There are ways to address your loved one who has dementia to help deter behaviors. Here are a few ways to use at all times with your loved one:
* Go to them slowly, with slow movements; not quick or rough movements.
* Get down to eye level using eye contact.
* Always use a smile.
* Be calm and quiet with positive body language.
* Put a hand on their shoulder (if they don’t usually mind touching), or hold their hand.
Addressing your loved one with the above tips, can at many times, deter an outburst. They tend to follow your behavior; i.e., if your angry, they can feed on that; or stressed, they will react to those negative, angry characteristics.
Start the day off right…
Allow your loved one to sleep until they wake up. If you need to get them up, wake them slowly, starting with putting the light on only. Then after a couple minutes or so, go in and rub their arm/shoulder and call their name. Use eye contact, smile and go to them slowly and happily. Again, they will feed on your mood and your body language; so, if you go in their in a rush and grumpy, they are going to be the same way. They very well may get jumpy and agitated. By going slowly, you can give them time to process what you are telling them.
Use one-step commands, giving them one item at a time (clothing articles, toothbrush, toothpaste, etc.) Giving them one thing to do at a time again, lets them process what you are telling them to do. Which comes to an important point…As you noticed, I said, “telling” them what to do… If you ASK the person if they want to do something, guess what they are going to say? “NO!” By just simply telling them, the majority of the time, they will just do it.
The more you can simplify things, the calmer the individual will stay. Behaviors start because of unmet needs and getting overwhelmed and confused by too much stimulation, such as by noise, light, too many people, too many questions or commands and too quickly. Unmet needs are: Pain, hunger, thirst, and toileting. If your loved one starts getting agitated, ask them if they have any pain. If that is “No,” give them a moment and ask if they have to use the toilet, etc. Ask each one until you find which need is not being met.
Many behaviors also start with bathing time. Often, they do not like showers or baths or prefer one over the other. There are several reasons why they resist showers. You have to figure out what the problem is. Here are some tips: If the person just isn’t taking an interest in a shower and is more sluggish than usual, there may be some underlying depression. Check with their doctor. It may be as simple as getting an antidepressant, which will give them more energy and interest in showering.
Another reason may be a control issue. Showering may be one thing they can have control over. The more you end up pushing them to shower, the more they are probably going to resist. Ask if they would like to have a shower or a bath, giving them a choice of which they prefer, not if they want one or not. Don’t ask, “Do you want a shower?” or “Do you want a bath?” leaving it at that. Let them have some control. If that doesn’t work and they just get more and more agitated, leave it for now and try it later in the day or on another day. The ideal is to get them at the time where they are their best; calm and agreeable, but also have energy. Many times the issue is that they forget what a shower is, that they need one and what it is about. My mom was terrified to have the water from the shower hose hit her body. It scared her. Plus, she usually took baths more often; so, I would start with a bath.
Fear is a big part of showering/bathing. People fear the water, fear falling/slipping in the tub or getting out. Try putting yourself in their shoes…not knowing what is being done to them or why, and why is this wet stuff hitting my body and I’m cold and have nothing on??? It is very scary. If nothing works, try bribery. Tell them you have a surprise for them and they need to clean up, or they need to try on a new outfit after, etc. Anything you can think of that they may like. Again, if nothing works, just try later or tomorrow. If it becomes a continuous issue, try having an aide come in to bathe them. My mom and many people tend to be calmer when someone comes in to bathe them. A stranger sometimes works.
Bathroom safety is a MUST! Make sure there are grab bars where needed inside and outside the shower and by the toilet. Do you have non-skid grips in the shower/tub; a shower hose; and a non-skid bath mat outside the tub/shower.
In preparation, get everything prepared before. Have soap, shampoo, towels, clothing, all ready. Have adequate lighting; soft, soothing music can help, putting lavender in a diffuse can help keep them calm. Keeping them calm in the shower is important so no accidents happen. If they need, use a tub transfer bench for safety so they don’t fall. Having an extra towel to cover them when washing legs, or back to cover their front for dignity and warmth! Cover them when able. And…allow them to do as much as they can. If all they need is supervision once in the shower, just supervise for safety. Only help when needed. Let them feel in control.
When they are done, give them one clothing item at a time (from when you let them pick from 2 outfits), in order of need.
As your day goes on..
Learn what triggers your loved one. This may change, but usually there are triggers that will consistently upset them. Then you can diffuse them before the behavior starts.
Lighting in the rooms can trigger behaviors. If its too dark or too bright, they may see shadows that will scare them and may get them agitated. Check to make sure the lighting is adequate.
