Redirecting A Loved One With Dementia
Alzheimers disease and dementia, which affect memory and other cognitive abilities, can create anger, anxiety, confusion and fear for a person living with the disease. It doesnt help that explaining and reasoning with person dementia probably wont ease their frustration.
An approach called redirection however, frequently helps. Redirection is a technique that is used to shift a distressed persons attention away from the situation that is causing anger, anxiety, fear, or dangerous and unsafe behavior to a more pleasant emotion or situation.
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.
What Is The Best Ways To Redirect Behavior Or Attention In Dementia
How are you able to do redirecting behavior for dementia? First of all, caring for a loved one with Dementia is very difficult. From preventing medication errors with a smart electronic pill reminder with alarms to the sounds of the dishwasher, anything can tripper bad behavior. Caregiver who bet understand the problem, can best limit outbursts. Finally, these tips can improve every bodies quality of life.
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Dont Try To Explain Or Reason
If Mom keeps pushing furniture against the door and insists that someone is trying to break in, explaining that no one is attempting to get in probably wont ease her fear. Instead, Kriseman suggests responding to the emotions behind the actions.
You dont have to say, I believe that this is happening but you can say Im so sorry this is happening to you, says Kriseman. You might say, Mom, I really want you to feel safe. How can I help you feel safe? In this scenario, you realize what is causing your loved ones agitation and redirect her feelings from a place of insecurity to one of security because she feels like you finally believe her and are on her side.
Give Them A New Focal Point
Once you’ve proven that you are there to help, you must give the person something new to focus on. This is the point in the process where you introduce some form of meaningful activity that you and the person can engage in together. Once you establish a new focal point, more often than not you’ll see the behavior disappear.
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Use Bridge Phrases To Put The Focus Back On The Person
If Mom wont eat and says shes not hungry, you dont have to push. Instead, try a bridge phrase that moves the conversation to a different place. For example, you can tell Mom how much you always loved her fried chicken and ask her if she remembers how the house used to smell while it cooked or how she prepared the meal. Then a little later, maybe return with Hey, how about we both have a bite of this sandwich?
Touch Is Key With Alzheimers Disease
Connecting through the sense of touch takes on a new level of importance with the memory-impaired. Gently guiding someone to the window with a light touch of the hand can redirect a repetitive activity like pacing. Point out the squirrel in the tree or flowers in bloom, creating a calm moment and stimulating a new conversation topic.
Spending time outside is good for both of you.
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Why Are Some People With Dementia Combative
It can be hard to understand why your loved one is behaving the way he or she does. Dementia changes the brain of the person you love. Through no fault of their own, you might experience unexpected aggression and anger from your loved one.
Often aggression will appear in the later stages of dementia. The first time your loved one is aggressive may surprise you. Your loved one may become angry without warning and yell at you, curse and scream, or even throw something at you.
Being on the receiving end of aggression is heartbreaking and frightening. But remember that your loved one is not in control of these feelings. Aggression and agitation stem from symptoms of the disease and the way his or her brain is changing. Your loved one may be combative as a reaction to feeling confused, frustrated or frightened.
You can learn how to handle the difficult behaviors seen in dementia. This gives you the ability to enjoy your days with your loved one. One of the things that dementia cannot steal from you is love. Research has shown that people with dementia remember feelings and emotions. They can feel love and happiness long after they have forgotten an actual visit or experience.
How To Talk To A Person With Alzheimers: The Fine Art Of Redirection
Caring for Caregivers| Author: Mary Webb Walker
My mom, recently diagnosed with early stage Alzheimers disease, had no idea her repetitive questions were tormenting me. I was patient the first 15 times, but answered badly to the 16th. Mom, youve already asked me over and over if weve ordered yet!
Repetition whether its questions, stories or actions is one of the early symptoms of Alzheimers. And, it can be maddening for the care partner, family members and friends. Getting through the repetition stage, which thankfully wanes later in the disease, requires more than just patience. Youll need an effective strategy to communicate with your loved one with built-in techniques to preserve your sanity.
The first step to spending time with a memory-challenged person is to be prepared to leave your own world behind. Youre on Planet Alzheimers now and things are different here. For me, one successful approach is what I call the Fine Art of Redirection. By actively changing the focus of the memory-challenged person, we can break the repetitive loop. Doing it creatively and compassionately sends the signal that you will not judge, scold, criticize, or laugh at them.
