By Shari Flight
“Remember the dementia patient is not giving you a hard time. The dementia patient is having a hard time.”
Dementia is the term to describe the symptoms that accompany a disease, such as Alzheimer’s, and these symptoms can change for the person as their disease progresses. Some of these changes in symptoms can include an increase in anxiety, aggression, and agitation. When the person living with dementia begins to exhibit these symptoms, they are frequently referred to as being “behavioral.” Our goal at The Cordwainer is to change the way people refer to these progressive symptoms, change the way we as the caregivers approach dementia-related behaviors, and work toward limiting medication to improve a resident’s quality of life.
When a resident is experiencing agitation, anxiety, aggression, or another dementia-related behavior, it can lead to wandering or “exit seeking.” These behaviors can escalate if the caregiver(s) do not approach the person in the right way. Something to remember is that the person with dementia is going to continue to change, which makes it harder for them to be brought back into our reality. Trying to bring them back into our reality is a common response when we as caregivers become frustrated by their progression; however, reality basing them can increase the dementia-related behaviors being exhibited. Instead, we should change with them and approach them by meeting them where they are in the given moment.
So, what do I mean by this? If your loved one is experiencing anger, sadness, anxiety, or exit seeking behaviors, you want to match them with the given emotion. For example:
Take the time to sit with them to ask what is wrong. Listen to their words even if what they are saying does not make sense, or if they are anxious about something (i.e., not knowing where a parent is that has been deceased for years) that is not accurate. Be a lending ear for them and show them compassion toward their worries. Remind them that you are there to help them, and use a therapeutic fiblet that whomever or whatever they are worried about is okay. Never reality base them by correcting them or reminding them that someone has passed.
You want to meet them where they are so that they do not feel like you are trying to stop them but are right there with them. If your loved one is mad because they can’t find the car keys (maybe because they no longer have a car of you have hid them), then match that anger. You can respond saying “I thought I was going crazy! I have been looking for them too!” Pretend to look with them to see if this deescalates their anger. If it does not, then you can take it a step further to say you will call a locksmith to provide you with a spare key. Your loved one will then feel like you are on top of it, and you can engage them in something else that will take their mind away from the keys.
3. Exit seeking:
If your loved one is trying to leave, whether in their home or in a community, you again want to meet them where they are. Use your therapeutic fiblets again by telling them “I am trying to figure out how to get out of here too. I actually just called a taxi for us so why don’t we hang in the living room and relax while we wait.”
In addition to changing how we respond, we also need to explore if there are common triggers. Does your loved one seem to experience the same behaviors day after day, or the same behavior at the same time of day? Just about all dementia-related behaviors have a trigger, because this is their way of trying to communicate something. Some questions to ask yourself upon seeing a behavior are:
What happened right before the behavior presented?
- Did they watch an upsetting news story?
- Did they see someone who reminded them of someone they do not like?
- Are they hungry, thirsty, hot, cold, in pain?
- Are they sundowning?
Trying to figure out the trigger will help you to understand what causes the dementia-related behavior, so that you can make sure they are not exposed to this trigger in the future.
By meeting them where they are in the given moment instead of immediately reacting, and figuring out the trigger, you can avoid the dementia-related behavior from presenting or escalating, which often can result in them needing some type of medication to assist in calming them down. We as the caregivers can change our approach to always meet them where they are as they continue to progress. By changing ourselves, we are not only helping the person with dementia but also helping ourselves because we tend to their behavior before it escalates.
The Cordwainer is a stand-alone Memory Care Community, which means our staff will have increased dementia-related training to best assist our residents as individuals who are on their unique dementia journeys. Our community is designed to always meet our residents where they are and change with them as they progress so that we always make sure we are providing them with the best of care.
The biggest takeaway from this blog is to remember that whatever the dementia-related behavior is that you are seeing in your loved one, remember that they cannot help it. Their brains are consistently changing due to their diagnosis, and if they were in the right state of mind, they would not be acting the way that they are. So, try not to allow yourself to take their comments and actions personally, and step away when you feel overcome with emotion and anger toward the changes you see.
The Cordwainer is proud to offer a Dementia Caregiver Support Group to discuss issues such as this one. Our goal is to assist caregivers through this journey in any way that you need. If you feel as though you could use a place to open up about your struggles, successes, and meet other caregivers then please reach out to us!
Shari Flight is The Cordwainer’s Director of Community Relations. She co-facilitates The Cordwainer memory care support groups alongside Program Director Somita Ray.