Watch for noise. If there are a lot of people around and children making noise, this will often cause confusion and agitation. Just as loud TV or music. Along with that goes the environment itself. If things in the room are hectic and anxious, that is how the individual is going to be. Keep the environment calm but cheery. Again, when the individual gets agitated or there is a common time they get agitated, such as sundowner’s, use a diffuser with lavender. Sundowning is basically late-day agitation. Ways to control this is to keep the individual active during the day, doing simple exercises (can be chair exercises), going for a walk or in a wheelchair, do an outing somewhere, throw a ball or balloon, etc. If you do an outing, keep it simple and always take extra clothing, briefs, water, snacks, etc. if needed. Keep your days as structured as possible, keeping things calm and pleasant. Avoid late afternoon and/or early evening naps, which will hinder bedtime.
As you know, there are certain things that will agitate the person. Bathing is a big one. Doctor’s appointments tend to be another big agitator. We had to tell my mom she was going somewhere else to get her in the car. By the time we got to the doctor, she forgot what we said. If she got upset again, we told her she was going to see her favorite doctor, then she was usually calm enough to get into the office. When all else fails, use therapeutic lying. We have had to do this very often. You do what you have to do to keep your loved one calm and happy, at least in the moment. Don’t feel guilty for therapeutic lying. It is in the best interest of your loved one.
Your loved one may also wander when they get upset about something. It may be they just may not recognize their surroundings, or need something that they can’t communicate, or can’t find anyone they recognize. They may just be bored/restless, can’t sleep, or they are looking for something or someone in particular. If this is an occasional problem, putting a “STOP” sign on the exit they try to get out of may help. They see “STOP,” so they STOP! If it gets real bad, you can get alarms and/or cameras that can alert you by a noise and by phone, email, etc. Many times, just redirecting them will work. Talk to them about something that calms them. If they are looking for their parent who was supposed to pick them up, start discussing about what they are going to do when their parent gets there, or what they are going to eat. Tell them they called and are going to be coming in a while; that they said to go for a walk, play ball, etc., until they get there.
Meals tend to get shaky at times also. Don’t ask them what they want. That is too difficult of a question. Rather, give them a choice of 2 things so they feel they have control. If self-eating is getting difficult and agitating for them, put the potatoes in one bowl, meat in another and vegetable in yet another. With all these extra dishes, maybe they can help wash dishes (nonbreakable plates are good). They may need to eat more finger-foods. Finger-foods are easier to handle and makes meals much calmer.
Bedtime can also be a difficult time. Again, putting a couple drops of lavender on their pillow or in a diffuser may help. By keeping them awake more during the late afternoon, bedtime may be easier. If they nap, do it right after lunch. Do simple exercises in the morning and after their nap. Physical activity can keep them awake plus it is just good for them! Try to keep them on a normal sleeping schedule, very structured; however, at times, you have to live in their world, because they may no longer be able to live in ours. That is when you sleep when you can (when they do); and this may keep them less agitated.
There are definitely going to be different triggers for your loved one. Trial and error is the key to help keep them from not getting so upset they have a catastrophic event. Essential oils have been found to be very effective in calming individuals and even occasionally helping their memory a little. This leads me into some alternative ways to try to calm behaviors.
Alternative ways to calm agitated behaviors:
* Lavender – put a couple drops on a pillow slip or in a diffuser anytime.
* DoTerra AromaTouch – a group of 8 essential oils, which applied in order as directed can calm down an individual and allow them to relax. Some of the oils included in some of the blends are: Chamomile, spruce Frankincense, lavender, wild orange peppermint and others.
* Wrapping them in a sensory blanket, which is a thick, heavier blanket that weighs on them giving them sensory feedback to help calm them. These can be easily made.
* Music has been found to be calming. Listening to music they enjoy that is soft and soothing. Allowing them to play a simple instrument along with music and singing music from their time.
* Special trinkets (stuffed animal, piece of clothing, etc.) in their view that they can get to and hold if wanted, needed.
* Familiar, meaningful pictures that can be reminisced about.
* Pets can be very calming AND enjoyable.
* One-on-one communication using eye contact and touch.
* Seeing and holding (if able) a baby, or having small children visit. Seeing babies takes them back (or they may mentally be at that age) of being a mom. Can be very enjoyable (but not for too long if there is chaos).
* Anything else you can try and think of. Remember, what works one time may not necessarily work the next and vice versa.
If you ever come into a position where the individual becomes combative, do not attempt to grab them. They may thing you are going to hurt them, as they may not recognize/know who you are. Try to find something to defuse the situation. Ask them questions, whatever you can think of. If they become dangerous, you may have to restrain them, if safe. Keep sharp items out of sight, and locked away if necessary. Even utensils, glasses, bottles, plates, etc. Make sure they are not a danger to themselves, you or anyone else. If so, get help immediately if you have to.
Remember safety for everyone comes first. Make the living space free of dangerous items, clutter-free, good lighting and elderly-safe. This in itself, can help keep things calmer.
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