Remember: Your Needs As A Caregiver Matter Too
Dealing with dementia behaviors can quickly wear out a caregiver or family member, causing caregiver burnout.
If your loved ones dementia behaviors have progressed to the point where you cannot manage them alone, help is available. Senior care options like home care or memory care can help relieve some of the caregiving burden while also helping to keep your loved one safe.
If you are feeling resentment, anxiety, or depression, seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.
Other families, other caregivers, are going through the same thing, Hashmi says. They have a lot of common challenges and common solutions to share. And often those are the most effective, because theyre going through exactly the same process.
Its Not A Dementia Anger Stage Its A Natural Stress Response To Something That Is Upsetting
However, if I were experiencing dementia, I couldnt do any of that because I would have lost the necessary skills. If my friend sounds distant and uninterested, I will take it personally. If my husband looks irritated when I slam down the phone and say something mean about her to him, my anger will increase and become grumpiness that persists. I might again be mean to my husband immediately or I might be surly or even aggressive with the next person I meet.
The Thoughtful Pause Between Stimulus And Response May Deteriorate In Dementia
In the last post, we discussed how and why frustration, depression, anxiety, and not participating in activities are common in dementia. In this article well tackle the thorny issues of apathy, irritability, agitation, aggression, combativeness, inappropriate behavior, willfulness, and sundowning.
Apathy is common in dementia. When dementia damages the front of the brain or some of its connections, apathy can result. The normal drive to plan for the future is lost. Sometimes this loss can manifest by letting house repairs go, neglecting to pay bills, or not going to the grocery store until every scrap of food in the house is gone. When more severe, the desire to do anything at all may be gone, and the individual with dementia can sit passively for hours staring at a blank wall or a television that is not turned on.
Disinhibited behavior can lead to safety issues. When your loved one has behavior problems it can be distressing, physically exhausting, and heart-breaking. Behavior problems can also lead to safety issues. Dementia may lead individuals to act precipitously without thinking of the consequences. If they are feeling angry, they could strike out with their fists or any available item, including knives, guns, and baseball bats. If they feel like getting out of the car they may do sodespite the fact that the car is moving! In later posts, well discuss ways of managing these safety issues.
Key Questions
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What Are The Causes Of Lewy Body Dementia
The precise cause of LBD is unknown, but scientists are learning more about its biology and genetics. For example, we know that an accumulation of Lewy bodies is associated with a loss of certain neurons in the brain that produce two important chemicals that act as messengers between brain cells . One of these messengers, acetylcholine, is important for memory and learning. The other, dopamine, plays an important role in behavior, cognition, movement, motivation, sleep, and mood.
Scientists are also learning about risk factors for LBD. A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. Age is considered the greatest risk factor. No specific lifestyle factor has been proven to increase oneâs risk for LBD.
Other known risk factors for LBD include certain diseases and health conditions, particularly Parkinsonâs disease and REM sleep behavior disorder, which have been linked to a higher risk of LBD.
Having a family member with LBD also may increase a personâs risk, though LBD is not considered a genetic disease. Variants in three genes APOE, SNCA, and GBA have been associated with an increased risk, but in most cases, the cause is unknown.
Strategies For Preventing Anger Outbursts
If you understand what triggers anger and aggression in your loved one with dementia, it will be easier to avoid those triggers and prevent aggressive behavior. Here are some tips on how to prevent aggressive outbursts.
- Never try to take physical control of the person with dementia or to use force, no matter how aggressive your loved ones behavior becomes.
- If you can, avoid the circumstances that trigger anger and aggression.
- If you can determine the cause of your loved ones distress, try to solve or minimize the issue.
- When talking to a person with dementia, always use a calm tone of voice.
- Try to keep your feelings of distress, upset, or anger under control.
- If possible, find someone to take over and remove yourself from the situation and give yourself and the person with dementia time to calm down. However, never leave the person unattended.
- Be reassuring and supportive.
- Dont reason or argue with the person. Show understanding and love instead.
Remember that your loved ones anger and aggressive behavior stem from confusion, insecurity, discomfort, and pain. Many family members and caregivers try do discipline the persons with dementia for their angry outbursts. This is a mistake that you should by all means avoid. Keep in mind that your loved one struggles with a loss of control over the basic life functions and activities.