What if you notice repetitious or uncharacteristic behavior in someone who has not been diagnosed with any form of dementia? Check out this article from Better Health While Aging for guidance.
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The Distant And No Longer Past As Reality
My mother did this one over an over with my sister but never with me go figure?
My mother would tell my sister that she wanted to get Volkswagen fixed so she could start driving it.
The VW in question had not been around for 30 years. It no longer existed. On top of that, my mother was no longer driving and had not driven in many years.
My sister would smile and respond in her normal voice, okay, lets do it tomorrow. Close enough to the 3 little words rule.
My mother would accept this with out question.
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In this example my sister embraced my mothers reality. That the VW actually existed, and she offered a solution. However, my sister would not address the issue of driving. She knew my mother was no longer driving, and, had learned it rarely works when you correct a person living with dementia.
In this example, a bit more complex there are 2 issue. A car that no longer existed and driving. My sister embraced the key issue, and resisted the urge to inform my mother she was no longer driving she realized it really didnt matter.
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Problem : Not Taking Care Of Ones Teeth
- Suffer memory loss
- Dislike help because he or she feels theyre being treated like an infant or out of control
- Have dexterity problems
- Visit a dentist twice a year to check for cavities, gum infections, dangerously cracked teeth, ill-fitting dentures, and the like. Make sure the office knows the person has dementia, to book adequate time. For tough cases, ask for a referral to a geriatric dentist who has experience working with dementia patients.
- Incorporate toothbrushing into the daily routine, such as when getting dressed or ready for bed . If it becomes a battle, pick the persons most cooperative time of day. Try brushing your teeth at the same time.
- Use the same brand of toothpaste the person has always used, if you can. Apply it to the brush for him or her.
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Do Offer Assurance Often
Many times, people with dementia may experience feelings of isolation, fear, loneliness or confusion. They may not be able to express this in the right way and thus may wander off or keep saying that they want to go back home, especially if they are in a senior living facility. This is not the time to shut them out. Its a good idea to assure them that they are safe and in a good place.
If you are close enough, provide a comforting hug every once in a while and remind them that they are in a place that has their best interest at heart. Where possible, engage in exercise or take a walk as even light physical activity may help to reduce agitation, restlessness and anxiety.
Im Hungry Im Starving
My mother would utter those words over and over every day. In the beginning I would inform her that she had just eaten , that she could not possibly be hungry, or she had already eaten 3 times that day.
What I failed to realize in the beginning was my mother: could not remember she had just eaten, could not remember what she had eaten that day, and that, in fact if she said she was hungry she was hungry.
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I failed over and over in the beginning to embrace my mothers reality. If she said she was hungry even right after she had eaten then she was hungry. Who was I to determine how she was feeling? Arent we all entitled to our own feeling, or for that matter beliefs.
Whenever I chastised my mom and told her she couldnt be hungry it usually ended in a horrible episode. My mom would go into her room and refuse to come out. I would be left alone feeling bad, and having a bad day.
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Then one day I discovered the solution by accident. Dotty said, Im hungry, Im starving. I looked at her smiled and said, okay, can you give me ten minutes to finish what I am doing and we will eat. She smile back and said, okay. That was that.
She didnt ask again and seem satisfied with my answer. I had embraced her reality, and that was what she really needed.
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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.
Ways To Respond When Someone Is Experiencing Dementia Hallucinations
1. Determine if a response is neededThe first step is to determine whether the hallucination is bothering your older adult.
If its pleasant, you might not want to respond or call attention to it.
Just know and accept that its a dementia symptom and thankfully isnt causing distress.
If the hallucination is upsetting them or causing them to do something unsafe, then its time to quickly step in to provide comfort or redirect to a safe activity.
2. Stay calm and dont argue or try to convince using logicWhen someone is having a dementia hallucination, its important to stay calm and avoid contradicting them.
What theyre seeing is a dementia symptom and is very real to them.
Trying to explain that it isnt real simply wont work because of the damage that dementia has caused in their brain.
In fact, knowing that you dont believe them might make them even more upset and agitated.
If theyre calm enough to explain, it may also help to understand what theyre seeing. Listen carefully and try to pick up clues to what theyre seeing.
But keep in mind that dementia damage in the brain may affect their ability to use the correct words. For example, they could unintentionally say cabbages when they mean green cushions.
