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How To Reason With Someone With Dementia

Being Quiet Or Quietly Being Forgotten

How to not argue with someone with dementia

Most of us need some quiet time every so often. Some people are naturally quieter than others too and prefer to watch and listen rather than joining in.

While we need to respect peoples preferences, it is important to make sure that no one ends up being left out or forgotten. When someone is quiet, it doesnt necessarily mean that they are withdrawn, but we need to be observant of their mood and ensure there are opportunities for them to be more engaged if and when they would like to be.

We need to be careful not to assume that just because someone is being quiet and undemanding, then theyre OK. It can be easy to overlook the fact that the person has, in fact, become withdrawn. This is most likely to happen in a group care setting where other clients are being more assertive in making their needs known. A person who is withdrawn probably has unmet needs, and when no attempts are made to investigate the reasons for their withdrawal, it is likely that the state will persist and the person may become less and less engaged with the world around them.

Ways To Reduce And Manage Mean Dementia Behavior

1. Calm the situation downThe first thing to do is reduce the tension in the room.

Start by limiting the distractions in the room, like turning off the TV or asking others to leave.

And if you stay calm, theyre also more likely to calm down.

It might help you to count to 10 or even leave the room for a short time to cool down. Repeat to yourself its the disease as a reminder that theyre not intentionally doing this.

If the current activity seemed to cause the agitation, try shifting to a more pleasant, calming activity. Or, try soft music or a gentle massage.

2. Comfort and reassure while checking for causes of discomfort or fearTake a deep breath, dont argue, and use a calm, soothing voice to reassure and comfort your older adult.

It also helps to speak slowly and use short, direct sentences.

Then, check for possible causes of agitation or fear, like:

  • Feeling disturbed by strange surroundings
  • Being overwhelmed by complicated tasks
  • Frustration because of the inability to communicate

It also helps to focus on their emotions rather than their specific words or actions. Look for the feelings behind what theyre doing as a way to identify the cause.

3. Keep track of and avoid possible triggersWhenever difficult behavior comes up, write down what happened, the time, and the date in a dedicated notebook.

Also think about what was going on just before the behavior started and write that down as a possible trigger.

Taking some time away can help both of you.

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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How The Disease Affects The Brain

Physiologically, dementia and/or Alzheimers affects various parts of the brain, specifically, it affects the brain in such a way that people have a difficult time learning new information. This is why, for a long time into the disease, patients and/or loved ones can remember things that happened a long time ago. They can remember wedding dates, the war they fought in, where they went to high schoolbut they can’t remember the visit that they had with their daughter yesterday. This is because the disease affects certain parts of the brainthe temporal lobeswhich are responsible for helping us learn new things.

The reason theyre able to hold onto the memories that happened a long time ago is because those memories are represented throughout the brain. Long-term memories don’t require just one or two areas of the brainthey’re probably represented in multiple systemsso the disease has to be quite advanced before patients and/or loved ones start losing those memories.

In the brain of someone with dementia and/or Alzheimer’s, there are actual holes in the brain that form. In an image of an Alzheimer’s brain, one can see where many of the brain cells have diedand it affects every area of the brain.

Develop Helpful Daily Routines

Why Do People With Dementia Wander?

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.

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Dealing With Dementia Behaviors: Expert Tips For Understanding And Coping

Anger, confusion, and sadness are a few symptoms a person with dementia may experience regularly. The result of these feelings is a range of unpredictable behaviors including using poor judgment, aggression, mood swings, and repeated questioning or manipulation.

Even though you know your loved ones dementia behaviors are symptoms of a disease and not intentional, dealing with them is often emotionally and physically challenging. Learn more about typical dementia behaviors in the elderly and expert tips for managing them.

Understand Why Someone With Dementia Says Mean Things

First, its important to understand why this hurtful behavior is happening.

Dementia is a brain disease that causes parts of the brain to shrink and lose their function, resulting in cognitive impairment.

These different parts control functions like memory, personality, behavior, and speech. Dementia also damages the ability to control impulses, which means actions arent intentional.

Even though its difficult, do your best to remember that they truly dont intend the mean things they say.

