Communication difficulties can be one of the most upsetting aspects of caring for someone with Alzheimer’s or another type of dementia — and it’s frustrating for those with the disease and for loved ones. Although it can be hard to understand why people with dementia act the way they do, the explanation is attributable to their disease and the changes it causes in the brain. Familiarize yourself with some of the common situations that arise when someone has dementia so that if your loved one says something shocking, you’ll know how to respond calmly and effectively.
Common situation #1: Aggressive actions or speech
Examples: Statements such as “I don’t want to take a shower!”, “I want to go home!” or “I don’t want to eat that!” may escalate into aggressive behavior.
Explanation: The most important thing to remember about verbal or physical aggression, says the Alzheimer’s Association, is that your loved one is not doing it on purpose. Aggression is usually triggered by something — often physical discomfort, environmental factors such as being in an unfamiliar situation or even poor communication. Sometimes, it even comes from fear.
DO: The key to responding to aggression caused by dementia is to try to identify the cause — what is the person feeling to make them behave aggressively? Once you’ve made sure they aren’t putting themselves (or anyone else) in danger, you can try to shift the focus to something else, speaking in a calm, reassuring manner.
DON’T: The worst thing you can do is engage in an argument or force the issue that’s creating the aggression. Don’t try to forcibly restrain the person unless there is absolutely no choice.
Common situation #2: Confusion about place or time
Examples: Statements such as “I want to go home!”, “This isn’t my house,” “When are we leaving?" or “Why are we here?”
Explanation: Wanting to go home is one of the most common reactions for an Alzheimer’s or dementia patient living in a memory care facility. Remember that Alzheimer’s causes progressive damage to cognitive functioning, and this is what creates the confusion and memory loss.
DO: There are a few possible ways to respond to questions that indicate your loved one is confused about where he or she is. Simple explanations along with photos and other tangible reminders can help, suggests the Alzheimer’s Association. Sometimes, however, it can be better to redirect the person, particularly in cases where you’re in the process of moving your loved one to a facility or other location.
DON’T: Lengthy explanations or reasons are not the way to go. You can’t reason with someone who has Alzheimer’s or dementia.
Common situation #3: Poor judgment
Examples: Unfounded accusations like “You stole my vacuum cleaner!” or trouble with math or finances such as “I’m having trouble with the tip on this restaurant bill.” Other examples include unexplained hoarding or stockpiling and repetition of statements or tasks.
Explanation: The deterioration of brain cells caused by Alzheimer’s is a particular culprit in behaviors showing poor judgment or errors in thinking. These can contribute to delusions or untrue beliefs. Some of these problems are obvious, such as when someone is hoarding household items or accuses a family member of stealing something. Some are more subtle, however, and the person may not realize that they are having trouble with things that they never used to think twice about.
DO: First you’ll want to assess the extent of the problem. Take a look at the check book. Take a look at the utility bill. Are bills being paid on time? The Alzheimer’s Association says to be encouraging and reassuring if you’re seeing these changes happen. Also, you can often minimize frustration and embarrassment by offering help in small ways with staying organized.
DON’T: What you shouldn’t do in these circumstances is blatantly question the person’s ability to handle the situation at hand or try to argue with them. Any response that can be interpreted as accusatory or doubting the person’s ability to handle their own affairs only serves to anger and put them on the defensive.
For more information about this and other tips to help you in your caregiving journey with someone with dementia or Alzheimer’s disease, contact the Butler County Department on Aging at 775-0500.