Dementia Symptoms
Is Dad or Mom having difficulty remembering appointments or names? Or getting lost coming home from the grocery store? You may notice it is becoming more difficult to have a conversation as your parent becomes confused and cant find the words to finish a sentence.
The signs of dementia are obvious to you, but when you mention the possibility to your parent, they deny the dementia symptoms and refuse to get help. What can you do?
Its important to understand the two main reasons why a parent would deny dementia symptoms:
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Managing Stress As Carers
- A consistent schedule can make life easier when living with a person with dementia.
- It often helps to remember that the person with dementia is not being difficult on purpose, but that their behaviour and emotions are affected by dementia.
- Learn as much as possible about dementia, and encourage friends and relatives to do so as well.
- It is important to talk things over with family, friends and other people in a similar situation.
- Take care of yourself by looking after your diet, getting regular exercise and maintaining your social contacts and lifestyle.
- Be realistic about what you can expect of yourself and recognise that you will be a better carer if you take care of yourself.
How To Communicate With Someone Who Has Dementia
As dementia progresses it affects peoples ability to express themselves so you may need to learn new ways to understand and communicate with them.
- If what the person is saying doesnt seem to make sense, try to look for the meaning behind the words.
- Speak slowly and clearly, using simple language and short sentences.
- Avoid choice and keep things simple with questions that only need a yes or no answer.
- Avoid testing the persons memory by asking them what they did earlier. Try not to get into argument about what they say, even if you think theyre mistaken. Simply listening to what theyre saying rather than correcting them can help someone feel acknowledged.
- Create a memory book to help the person with dementia remember special times. This can be a collection of photos that represent happy events like weddings, holidays and the birth of children.
- Memory books can also help health and social care professionals appreciate the persons likes and understand their past experiences.
- If youre struggling with unusual or challenging behaviour speak to the persons GP to get a referral to your community mental health team. The Alzheimer Societys factsheet Aggressive behaviour has useful information including how to react, working out triggers, and dealing with your own feelings.
Distress and confusion may be caused by other health needs, rather than dementia. Always discuss any concerns with the GP so they can check for physical causes or reactions to current medication.
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Get Clear About Whats Really Behind The Difficult
Be honest. Is it really them, or could you possibly be contributing to a bad situation, even unwittingly? If youre not sure, the ideal person to ask is someone who knows you both and can be trusted to gently share the truth with you. This person should also not further stir the pot.
If youre contributing, it could be a sign of burnout. Move self-care to the top of your list immediately. I know care partners hate to talk about self-care, let alone indulge in it. But heres the thing. If you dont take care of yourself, something bad is going to happen to you. Then who is going to take care of your parent or partner?
If youre clear its really your family member that is creating the family conflict, then its time to resolve the situation. As someone who looks for a table to dive under at the first sign of conflict myself, I understand if that makes you squirm. But in this case, we are talking about a disease process that usually last 7-12 years. It can even take up to 20. Thats an excruciatingly long time to live with family conflict.