Doctors might refer to dementia as a general term for a decline in mental ability severe enough to interfere with daily life, but, for many of us, dementia means something much more specific. Medical definitions don’t accurately convey what we experience when we are around our loved one. We deal with dementia and Alzheimer’s on a daily basis and each one of our loved ones is unique. In many circumstances, dealing with dementia is counter-intuitive. One piece of advice might work better than others, so with dementia, remaining patient and flexible will help everyone involved.
1. Try not to use reason. When someone with dementia is behaving erratically, explaining the situation to them probably won’t help. Like a flight attendant telling everyone to ‘remain calm’ in a time of duress, you should consider their advice. Start by getting your loved one’s attention, making eye contact at their level. Use their name and wait for a response. Clarify who you are if need be, and see if they will follow you into a different, calmer setting. The simple act of changing locations can help. Try to convey positive body language, calm yourself down and smile. Those with dementia are much more likely to respond to body language and tone rather than verbal cues. When you talk, try to be short and simple, then wait for a response.
2. Lying is often OK. When someone has dementia lying can help reduce stress for both parties. If your loved one thinks they are supposed to be somewhere or see someone (who might be dead), playing along might be the best bet. For example, reminding them of a possible loved ones death can cause all of the feelings of loss to remerge. Most importantly, there is no need to convince a loved one that they are wrong. Again, no long explanation is necessary and sometimes all they might need is positive physical contact. Hold hands, hug and reassure them that everything is OK because that is what matters the most.
3. Give yourself a break. These first two items take a great deal of care and patience which can be taxing. In times of stress, refer to the Caregiver’s Bill of Rights. The first of which is to “balance between caring for my loved one and caring for myself. This includes my desire to avoid the “Caregiver Achilles Heel” — reluctance to ask for and accept help.” Don’t wait until you are desperate. If someone offers help, say, “Yes.” There is no such thing as the perfect caregiver, but you are still in control of your own happiness. If you are happy, it will set a positive mood for everyone around you.
4. Don’t try to change them or make agreements. This might sound like common sense, but when someone has dementia, the world needs to accommodate them, not the other way around. You can’t control the behavior of someone who has dementia, but you can reduce the things that might trigger patterns of behavior. Reducing triggers means making the house a safe place to live. If they want to sleep on the floor, put a pad down to make it more comfortable. If you change your behavior you are much more likely to help change your loved one’s behavior.
5. Adapt to everyday differences. What works today might not work tomorrow. This means that one day you might overestimate their ability while the next you underestimate it. That’s alright. To make these adjustments easier to handle, break each activity into smaller steps. If they need to put on a shirt, start by just focusing on getting one sleeve on at a time. Everyday routines and repetition will help. If something doesn’t work once, try to do something else and then come back around to it.
6. Minimize choices. Asking someone with dementia, “What would you want to do today?” can be asking too much. If you ask if they would like to play cribbage or go on a walk, that would be just right. Yes/No questions are good too. Do you want to go on a walk? If all else fails, you can even tell them you will go on a walk and ask them if they would please join. The three keywords to use are ‘can’, ‘will’ and ‘please’.
7. Add time to errands. If there is a place you both need to be, give yourself plenty of buffer room. Rushing someone with dementia will create a stressful situation that can become more of a problem. If anything is time sensitive, play it safe.
Some of these tips are common sense, while others might be counter-intuitive. If you need someone else around to provide guidance or to help with anything around the house, we can be your backup. Or, learn more tips to establish a better routine and deal with sundowning.
