Focus on abilities is the key to caring for a loved one who has dementia. When someone you care about has dementia it is easy to become focused on what is lost. But both you and your parent will benefit from a focus on what he or she can still do.
One example of focusing on a dementia patient’s abilities – as opposed to disabilities – is to allow him to make decisions on things he can still manage. Keeping a person engaged in their own life decisions, even simple ones, helps retain confidence and a sense of self. In turn this can improve both emotional and physical health.
An added benefit for both your loved one and you is that sustained engagement in one’s own life lowers agitation and frustration. Your relationship will be helped too when you are relating as a family member, not just as the person who takes care of everything.
When these changes happen the person impacted will often show anger and frustration. I can recall an example of a man who was in a care program I managed. He was convinced we were keeping him from his wife and would ask frequently where she was and when he would see her. He often became very agitated because he was sure we were preventing him from seeing her. Telling him he would see her in a few hours when he would return home would only help for a few minutes.
Dementia is a general term for many different conditions that lead to progressive loss of brain function. Alzheimer’s is not the only cause of dementia. In any form of dementia it becomes progressively difficult to remember times, places and events. The ability to think through daily challenges, big and small, gets harder. Eventually the dementia sufferer struggles with caring for themselves and relating to those who have been close to them.
When communicating with a person with dementia it is important to be calm and reassuring. Even when you have answered the same question a dozen times, being positive and calm helps.
A helpful concept in dealing with a dementia sufferer is called redirection. Simply put, this means finding something else for the person to focus on, something that will distract them from whatever it is they are seemingly locked into. Finding activities that the person can do will help. The tasks for an activity should be set out in as simple a manner as possible. Allowing small, simple successes will reduce frustration. Acknowledging the strong feelings is better than ignoring them however, so you might say, “I know you are anxious about seeing your wife. I am sorry that this has upset you. Let’s go for a walk together.”
You can’t generally change the behavior of a person with dementia but you can change how you respond to it. When someone can’t tell you what it is they want or need, it is easy to understand that this is upsetting. ( Being a caregiver is hard work. )
Correcting mistakes is not usually a good thing to do with dementia sufferers. A woman I knew who suffered from dementia used to become quite angry when someone dared to correct her mistakes. She was just not used to making mistakes. She was used to remembering. This loss made her angry.
Reassurance and acceptance help. When you make an effort to understand why someone is acting in a particular way you it is easier to have compassion for them. Maybe you can even find a way to help support the strengths that still remain to reduce the anxieties over what is being lost.
Can you even imagine what it would be like to have someone tell you that you can’t go out of the house on your own? Or to have a home care worker whom you can no longer remember tell you it is time to go to bed or take a bath? No wonder people with dementia are anxious, angry, and scared much of the time.
Another thing I have seen that works to calm people who have dementia is tai chi. It may be hard to learn the various postures and moves of tai chi but the calm effort of trying can be very soothing.
So focusing on what a person can still do and decisions they can still make will help you both. Think about what brought pleasure or added routine to your parent’s life before dementia began to take its toll. Perhaps something sensory is important. Familiar music for some, or the smells of cooking or baking for others.
Some time ago I watched a video about a care facility that provided portable music with headphones for people with dementia. The staff found out the type of music favored by each person and loaded the players with that kind of music. The residents were calmer and happier listening to music that recalled favorites of an earlier time.
Watching to see what abilities are still there might mean allowing simple choices instead of making every decision yourself. Would you like to wear the blue or the green shirt? But keep the choices simple, like between two possibilities. Don’t ask them to choose from everything in the closet because that is much too overwhelming for the typical dementia sufferer.
The most important point here is to not take away all decision-making.
There are people who can help. Local chapters of the Alzheimer’s Association have many resources as well as support groups for the families of dementia sufferers. [6 Ways to Avoid Caregiver Stress]
A wonderful source of additional information can be found on the Family Caregivers Alliance website – Caregiver’s Guide to Understanding Dementia Behaviors.