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Early Signs Of Dementia In Men
Dementia is a collection of symptoms, and there are many overlapping features between the different types. Other diseases and disorders can contribute to dementia, which may affect thought processes, communication ability, focus, and memory capacity of those affected. It is important to not assume your loved one has dementia just because they are facing memory problems. The diagnosis can be complicated and requires the assessment of a doctor or medical professional. The following are some of the more common signs of early dementia in men:
Recent memory loss: Forgetting recent conversations or events is often the first sign. Memories are often not affected and may throw off family members, making them think that memory is okay. Often those affected by dementia will not be able to remember what they eat for breakfast.
Difficulty performing familiar tasks: A very reliable warning sign, according to many medical experts. Dementia patients often lose the ability to cook food they once did flawlessly or get lost on their way home in a neighborhood theyve lived in their whole lives.
Language problems: Struggling to communicate thoughts is often an early sign of dementia. They have difficulty explaining things or have trouble finding the right words to express themselves. They may also substitute the wrong word either knowingly or not.
Coping With Agitation And Aggression In Alzheimer’s Disease
People with Alzheimers disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesnt seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.
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Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
Do Not Initiate Contact
This tip goes hand-in-hand with allowing the person space and remaining calm. For some, physical contact can be relaxing and reassuring. However, in periods where the person is angry, confused, and aggressive, contact can lead to physical aggression that will escalate the situation.
You should never react to violence with force as this can send the situation spiraling out of control, possibly leading to bodily harm for yourself or them. Unless your safety or the safety of somebody else is threatened, avoid physical force and contact at all costs.
At Iora, comprehensive care and treatment are priorities. When patients walk into our practice, our dedicated and passionate care teams work to treat the whole patient. Our care model seeks to empower our patients through extensive physical and behavioral care, putting the power of the patients health back in their hands.
Of course, we understand the hardships that come with caretaking can be quite stressful. However, we have several resources to help you be the best caregiver you can be.
Now that you understand more about the causes of dementia and anger, and how to talk to someone with dementia, check out the five main reasons for caregiver burnout.
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What Is The Treatment For Symptoms And Complications Of Dementia
Some symptoms and complications of dementia can be relieved by medical treatment, even if no treatment exists for the underlying cause of the dementia.
- Behavioral disorders may improve with individualized therapy aimed at identifying and changing specific problem behaviors.
- Mood swings and emotional outbursts may be treated with mood-stabilizing drugs.
- Agitation and psychosis may be treated with antipsychotic medication or, in some cases, anticonvulsants.
- Seizures usually require anticonvulsant medication.
- Sleeplessness can be treated by changing certain habits and, in some cases, by taking medication.
- Bacterial infections require treatment with antibiotics.
- Dehydration and malnutrition may be treated with rehydration and supplements or with behavioral therapies.
- Aspiration, pressure sores, and injuries can be prevented with appropriate care.
Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
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The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
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.
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Can Dementia Get Worse Suddenly
Dementia is a progressive condition, meaning that it gets worse over time. The speed of deterioration differs between individuals. Age, general health and the underlying disease causing brain damage will all affect the pattern of progression. However, for some people the decline can be sudden and rapid.
Early And Middle Stages Of Vascular Dementia
Some symptoms may be similar to those of other types of dementia. Memory loss is common in the early stages of Alzheimer’s, but is not usually the main early symptom of vascular dementia.
The most common cognitive symptoms in the early stages of vascular dementia are:
- problems with planning or organising, making decisions or solving problems
- difficulties following a series of steps
- slower speed of thought
- problems concentrating, including short periods of sudden confusion.
A person in the early stages of vascular dementia may also have difficulties with:
- memory – problems recalling recent events
- language – eg speech may become less fluent
- visuospatial skills – problems perceiving objects in three dimensions.
As well as these cognitive symptoms, it is common for someone with early vascular dementia to experience mood changes, such as apathy, depression or anxiety. Depression is common, partly because people with vascular dementia may be aware of the difficulties the condition is causing. A person with vascular dementia may also become generally more emotional. They may be prone to rapid mood swings and being unusually tearful or happy.
Need advice on managing behaviour changes?
Read our top tips for managing and reducing out of character behaviour.
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How To Prevent Dementia And Angerits All About Body Language
And finally, because of all this, we need to become very aware of our nonverbal communications. In my article on mean dementia I explained that reading nonverbal communication is one of our intuitive thinking skills, and so it is something not lost to dementia. We begin learning to read our companions expressions, body language, and intonation at an incredibly young agewithin hours of birth. And we keep those skills in dementia.