These mean comments and hurtful accusations often happen because the person is unable to express whats actually bothering them.

It could be triggered by something in their environment that causes discomfort, pain, fear, anxiety, helplessness, confusion, or frustration.

Working to accept the fact that theyre not doing this on purpose helps reduce stress and makes their behavior easier to manage.

The overall strategy is to take a deep breath, remind yourself that its not personal, take care of immediate discomfort or fear, and try to find the cause behind the behavior.

Next, look for long-term solutions that will help you get the support and rest you need to keep your cool in challenging situations like these.

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Should You Tell The Person They Have Alzheimer’s

Families may frequently ask, Should I tell the person that he/she has Alzheimer’s? Keep in mind that the patient and/or loved one can’t reason. They don’t have enough memory to remember the question, then think it through to form a conclusion. Caregivers and/or family members may often think if they tell the person with memory loss that he/she has Alzheimer’s, then he/she will understand and cooperate. You cant get cooperation by explaining that he/she has the disease and expect him/her to remember and use that information.

Tips For Changes In Communication And Behavior For People With Dementia

Why Do People with Dementia Repeat Themselves? (3 Reasons)

Communication can be hard for people with Alzheimers and related dementias because they have trouble remembering things. They also can become agitated and anxious, even angry. In some forms of dementia, language abilities are affected such that people have trouble finding the right words or have difficulty speaking. You may feel frustrated or impatient, but it is important to understand that the disease is causing the change in communication skills. To help make communication easier, you can:

  • Reassure the person. Speak calmly. Listen to his or her concerns and frustrations. Try to show that you understand if the person is angry or fearful.
  • Allow the person to keep as much control in his or her life as possible.
  • Respect the persons personal space.
  • Build quiet times into the day, along with activities.
  • Keep well-loved objects and photographs around the house to help the person feel more secure.
  • Remind the person who you are if he or she doesnt remember, but try not to say, Dont you remember?
  • Encourage a two-way conversation for as long as possible.
  • Try distracting the person with an activity, such as a familiar book or photo album, if you are having trouble communicating with words.

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Do Try To Be Pleasant

Caregivers are also humans who are prone to emotions like anger, stress, impatience, and irritation. Even when one goes through caregiver burnout, it is best that the patient does not get wind of it. It is better to step out of the room and try some breathing exercises to calm down before going back to deal with the dementia patient. Where possible, shelve the bad feelings and try and deal with them later. Dementia patients deal with a lot and they do not need more on their plate if they are to lead fulfilling and happy lives.

How Can I Support Someone As Their Dementia Progresses

In the later-stages of dementia the person may become increasingly dependent on others for their care.

They may have severe memory loss at this stage and fail to recognise those close to them. They may lose weight , lose their ability to walk, become incontinent, and behave in unusual ways.

Not everyone will show all these signs, and some people may show them earlier on in the illness.

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Encouraging Someone With Dementia To Communicate

Try to start conversations with the person you’re looking after, especially if you notice that they’re starting fewer conversations themselves. It can help to:

  • speak clearly and slowly, using short sentences
  • make eye contact with the person when they’re talking or asking questions
  • give them time to respond, because they may feel pressured if you try to speed up their answers
  • encourage them to join in conversations with others, where possible
  • let them speak for themselves during discussions about their welfare or health issues
  • try not to patronise them, or ridicule what they say
  • acknowledge what they have said, even if they do not answer your question, or what they say seems out of context show that you’ve heard them and encourage them to say more about their answer
  • give them simple choices avoid creating complicated choices or options for them
  • use other ways to communicate such as rephrasing questions because they cannot answer in the way they used to

The Alzheimer’s Society has lots of information that can help, including details on the progression of dementia and communicating.

Understanding The Causes And Finding Ways To Cope

Updated: 20 things not to say to a person with dementia ...

While some people living with Alzheimer’s disease or other types of dementia remain pleasant and easy-going throughout their lives, others develop intense feelings of anger and aggression.

When someone with dementia lashes out at you for seemingly no reason, it’s normal to feel surprised, discouraged, hurt, irritated, and even angry at them. Learning what causes anger in dementia, and how best to respond, can help you cope.

