A syndrome that occurs as a result of Alzheimer’s disease is dementia. It starts gradually and often presents behavioral problems. Anger, sadness, paranoia, confusion and fear experienced by people with this disease can turn into aggressive behavior and insults.
Here we talk about how to recognize and learn to deal with common situations for people with dementia.
One of the most difficult things about caring for someone with Alzheimer’s disease or some type of dementia is the communication. It is frustrating for the person with this disease as well as for the family.
Although it is difficult to understand why people with dementia behave the way they do, the explanation is related to the disease itself and the changes it causes in the brain.
We will introduce you to common situations that occur when someone has dementia. You will see how you can react calmly and efficiently when your loved one says something shocking.
Situation No. 1: Aggressive behavior or speech
Example: Statements like “I don’t want to take a shower!”, “I don’t want to go home!” or “I don’t want to eat that!” can escalate into aggressive behavior.
Explanation: The most important thing to remember is that a person does not commit verbal or physical aggression on purpose. Aggression is usually triggered by something – often physical discomfort, environment (unknown situation) or even poor communication. In most cases, the reason for aggression is also fear. One second everything is fine, and in another second the person is shouting and being aggressive. It is often a mystery what exactly triggers such a reaction.
What to do: The key to responding to aggression in dementia is to find the cause. What makes that person uncomfortable to behave so aggressively? After ensuring that the person is not putting themselves and others in danger, try to shift your focus to something else and speak in a calm tone. Give this person space if he/she needs to.
DON’T: The worst thing you can do is deliberately cause a fight or instigate a problem that causes aggression. Do not tie a person by force, unless you have no other choice.
Situation No. 2: Confusion about time and location
Example: Statements like “I want to go home!”, “This is not my house!”, “When are we going home?”, “Why are we here?”
Explanation: The desire to go home is one of the most common reactions among people with dementia who live in a nursing home. Remember that Alzheimer’s causes cognitive impairment and this is what creates confusion and memory loss.
What to do: There are several ways you can respond to questions that indicate the person is confused about where they are. A simple explanation, pictures or other tangible reminders will help. In some cases, it is necessary to move the person, to a home for the elderly and infirm or to another location. The best solution is to say as little as possible about the fact that things are packed. They need to divert their attention to another activity, go for a walk, eat something, etc. If they ask something like “When do we leave?”, you can answer “We can’t go yet…traffic is congested, the weather forecast is bad, it’s too late to leave today ,…”. Think and say what will make the person feel safe, even though it may be a lie.
NO: Long explanations and reasons are not the right solution. You can’t reason with someone who has Alzheimer’s or dementia. You can often incite aggression because of the questions you have asked.
Situation No. 3: Poor judgment or cognitive problems
Example: Unreasonable accusations: “You stole my vacuum cleaner!”, difficulties with mathematics or finances: “I can’t calculate it.” Other examples include inexplicably collecting things and repeating statements or tasks.
Explanation: Alzheimer’s disease causes the deterioration of brain cells which is reflected in behavior (poor judgments or errors in thinking). This can progress to hallucinations or false beliefs. Some of these problems are obvious, such as when someone collects household items or accuses a family member of theft. Some are subtle, so the person may not realize that they are having problems with things they have never given much thought to.
What to do: It is best to first assess the size of the problem. If you’re curious and don’t want to ask, look at the receipts. Sometimes payments are strange or bills are not paid at all. Try to encourage and reassure them if you notice these changes. Also, reduce their frustration and embarrassment by offering to help them organize. That way, over time, you will be able to fully take care of their finances.
DON’T: In these situations, you should never question the ability of the person with Alzheimer’s disease to resolve the situation or argue with them. Any answer will be interpreted as an accusation which will cause anger. After that, that person will take a defensive stance.
You can find additional advice on the website of the Croatian Association for Alzheimer’s Disease.
Is someone in your family struggling with Alzheimer’s disease or dementia? Does all this sound familiar? We’d love to hear your stories.