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How To Redirect Someone With Dementia

What To Do If They Refuse To Let Go Of The Idea

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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.

Planning For When Your Loved One Does Wander

In case your loved one does wander, its a good idea to have a plan in place.

  • Notify neighbors and local police about your loved ones tendency to wander, and circulate your phone number.
  • Have your loved one wear an ID bracelet or labels in clothing. Digital devices using GPS technology can track your loved ones location.
  • In case a police search becomes necessary, have a recent photo of your loved one and some unwashed clothing to help search-and-rescue dogs.
  • In the U.S., sign up for the Alzheimers Associations Medic Alert and Safe Return Program, an identification system to help rescue lost Alzheimers patients.

How to find a missing Alzheimers patient

A person with dementia may not call out for help or answer your calls, even when trapped somewhere, leaving them at risk for dehydration and hypothermia.

Check dangerous areas near the home, such as bodies of water, dense foliage, tunnels, bus stops, and high balconies.

Look within a one-mile radius of where the patient was before wandering.

Look within one hundred feet of a road, as most wanderers start out on roads and remain close by. Especially look carefully into bushes and ditches, as your loved one may have fallen or become trapped.

Search in the direction of the wanderers dominant hand. People usually travel first in their dominant direction.

Investigate familiar places, such as former residences or favorite spots. Often, wandering has a particular destination.

Understanding The Causes And Finding Ways To Cope

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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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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How Does This Person

3 Ways to Redirect a Dementia Patient and Embrace Reality

Validate, redirect, and then go slowly with somebody with dementia. Because the more you rush somebody with dementia, the more they get agitated. If the caregiver gets upset, then the person with dementia is like a sponge they pick up on that and express more behaviors. And now youre in trouble, because its 10 times harder to get out of the behavior cycle than it is to prevent it in the first place. A person with dementia can handle one or two steps at a timetwo maximum. If a daughter with a mother who has dementia greets Mom in the morning by saying, Mom, were going to have breakfast, then were going to take a shower, then well get dressed, and then Ill take you to your doctor, youve lost her at breakfast.

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How To Redirect Difficult Dementia Behaviors

Hello Careblazers! Today, Lets talk about difficult dementia behaviors. When your loved one is doing something that you are finding difficult, challenging, and something you wish would stop, you want to do whatever you can to get that behavior to stop. In many of my behavior posts, Ive talked about redirection and how you can use redirection to stop that behavior.

In todays post, I want to share 3 of the most common redirection errors that are easy to make when it comes to redirection and Ill give you 3 solutions you can use. By the end of this blog post, I want you to decide which one of these solutions you will use so that you are prepared and ready to respond the next time you’re faced with responding to a difficult dementia behavior. Let me know which one you are going to try in the comments below. Also, I give a bonus tip on an activity your loved one may enjoy doing at the very end so dont miss that.

Before I do, I want to invite you to check out my Care Course. Its my program on how to manage caregiver stress without changing your loved one, without needing to hire more help, and without having to get everyone around you to agree or understand. You can click this link to learn more.

If you would rather watch a video on this topic, click here.

Lets start with Redirection Error #1: We switch topics/focus immediately.

Error #2 We try to redirect right away.

Error #3: Our redirection is isnt smooth.

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Give Them A New Focal Point

Once youve 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 youll see the behavior disappear.

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Reduce Your Own Reactions

If you want to be successful at redirecting your elderly loved one, you must reduce your own reactions. If they see you getting upset, they are much more likely to amplify the behaviors they are already exhibiting. However, if your elderly loved one sees that you are calm and that their attitude isnt bothering you, they are much more likely to accept the redirection.

Behavior Deficits: Apathy And Depression

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The other category of challenging behaviors is behavior deficits, such as apathy and depression. When individuals with dementia experience apathy or depression, they will have more difficulty performing tasks and following what you are saying.

Apathy can be a symptom of Alzheimers disease, and depression is often seen in those with Alzheimers. Apathy and depression are related but are separate conditions. Apathy is a dulled emotional state characterized by indifference. Apathetic people show little or no emotions, may appear bored and uninterested in interacting with others. Apathy can be recognized by the persons diminished initiative, poor persistence in activities, lack of interest, low social interaction, blunted emotional response and lack of insight. Apathy can be a symptom of depression.

Depression is a mental illness that usually presents with a marked lack of interest, loss of motivation, feelings of hopelessness, fatigue, poor concentration, difficulty making decisions, suicidal thoughts, and low self-esteem.

Both can contribute to withdrawal, immobility, malnourishment, poor dental hygiene and many other debilitating situations that can lead to faster functional and physical decline.

