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.
4. I told you
Instead, repeat what you said.
Dementia Behavior: Sleep Problems
While quality sleep tends to decrease as you age, people who have dementia experience more sleep disturbances than other seniors. In fact, sleep problems affect as many as a third of seniors with dementia.
Common sleep issues may include:
- Difficulty getting and staying asleep
- Agitation and restlessness when trying to sleep
- Thinking its daytime when its night, going as far as getting up, getting dressed and wanting to start the day, Hashmi says
Sleep disturbances are hard on patients and caregivers alike, Hashmi says. Its physically and mentally exhausting to be up night after night.
Talk With Your Family And Children About Caregiving
Be honest while explaining dementia to children. Children are very intuitive. They will know that their grandparent, aunt or uncle are changing and that their behavior is odd. Explain the disease and that loving the senior family member is most important. Engage them and empower them to be part of the caregiving process. Younger children can read to the senior, or help you with chores. The family will be less stressed when the situation is discussed out in the open.
You might also wish to share ideas with your kids on how to communicate with your loved one:
- Go with it. If the grandparent says something that doesnt seem to make sense, tell children to just play along. Its sort of like playing make believe.
- Plan ahead. Suggest what to talk about, or choose an activity in advance.
- Use activities. Try a coloring book, listen to music or sing songs together.
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Establish Realistic Care Expectations
The first thing you can do when caring for an elderly parent in your home is to assess the level of daily care your parents need in order to continue living healthily and happily.
Some likely examples of care that your parents may require include:
- Support moving about the house
- Encouragement to stay physically/mentally active
- Someone to be home in case of an emergency etc
Once youve finished the assessment, consider and state clearly which kinds of help you can and cannot provide. This will reveal gaps in the level of care you can reasonably provide your loved one.
Discovering gaps in care might seem like a bad thing, but its actually very important. Identifying care gaps allows you to start making alternative care arrangements to meet these needs.
Be honest with yourself about what care you can and cant provide. . You dont have any obligation or responsibility to agree to more than you can handle.
Treat Your Aging Parents Like Adults
Your parents are still your parents, and it can feel jarring to them and to you if you begin treating them like the child in the relationship. Remember that your parents are adults and they deserve to be treated as such. During your conversations, focus on empowering them and giving them plenty of choices and input into every decision.
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Let Your Parent Know Youre On His Or Her Side
If your parent has become suspicious, donât be confrontational. Highlighting your parentâs paranoia will make you seem like an enemy, Klontz says. Instead, listen with empathy as your parent shares fears and acknowledge your parentâs concerns. âYou want them to feel like youâre on their side,â Klontz says. âIt will help ease the anxiety.â
Using Inappropriate Language Or Making Offensive Comments
Cognitive decline is often the reason behind seniors making offensive comments or using inappropriate language. However, it can still be jarring for adult children or caregivers to hear, even if theyre aware of the source.
When seniors begin using new inappropriate language or offensive comments, it is often because they are in pain, frustrated, or reaching a new stage in their cognitive decline. A sudden personality change could also point to an infection.
Ignoring the behavior can often solve it right away. You can also call out the behavior and say you do not like it when they do that. However, if your loved one has dementia, it is important for you to note that they will likely not be able to remember your direction or consequences.
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Living Alone With Dementia
One of the most difficult conversations to have with a senior with Alzheimers involves discussing living arrangements. Living alone with dementia is risky, but most seniors prefer to age in place. As the disease progresses, risks of falling, wandering, leaving a stove on, forgetting medications, or experiencing isolation and loneliness increase.
The stage of the disease and safety are important factors to consider when discussing aging in place. Now is the time to consider in home care, support that can prove invaluable to a senior coping with dementia.
When a family comes to me with concerns about a loved one with dementia, I often recommend a home care provider so the older adult can safely remain at home for as long as possible. states Jill W. Love, Geriatric Care Manager with Peters and Love. Caregivers provide valuable assistance with meal preparation, personal care, medication reminders, companionship, supervision, and so much more. Since caregivers get to know their clients very well, they have the ability to improve the older adults quality of life through engagement and personalized care. As a geriatric care manager, I rely on the caregivers observations and insights when considering changes to the care plan, and I consider them an integral part of the care team.
