Caring for a loved one with dementia can feel like a daily battle. You are dealing with the loss of the person you once knew. At the same time, you love them even as you adapt to their changes in behavior and learn to handle episodes of agitation and aggression.
The challenges of dementia caregiving can break your heart on a regular basis. Executing simple tasks and scheduling events for a loved one can turn into a disaster. At times, your loved one’s behavior may be difficult to predict; dementia is cruel to both the person with dementia and to the caregiver. This blog posts outlines some strategies that can help you respond to the challenges of dementia in an effective and mindful way.
Learning how to handle difficult behaviors caused by dementia will give you the ability to enjoy spending time with your loved one. While dementia may take memories, it cannot take the love shared between you and your loved one. Research has shown that people with dementia will still feel love and happiness even after they have forgotten an specific visit or experience (1).2 Love remains. That is your defense against dementia, both for you and your loved one.
These five methods to calm agitation and aggression will give you a way to focus on the love in your relationship. At the core of these five strategies is find effective ways to communicate (2). Keep that in mind as you read further. With these in your arsenal, you will be able to build on the bond you and your loved one share.
1. Stay Calm
Agitation and aggression are contagious. It is very natural when you are talking to somebody who is getting agitated to feel upset yourself. This natural response is called mirroring, and in many instances can work to your benefit. Instead of mirroring your loved one’s agitation, by remaining calm, you are presenting a demeanor for your loved one to mirror.
When you stop and take a deep breath to calm yourself, you are demonstrating calmness to your loved one. This helps to make them feel safe and reassured (3).3 Take a step back and see if you can identify a cause for the agitation. Remember that your loved one is not trying to give you a hard time – he or she is struggling as much as you are.
Stop whatever you are doing and slow down. Listen to what your loved one is saying, even if it doesn’t make sense! Don’t correct. This can make the agitation worse. Take a moment to remember a positive memory you share with your loved one. Allow that warmness to enter your eyes and look directly at him or her. Smile gently and try to ask for permission to do the thing you need to get done, or offer your loved one some help in the task. Calmness often reassures those with dementia, which will allow you to make a positive request like “will you walk with me to the store?” or “can I help you wash the dishes?”
2. Focus on Feelings not Facts
Dementia can impact a person’s ability to reason and communicate. However, feelings remain strong. You need to respond to your loved one’s feelings instead of their words. Trying to reason and argue with a person with dementia will only frustrate both of you. (4).
Listen to the expression of frustration even if the actual words don’t make sense. Your loved one might be saying, “I need the car to take the ball!” You could respond to that expression by saying, “you really are wanting the car today?” Then try to provide clear reassurance, for example “I will take you out in the car today and we can get what you need.”
Treat your loved one with love and respect. Love and respect can bridge communication problems between yourself and someone with dementia. You should always treat your loved one with dignity. Although you may see behaviors that remind you of a child, your loved one is not a child. Guarding his or her dignity will prevent hurt feelings that lead to agitation. The reality your loved one is trying to convey may not align with your interpretation of the world. But their feelings about what they are experiencing can lessen that divide.
3. Limit Distractions
Dementia causes damage to the brain that makes it difficult to express thoughts and perform tasks. Background noises, clutter, crowds, and even lights can overstimulate the brain and bring on feelings of restlessness and distress (5).5 Foster an environment of calm in your home. Choose smaller gatherings over crowds as much as possible. For example, instead of inviting crowds of people at once, try one or two visitors at once. Also turn off the TV when talking to your loved one. The noise from the TV can be difficult for them to block out.
Reduce the amount of non-essential items in your home. Bright, distracting patterns and moving objects can confuse your loved one. One or two meaningful, personal pictures will offer a more calming décor than twenty fancy frames.
Lights are another stimulating stimulus. Particularly in the evenings and late afternoon, it is important to switch from bright overhead lights to smaller, dimmer lights. The glare and reflections from lights bouncing off windows, mirrors, and picture frames can be startling or even frightening to your loved one.
Always aim to simplify your surroundings when you notice signs of agitation. Use simple sentences. Move into a quieter space. A calm environment will often calm your loved one.
4. Check for Discomfort
Your loved one’s difficulty communicating means that they can have trouble telling you when they are uncomfortable. One sign of physical discomfort may be that your loved one is having trouble sitting in one place and is constantly on the move, fidgeting and irritable. Below is a thorough checklist to help you identify physical discomfort:
When did your loved one last eat? Could they be hungry? Try offering a small, nutritious snack. Better yet, sit down with them and have a snack yourself. Ensuring that you aren’t hangry will also help your loved one remain calm (remember method one?).
Could your loved one have an infection? Urinary tract infections and bladder infections can often develop or worsen symptoms of confusion, decreased mobility, and enhance agitation (6).
What has your loved one had to drink in the last 24 hours? Dehydration is common in seniors due to a decreased sense of thirst. Dry eyes, mouth and skin are symptoms to watch for along with confusion and forgetfulness. Make your loved one a hot or cold cup of non-caffeinated tea, offer a slice of juicy watermelon, and make sure to add water dense foods into their daily meals. Or gently remind your loved one to sip on water throughout the day.
Do you know when your loved one last had a bowel movement? That’s an important discomfort to address.
Don’t forget to do a quick glance of the clothes your loved one is wearing. A waistband that itches, the tongue of a shoe that is rubbing, socks bunched at the toe, a collar that is too tight, or a fabric that scratches could all result in discomfort. All of these minor irritations can be distracting and irritating.
Making sure that your loved one is physically comfortable will drastically reduce aggression and agitation.
Dementia can be a frightening and a stressful time for both you as the caregiver and for your loved one. The most important thing you need to keep in mind while working through the aggression and agitation is connection. Dementia CANNOT steal the love from your relationship. It only changes the relationship.
Always look for ways that you can cherish your loved one instead of focusing on the more frustrating aspects of being caregiver. If the immediate situation or activity seems to be triggering your loved one, try to be proactive in changing that situation. Redirect to a more peaceful and relaxing activity. If a conversation is upsetting either you or your loved one, acknowledge what your loved one said and then move to a different topic.
Aim to say yes as much as possible. If your loved one mentions that she saw someone who has passed away years ago, agree with how lovely that would be to talk to them again. Even build on it and ask what they talked about. This gives you both a connection with one another and serves as a comforting conversation.
Remember that you can only count on today. Enjoy the moments that you have. Listen to music together, dance (if you can!), play an instrument, offer a massage or brush your loved one’s hair. Go for a walk outside and listen to the bird songs or look at flowers. As Alzheimer’s and dementia progress, the world is largely experienced through senses. Express your love through touch, sounds, sight, tastes, and smells.
Home Care Assistance hopes that these tips will help you continue to cherish your loved one even as dementia changes the dynamics of your relationship. Dementia, particularly dealing with aggression and agitation it causes, can be challenging for caregivers. Remember the importance of connecting with your loved one, and rely on communicating your own positive attitude so that they can mirror you. Provide a soothing environment and aim to remain calm and loving. Empathize with your loved one’s feelings and always emphasize love. When it comes time to invite more help into the home, look for caregivers that are trained in Alzheimer’s and dementia care.