3. Validate their feelings and provide reassuranceBe careful not to dismiss your older adults experience.
Brushing off what theyre seeing by saying something like, Dont be silly, theres nothing there, is likely to upset them.
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How To Deal With Dementia Behavior Problems
- How to Deal with Dementia Behavior Problems: 19 Dos and Donts
Dementia is a disease that affects millions of people across the globe every year. It is often a highly misunderstood condition that is marred by numerous misconceptions, which make the condition difficult to understand and study.
You should know that dementia is not a name for an illness, rather it is a collective term that describes a broad range of symptoms that relate to declining of thinking, memory, and cognitive skills. These symptoms have deteriorating effects that usually affect how a patient acts and engages in the day-to-day activities.
In advanced dementia stages, affected persons may experience symptoms that bring out a decline in rational thought, intellect, social skills, memory, and normal emotional reactivity. It is something that can make them powerless when it comes to living normal, healthy lives.
Relatives, caregivers, spouses, siblings, children and anyone close to a person who has dementia need to know how to deal with behavioral problems that surface because of the illness. Examples of dementia problems may include aggressiveness, violence and oppositional behaviors. Find out some of the vital Do and Donts when dealing with a dementia patient.
Use Touch To Calm And Focus
Not everyone with dementia feels comforted by touch. However, if the person is okay with it, touching that persons arm or shoulder or gently holding their hand can be comforting and grounding.
With redirection, keep in mind that one technique may work fine one time but not the next, so its a good idea to have several options on hand.
The whole idea of redirection is that you want the person to feel cared about and listened to and make sure theyre in a safe situation, says Kriseman.
Are you a family caregiver who has more suggestions on how to redirect a loved one with dementia? Wed like to hear your tips in the comments below.
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Try To Identify Possible Causes Of The Aggression
There are some basic things to rule out when patients begin to act out. Be sure basic needs are met. These include:
Pain uncontrolled pain can cause individuals to lash out. They often are not able to communicate. It is vital to look for non-verbal signs of distress, including:
- Facial grimacing.
- Guarding certain areas or withdrawing from touch.
- Writhing or constant movement.
- Increase in blood pressure or respiratory rate.
Constipation-this can make anyone uncomfortable, including dementia patients. Be sure they follow a toileting schedule and pay attention to the frequency of bowel movements.
Urinary tract infections These can be a cause of pain and discomfort and are more common in elderly patients. Monitor the patient for smelly, cloudy, or discolored urine. If these signs appear and the patient is acting differently, they should be seen by a medical professional for an evaluation.
Try to keep the patient comfortable. Maintain a reasonable room temperature and create a good place for the patient to relax.
Sleep We all can become grumpy if we dont get enough sleep.Follow the basic sleep hygiene guidelines listed below.
- Follow a sleep schedule. Try to get the patient to sleep at the same time each night.
- Avoid letting the patient take long naps during the day.
- Do not give the patient large amounts of fluid close to bedtime. This can increase nighttime awakening.
- Be sure the room where the patient sleeps is dark, quiet, cool, and comfortable.
Slrs Whole Person Treatment Approach
With a non-pharmacological approach at the Compass Support Neighborhoods core, the care and programming staff worked together on a plan for Mary to decrease her aggressive behaviors by giving her a renewed sense of purpose. Knowing that Mary enjoyed homemaker duties, the staff included Mary in small daily tasks including folding clothes, sweeping, setting dining tables and gardening. We knew that Mary needed to be treated with compassion, not with medication. She was warm and caring, and we just needed to get to the bottom of what Mary really needed, figure out what she felt was missing in her life, said SLR Resident Care Director Angela Peterson. Keeping Mary happy and engaged helped to redirect her from her anxiety-driven behaviors.
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Problem : Forgetting To Bathe
- Have memory loss that prevents them from keeping track of or caring about bathing
- Feel confusion about the sequence of steps involved
- Feel juvenile, anxious, or defensive when asked or reminded about bathing
- Stick to a consistent bathing routine. Make it the same time the person previously bathed .
- Dont remind or even mention how long its been since the last cleanup. Instead of arguing, proceed with bath preparations.
- Dont ask, Did you shower? or Would you like to shower now? Get everything ready and invite the person in: Look, your bath is ready. I know how you love your evening bath.