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Rummaging And Hiding Things

Caring for a patient who rummages around or hides things in the home can be a challenge, but not an insurmountable one.

Rummaging/hiding things behavior management
Protecting property
Lock certain rooms or cabinets to protect their contents, and lock up all valuables.
Have mail delivered out of reach of your loved oneperhaps to a post office box.
If items do disappear, learn the persons preferred hiding places.
Restrict access to trashcans, and check all wastebaskets before disposing of their contents in case objects have been hidden there.
Protecting your loved one from harm
Prevent access to unsafe substances, such as cleaning products, alcohol, firearms, power tools, sharp knives, and medications.
Block unused electrical outlets with childproofing devices. Hide stove knobs so the person cant turn on the burners.
Lower the temperature on water heaters.
Designate a special drawer of items that the person can safely play with when keen to rummage.

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.

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Reassure Them Of Their Safety

The desire to go home is probably the same desire anyone would have if we found ourselves in a strange and unreasonable place.

Try this instead:

Reassure the person verbally, and possibly with arm touches or hand-holding if this feels appropriate. Let the person know that they are safe.

It may help to provide reassurance that the person is still cared about. They may be living somewhere different from where they lived before, and need to know theyre cared for.

Why Someone With Alzheimers Is Repeating The Same Thing Over And Over

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In addition to short-term memory loss, repetitive behaviors can be triggered by stress, anxiety, frustration, discomfort, or fear.

A person with Alzheimers or dementia is often unsure of whats happening, where they are, or what time or day it is. Those are pretty unsettling feelings.

And if theyre feeling uncomfortable or in pain, they may not be able to clearly express their needs.

So when your older adult is repeating the same thing over and over, theyre not necessarily asking because they want an answer.

They may be asking because theyre feeling stressed or anxious and need reassurance or to have a physical need met.

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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.

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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Repetitive Speech Or Actions

People with dementia will often repeat a word, statement, question, or activity over and over. While this type of behavior is usually harmless for the person with dementia, it can be annoying and stressful to caregivers. Sometimes the behavior is triggered by anxiety, boredom, fear, or environmental factors.

  • Provide plenty of reassurance and comfort, both in words and in touch.
  • Try distracting with a snack or activity.
  • Avoid reminding them that they just asked the same question. Try ignoring the behavior or question, and instead try refocusing the person into an activity such as singing or âhelpingâ you with a chore.
  • Donât discuss plans with a confused person until immediately prior to an event.
  • You may want to try placing a sign on the kitchen table, such as, âDinner is at 6:30â or âLois comes home at 5:00â to remove anxiety and uncertainty about anticipated events.
  • Learn to recognize certain behaviors. An agitated state or pulling at clothing, for example, could indicate a need to use the bathroom.

How To Respond When Someone With Dementia Says I Want To Go Home

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Many dementia caregivers have heard their loved one say I want to go home, sometimes while they are even in their own home. Sometimes its their home of 30 years. Thats frustrating when logic says the problem is already solved.

Or sometimes theyre in a memory care unit or nursing home or somewhere else where going home is no longer an option. That can be heartbreaking in a different way, when you know you have to disappoint them, when they are so upset, when all you want is for them to understand the reason they have to stay where they are.

Repetitive statements and questions can be frustrating, and this one can be especially difficult to deal with, no matter where home actually is. A helpful first step is to consider *why* they say this, and whether their request should be taken at face value.

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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.

Improving Communication With Someone With Dementia

As a gerontologist working for nearly 30 years in health promotion/administration and Alzheimers disease, Dr. Diane Darby Beach specializes in trainings on dementia care for families and care professionals. Dr. Beach has a masters degree in public health and a doctorate in education and is a spokesperson for the Right at Home Cognitive Support Program. Below, Dr. Beach provides answers to questions about communicating with a person who has dementia, to benefit family and professional caregivers.

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How Do Dementia Behaviors Alter Interpersonal Communication

When people with dementia express repetitive questioning, or they shadow you or show combative behavior, thats how theyre communicating with you, because they dont have the words anymore. Their language comes out in behaviors. When we learn how to manage the behaviors of a person with dementia, then we can redirect the behaviors, much like we would a three-year-old, and get the person focused on something else. And the heart of this is the ability to validate and redirect patients with dementia through communication. To do this effectively, you have to know the person with dementia.

Family caregivers need to know what their loved one likes and dislikes. What did the person with dementia do for a living? What makes them happy? What were their hobbies? You can use all of this information to validate the person and redirect their behavior. Professional staff in home care or in an assisted living environment can be trained on how to obtain an accurate social/emotional history. It is vital to get a medical history, but also vital to figure out the social/emotional background to learn how to validate and redirect the patient with dementia.


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