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Dont Forget To Care For Yourself Too

Joining a carers group can be a good way for you to find people who truly relate to the situation you are in. It is a good place to share and talk it out or learn coping mechanisms others use to care for those with dementia. Social services or a dementia adviser or counselor can direct you to a local group. Alternatively, there are plenty of online support groups you could consider joining.17

When you are close to someone with dementia you may find yourself asking why me. You may also get upset, angry, or frustrated, and possibly even feel guilty about thinking this way. At times, you may feel you are losing the love or affection you have for that person as these emotions take control. On the flip side, you may also feel guilty for taking time out to do something for yourself, or about losing your temper at them or not being kind enough. Dont beat yourself up about it. This is as hard on you as it is on the person you love who has dementia. And you need downtime too. Some of these things could help:18

References

Encourage Them To See Their Doctor

If youve noticed that someone close to you is showing symptoms of dementia, its important to encourage them to see their doctor to talk through whats been going on.

Talking to someone about changes youve noticed in them can be difficult. It can help to have the conversation in a space where both of you are comfortable, are able to hear each other clearly and speak freely. Health Direct recommends starting the conversation by talking about what youve noticed and the other common reasons this might be happening. For example, you might say youve noticed the person has had trouble with their memory recently, and ask if theyve been stressed or not sleeping well. Then you can suggest that its time to see a doctor to find out whats happening.

If you dont have a close relationship with the person, you might talk to someone who knows them well about what youve noticed, see if theyve noticed the same things and ask them to bring it up with the person.

If a person remains resistant to following up about changes in their memory or behaviour, Dementia Australia recommends finding a different, physical reason to encourage the person to see the doctor, like an overall physical check-up, a blood pressure test or diabetes check. You can see more suggestions on what to do if the person you are concerned about does not want to see their doctor on the Dementia Australia website.

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Dont Just Talk Loudly

Not every person with dementia has a hearing impairment, and using a loud tone can make them feel like you are yelling at them. Use a clear, normal tone of voice to start a conversation with someone.

If the person doesnt respond or you become aware that they have a hearing problem, you can increase your volume. Speaking in a slightly lower register can also help if someone has a hearing problem.

New Approaches To Difficult Dementia Behaviors

When someone with dementia believes something untrue.

When dealing with difficult behaviors from someone with dementia, its important to remember that they are not deliberately being difficult.

Our loved ones sense of reality may now be different from ours, but it is still very real to him or her. As caregivers, we cant change the person with dementia, but we can employ strategies to better accommodate any problem behaviors. Both the environment you create at home and the way you communicate with your loved one can make a significant difference.

These tips may help get you through some difficult moments using the What, When, Where, Why, How technique shared in: When Caring Takes Courage: A Compassionate and Interactive Guide for Alzheimers and Dementia Caregivers.

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Things To Keep In Mind When Dealing With Difficult Behaviors

Whats not okay? People with Alzheimers or dementia often exhibit behaviors that are unpredictable and may be outside the bounds of what others consider normal or socially acceptable. It may be tough to know when to worry and when to be flexible.

In general, try to remember that these behaviors do not define the person, they are just a product of the disease. If your loved one had the ability, they would probably choose to act differently.

Also, remember to practice patience and forgiveness. The disease, not the person, is likely causing these things to occur. Try to let things go and avoid holding a grudge over something they may not have meant to do or say, or even remember doing. The exception is if your loved one becomes a physical danger to themselves or others. Physically abusive behavior is not okay. Even a one-time occurrence should be communicated to your physician or other healthcare or mental health provider immediately to ensure your loved ones safety as well as your own.

Finally, there are so many more behavior interventions, treatments and specialty care providers now than ever before. Dont be afraid to reach out.

What approaches do you use when dealing with difficult dementia behaviors? Share your story with us in the comments below.

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Avoid Arguing About Whether They Are Already Home’

For a person with dementia, the term ‘home’ may describe something more than the place they currently live. Often when a person with dementia asks to go home it refers to the sense of home rather than home itself.

Home may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.

Its best not to disagree with the person or try to reason with them about wanting to go home.

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