The various dementias produce challenges with memory, behavior and personality.
How we design an intervention will depend on your role with the individual and the specific dementia and dementia behaviors. We start with these two variables in creating an intervention or strategy. Then you need to take into consideration the environment, time of day and the season of the year to target an appropriate approach.
The word “solution” might be the reason most of you will read this article. The disclaimer is that solutions do vary between individuals and all the variables mentioned above. We also need to consider the added issues of other illnesses and medications.
With that I need to say there is no “magic wand” or one fix for every behavior that is challenging. Some of the dementia behaviors that present will need to be accepted and compensated for by you, the primary person presented with the challenge. Part of the strategy is for you to learn how to communicate effectively with the person who has a dementia in order to reduce their anxiety and preserve their dignity and self-esteem.
One of the first lessons family, caregivers, and spouses need to learn is that these strange dementia behaviors are not because of stubbornness.
It is from a disease that impairs judgment, memory, cognition, the ability to sequence, the ability to plan, moods and more. Try to put yourself in their shoes. Think of flying to a foreign country where you do not know the language, traditions, dress or other norms of that society. Imagine getting off a plane in an airport that doesn’t look like what you are familiar with, and you can’t read or understand any signs or directions. How would you feel? That is often what it is like to be living in our world with a dementia.
Dementia behaviors can also be exacerbated by infections (the most common is a urinary tract infection), medications, changes in the time of day (sundowning – more anxiety in the late day), not understanding what is being said or incongruence between words and the body language of others.
The first step in trying to circumvent challenging dementia behaviors is to look at all the variables; the time of day, the environment, who is in the room, what is the noise level, what the person ate that day, what are the medications (any changes?), and what is the anxiety level compared to other times or days. Keeping a journal with these details will help you find out what you need to eliminate or add to the daily routine to manage or eliminate a behavior. It is also information to share with their medical provider.
The second step is to look at your behavior. Are you trying to reason with the individual? Are you the spouse, adult child or a friend/volunteer/caregiver? Your approach might be that we have always been honest with one another, or I have never lied or deceived my parent, or I am not the family member who can’t give the individual an answer that isn’t the truth. Your role often dictates your approach and some of us are more successful at getting cooperation than others. Research shows that a son-in-law or daughter-in-law is much more successful at getting cooperation from a parent than a son or daughter.
One of the most effective interventions that nearly all care providers find is learning to be able to use “Therapeutic Fiblets.”
This process takes some practice and permission from others to use the fiblet. The classes we teach at Eldercare Services are an excellent place to start. You can also join a support group where others can tell you that once you start using these interventions, the anxiety and stress is reduced. Others have also learned that communication skills can also help reduce anxiety and stress for everyone in the family system. Our goal is always to respect the dignity and enhance the quality of life. Part of that is the reduction of stress and the heightening of self-esteem.
We offer free educational classes for families that address wandering, emotional issues ranging from depression to anger, communication tips, delusions, hallucinations and many more relevant topics.
They are always led by a professional Care Manager with years of experience and credentials in social work, counseling or nursing. Each is also certified as a professional Care Manager.
Remember – you are not alone – when we come together it reduces our burden. Hearing stories of others, learning creative interventions and participating in professional support systems that are in our community help us to breathe a little easier.