Dementia will take away our ability to understand language and eventually the meaning of even the first words we learned as toddlers, but people who are experiencing dementia remain very aware of their companions expressions, body language, and intonation. And without memory skills to distract them with memories of the past, or rational thinking skills to distract them with plans or anticipation of the future, people who are experiencing dementia are entirely presentfully alive in the moment and to whats happening around them.
Mood Transferenceour Mood Becomes Their Mood
Think about this: If someone experiencing dementia cannot change their own moods, what happens when a caregiver arrives looking worried or concerned, or someone walks into the room in a bad mood? What happens is mood transference, because we need memory and rational thinking skills to protect ourselves from other peoples moodsand without those skills we can only absorb their moods and feel bad too.
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What Are The Signs And Symptoms Of Late Or Severe Dementia
- Worsening of symptoms seen in early and intermediate dementia
- Complete dependence on others for activities of daily living
- May be unable to walk or move from place to place unassisted
- Impairment of other movements such as swallowing: Increases risk of malnutrition, choking, and aspiration
- Complete loss of short- and long-term memory: May be unable to recognize even close relatives and friends
- Complications: Dehydration, malnutrition, problems with bladder control, infections, aspiration, seizures, pressure sores, injuries from accidents or falls
The person may not be aware of these problems, especially the behavior problems. This is especially true in the later stages of dementia.
Depression in elderly people can cause dementia-like symptoms. About 40% of people with dementia are also depressed. Common symptoms of depression include depressed mood, loss of interest in activities once enjoyed, withdrawal from others, sleep disturbances, weight gain or loss, suicidal thoughts, feelings of worthlessness, and loss of ability to think clearly or concentrate.
People with irreversible or untreated dementia present a slow, gradual decline in mental functions and movements over several years. Total dependence and death, often from infection, are the last stages.
Treating Sleeplessness And Anger For Instance Are Challenges For Caregivers And Doctors Alike Plus The Latest Research
by Stacey Colino, AARP, July 24, 2018
At its annual conference today, the Alzheimers Association highlighted research on treatments for some of the noncognitive symptoms people with dementia often experience. Such behavioral and psychological symptoms of dementia agitation, apathy, mood changes, hallucinations, sleep disturbances, wandering and the like are often among the most challenging for family members and caregivers to handle. They’re also particularly difficult to treat since no drugs are approved to specifically address these dementia-related symptoms, which are often the leading reasons patients are placed in assisted living facilities or nursing homes, according to the AA.
“Most people think about Alzheimer’s disease as being a forgetfulness disorder, but a quarter of people present with nonmemory, noncognitive changes,” says James M. Noble, M.D., an associate professor of neurology at the Columbia University Irving Medical Center and a faculty member at the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain in New York City. “Noncognitive symptoms become quite stressful for caregivers. Seeing changes in personality in important relationships that may have been previously loving can be very challenging.”
“I never know what I’m going to walk into there’s no predicting how his anger is going to be,” says Cheryl, who notes that her husband often has no recollection of encounters in which he’s yelled at family members.
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Preventing And Handling Anger In Alzheimers Care
The more you are able to understand your loved ones aggressive triggers, the easier it will become to avoid those triggers and prevent anger outbursts. That said, it isnt always possible to avoid certain triggers. Because of this, it is important that you know how best to handle outbursts of anger, including both verbal and physical aggression.
Here are some guidelines for managing anger outbursts in Alzheimers care recipients:
- If you can determine the cause of their distress, see if it is possible to alleviate or solve the issue. This can stop an issue from becoming worse, and often helps dispel their anger.
- Avoid physical contact and NEVER react to violence with force, unless your personal safety or the safety of someone else is threatened. Trying to take physical control of a dementia sufferer often increases their anger and aggression.
- Use a calm tone of voice and avoid outward displays of distress, upset, anger, or fear. These signs are often detected by the angry person and will likely make their own distress and agitation worse.
- If possible, remove yourself from the room or situation. Give yourself and the person time to calm down. This will make it easier for you to react and may defuse or dispel their anger.
- Be kind and reassuring at all times. Do not attempt to argue or reason with the person. Instead, be sympathetic and accepting of their anger and frustration.