Sometimes, its easier to take smaller steps rather than make one big change. If your aging parent expresses that they want to remain at home:
Knowing When To Step In
There are a variety of reasons family members step in as caregivers a parents gradual health decline, a sudden health emergency or new health issues, a new diagnosis or treatment plan, etc. The realization that its time for adult children to step in and get their parents help, may hit each family at different stages for different reasons. That being said, its important to be involved in your parents day-to-day routine as they get older so you can notice changes in their behaviors or habits if the change is gradual. Recognizing a shift in your parents patterns could help you realize when its time to step in or coordinate extra care for them. A pattern change could look like elderly parents skipping dates with friends, missing a bill payment, looking over a doctors appointment, etc. The more youre involved, the more you can recognize when your parent may be losing touch and needs someone to step in.
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Cope With Changes In Communication
As your loved ones Alzheimers or dementia progresses, youll notice changes in how they communicate. They may have trouble finding words, substitute one word for another, repeat the same things over and over, or become easily confused. Increased hand gestures, losing their train of thought, and even inappropriate outbursts are all common as well.
Even if your loved one has trouble maintaining a conversationor less interest in starting oneits important to encourage social interaction. Making them feel safe rather than stressed will make communication easier, so try to manage your own frustration levels.
Be patient. If your loved one has difficulty recalling a word, for example, allow them time. Getting anxious or impatient will only inhibit their recall. Gently supply the word or tell the person that you can come back to it later.
Be aware of your body language. Your loved one responds to your facial expression, tone of voice, and nonverbal cues as much as the words you choose. Make eye contact, stay calm, and keep a relaxed, open posture.
Speak slowly and clearly. Give one direction or ask one question at a time, use short sentences, and give your loved one more time to process whats being said. Find a simpler way to say the same thing if it wasnt understood the first time.
Maintain respect. Dont use patronizing language, baby talk, or sarcasm. It can cause hurt or confusion.
Paranoia Delusions And Hallucinations
Paranoia and hallucinations in the elderly can take many forms. Seniors may make false accusations of theft or abuse, see people and things that arent there, or believe someone is trying to harm them. These behaviors can be especially difficult for caregivers to witness and try to remedy.
How to Handle Mental Health Issues in the Elderly
Hallucinations and delusions in elders are serious warning signs of a physical or mental problem. Keep track of what your loved one is experiencing and when so you can discuss it with their doctor as soon as possible. This behavior could be explained by something as simple as a side effect of a new medication they are taking, dehydration or a UTI.
Oftentimes, paranoia and hallucinations are associated with dementia. When this is the case, caregiving experts seem to agree that the best thing to do is go with the flow. Do not try to talk dementia patients out of a delusion. Validation is a good coping technique, because what the elder is seeing, hearing or experiencing is very real to them. Convincing them otherwise is fruitless and may make them more upset. Acknowledge the seniors concerns and perception of reality in a soothing voice. If they are scared or agitated, redirect them while assuring that they are safe and you will help them through the experience.
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How To Get Help Coping With Dementia Symptoms
For help coping with the experience whether its how to get your mom in to see the doctor, how to deal with the doctors, how to cope with your stress, how to manage her outbursts, how to plan ahead I would recommend you try the following resources:
- Talk to a professional trained to help people struggling with aging parents, such as a geriatric care manager or a senior care adviser.
- Visit online support forums. Theres a quite active forum at AgingCare.com. The Alzheimers Association is another good source of support groups.
- Read a few good books, as its hard to learn a lot by skimming web pages. For dementia, the 36 Hour Day is well respected, and I like Surviving Alzheimers a lot too. Or consider a course offered by your local Alzheimers Association. Another option would be dementia management videos, such as those by Teepa Snow. Pick whatever method of education works best for your style of learning.
- Remember to take deep breaths, and to take care of yourself. Dementia or no, helping an aging parent is usually a long journey. Building some daily walking and daily mindfulness practice into your day can make a big difference.
Good luck! Do get that dementia assessment and then get help learning to deal with her behaviors. Its an effort but it will pay off in the long run.
