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The job of a caregiver can sometimes feel like a thankless one, but when a person with dementia develops aggressive, and sometimes violent, behaviors it can start to feel like we are failing ourselves and our loved ones. Although these problems can be difficult to deal with, it is important to remember that it is not a helpless situation. Calming them down is the first step to getting through the outbreak. Here are some strategies to help you deal when the going gets tough.
Start With Empathy
Feel what they are feeling. Get on their level. Try to relate. Focus on their feelings, not on the actual facts of the situation. If we take a moment to try and put ourselves in their world, we may find that the reason for their behaviors is easily rectified. When we start with connecting to their emotions, it facilitates trust and allows them to feel safe in telling you what may be bothering them. Watch their body language for clues as to what they may be feeling or trying to express. For example, perhaps they are stressed or frustrated because they are unable to communicate a need that is not being met. Are they touching their stomach, licking their lips, or holdng a part of their body? Perhaps they are hungry, thirsty or in pain. Maybe they aren't getting enough sleep.
Survey the Environment
Dementia causes damage to the brain can result in overstimulation and bring on feelings of restlessness. To prevent these feelings, limit the distractions and create a calm in the environment. Are the current surroundings having an effect on your loved one? Is it too loud, too hot, too cold, too dark? Maybe there's a strange odor or too many people in the room? Environmental stimuli can affect their mood, so if there is a change in their atmosphere, you may see a reaction to the irritant. To minimize frustrations for both the caregiver and the person with dementia, be aware of your surroundings and use some basic strategies to filter the distractions. For example - declutter the space, turn the TV off when you are trying to communicate, place smartphones in the other room during activities and minimize the number of visitors at any one given time.
It is important to give your loved one your undivided attention to ensure you catch the early signs of agitation before they become a problem. If anger ensues, try introducing pleasant stimuli to the environment such as a favorite song, food, drink, picture or other item you know they enjoy to evoke a positive feeling. It may be beneficial to keep a "behavior box" full of items that you can grab quickly to help quell moods of frustration and anger. Caregiver should be mindful of keeping dangerous objects, such as scissors and knives, hidden and out of reach in case of a behavior outbreak.
Communicate Clearly
Once you as the caregiver have gained some insight and trust from your loved one, you should transition to using a calm and clear voice to reassure them that you are here to help. Use short, simple sentences such as "I am here to help you" or "I understand what you mean" and allow them time to reflect and decompress for a moment if need be. Allowing them to have their space and regroup before re-addressing the issue may help to prevent or divert fits of rage. Redirection or suggestion can help them to focus on things other that what is upsetting them, so asking them to help you with a task such as folding the laundry, or inviting them to go for a walk may make a big difference in their agitation level and help them to forget what has upset them. Know when to let things go and try to avoid correcting their actions if they are not responsive to your calming attempts, particularly when the outcome is less than critical. If mom wants to pull all the dishes out of the cabinet and stack them on the tabletop, then let her do it. Eventually she will finish the task and move on to something else. Fighting over the issue will only frustrate both parties.
Use Touch to Facilitate Return to Normal
Your loved one will respond to your body language, facial expression, tone of voice and tactile stimulation. Use eye contact, a smile, and a reassuring touch to convey your compassion and willingness to help. Try to come from a place of accepting, instead of contradicting. Remember that it is the dementia that has them overreacting, it is not personal towards you. Use the hand under hand method to help the dementia person to feel more relaxed and guided. Many times when someone is upset, they may already be holding their hands out to you. If this is the case or you are able to grab their hand without struggle, place your hand under theirs on their dominant side and gently squeeze and release their palm in a heartbeat rhythm while deep breathing. This will slow their breaths and encourage mimicking, which will allow them to also take deeper breaths and take in more oxygen to aide in re-centering themselves following a behavior episode.
Caring for a loved one with dementia can often times feel like a daily battle. Navigating the personality changes and mood swings of someone you love, but hardly know anymore, can create a lot of stress for the caregiver. Using these strategies can help you respond to your loved one in a respectful and mindful way, while hopefully preserving the some sanity for you both. Dementia specialist, Teepa Snow, provides some valuable insight and visual examples of how to put these strategies into effect in the video below.
And if all else fails, seek medical help. If your loved one becomes a physical danger to themselves or others, then it is essential you consult with your physician or other healthcare or mental health provider immediately to ensure the safety of your loved one as well as yourself and your family. Physically abusive behavior is not okay. Not even a one-time occurrence should be excused. Don't ignore it, or it just may get worse. If you have questions or comments that may help others, please use our forum to keep the discussion going. If you or your loved one is struggling with dementia, we can help. Contact us today to schedule an evaluation and let us help you and your loved one lead a more happy, healthy and independent life.
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