Spend Time With Your Partner And Children
Caring for someone with dementia can quickly become the focus of attention for the household. Young children and spouses can feel excluded and left behind. Take time to schedule activities for just the family. A family member or professional caregiver can stay with your loved one and bring special activities so it is a fun evening for him or her as well.
- Create a family calendar. This should include not just appointments, but fun activities centered on togetherness.
- Find a support system. Being the primary caregiver doesnt mean one has to be the only caregiver. Create a tag team and let other family members get involved.
- Talk things through. Shine a light on the factors that may stress relationships by holding a family meeting.
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Ask For Helpand Say Yes To It
When someone offers to help, say, Yes! And sometimes you will need to ask for help as welldont hesitate. My clients are always amazed at how many people will pitch in if you ask. If youre raising kids and caring for an elderly or sick relative, its also important for you to know that there is help for youboth for dealing with your children and your aging parents. The key is to know how to access that assistance.
For some, that assistance is as close as your childs school. School social workers and guidance counselors can be a good resource for finding assistance and services for your child and family. Often, people around you are dealing with aging relatives as well. Try reaching outwhats the worst that could happen? And dont forget your faith community. Talk to your clergyman and ask him or her to send word out that you need some help with chores, respite, sitting with your elder or meals. People love to help and will do so if asked. The Area Agencies on Aging can help with resources as well. Go to www.n4a.org to find one in your area.
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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Make Use Of Music Therapy
Listening to songs or music is therapeutic to parents with Alzheimers and dementia. Play their favorite music to help calm them down and recall happy memories. This is according to research from the Alzheimers Association when we listen to music, it releases dopamine in our brain that triggers good mood. It also improves our memory functions and encourages social interaction more.
My Mother Fell Down Againand My Kids Are Constantly Acting Out Help
Children often act out when their parents are under extreme pressure from the numerous responsibilities of taking care of elderly or sick relatives. Acting-out behavior might occur if your child is:
- Anxious about whats going on within the family
- Sad about the changes their grandparents/relatives are experiencing
- Feeling ignored because your attention is elsewhere
- Scared of whats going to happen
Your child might also just be plain angry and feeding off the stress in your householda house that might feel as if its frequently in crisis mode. If this is the case, its important for you to step back, take a deep breath, evaluate whats going on in your home and make a plan to take back control of your situation. Preparing by creating a plan will help make you feel stronger and more empowered in your lifeand less like youre living from crisis to crisis.
What does this plan look like?
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Find The Why In A Dispute
It can help to think about reasons your parent may be arguing with you, Zarit says. âOne thing is their own anger and fear over needing help. No one likes to feel dependent. â¦ Also, keep in mind that you are their child. They may not want to accept advice from you, no matter how rational it might seem to you.â
Instead of getting swept up, take a breather to dial down the conflict. Zarit recommends mindfulness training to help lessen stress and keep calm. Rooted in Buddhism, but no longer just religion-based, the practice teaches you to stay in the present with a focus on your breath. A geriatric mental health specialist can also help you come up with other ways to keep the peace.
Excessive Cursing Offensive Language And Inappropriate Behavior
When a senior suddenly begins spouting the worst profanities, using offensive language or saying inappropriate things, family members are often baffled as to why and what they can do about it.
Caregivers have shared countless stories in the forum about elders who used to be mild-mannered and proper suddenly cursing at them or calling them insulting names. When these verbal outbursts happen in private, theyre hurtful When they happen in public, its downright embarrassing.
Coping With Verbally Aggressive Behavior in the Elderly
When this behavior is out of character for an elder and gradually gets worse, the start of Alzheimers disease or another form of dementia is a likely cause. If the onset is quite sudden, a urinary tract infection is another common culprit. UTIs present very differently in seniors than in younger individuals, and symptoms often include behavioral changes like agitation.
But if dementia is not an issue and a senior is just plain crass, how do you deal with swearing and rudeness? You can try to set firm ground rules for them. Make it perfectly clear that you will not tolerate such language, especially in public settings. A little bit of guilt may be effective in getting them to realize that their behavior is unacceptable and offensive to other people. Try something like, Dad, if Mom were here right now, she would be appalled by your language, or, You would never want your grandchildren to hear you speaking like that, would you?
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