What Do You Do With Family Member With Dementia

Heed

To listen to this fact sheet, click the links below.

Part 1: Introduction

Part 2: Handling Troubling Behavior

Part 3: Handling Troubling Behaviors cont.

Introduction

Caring for a loved i with dementia poses many challenges for families and caregivers. People with dementia from conditions such equally Alzheimer's and related diseases have a progressive biological brain disorder that makes it more than and more difficult for them to think things, think clearly, communicate with others, and accept care of themselves. In addition, dementia can crusade mood swings and even alter a person's personality and behavior. This fact sheet provides some applied strategies for dealing with the troubling behavior problems and communication difficulties oft encountered when caring for a person with dementia.

Ten Tips for Communicating with a Person with Dementia

Nosotros aren't built-in knowing how to communicate with a person with dementia—but we can learn. Improving your communication skills will aid make caregiving less stressful and will likely better the quality of your human relationship with your loved one. Proficient communication skills will besides heighten your power to handle the difficult behavior y'all may see equally you treat a person with a dementing illness.

Set a positive mood for interaction. Your attitude and torso language communicate your feelings and thoughts more strongly than your words practice. Set up a positive mood by speaking to your loved one in a pleasant and respectful style. Apply facial expressions, tone of vocalism, and physical touch to aid convey your bulletin and show your feelings of affection.
Get the person's attention. Limit distractions and noise—plow off the radio or TV, close the defunction or shut the door, or move to quieter surroundings. Before speaking, make sure yous have her attention; accost her past proper name, identify yourself by name and relation, and use nonverbal cues and affect to help keep her focused. If she is seated, get down to her level and maintain eye contact.
State your message clearly. Use elementary words and sentences. Speak slowly, distinctly, and in a reassuring tone. Refrain from raising your voice college or louder; instead, pitch your voice lower. If she doesn't empathize the first time, use the same wording to repeat your message or question. If she still doesn't understand, wait a few minutes and rephrase the question. Use the names of people and places instead of pronouns (he, she, they) or abbreviations.
Ask simple, answerable questions. Inquire 1 question at a time; those with yes or no answers piece of work best. Refrain from asking open-ended questions or giving too many choices. For case, ask, "Would you like to wear your white shirt or your bluish shirt?" Better still, show her the choices—visual prompts and cues also aid clarify your question and tin can guide her response.
Listen with your ears, eyes, and heart. Be patient in waiting for your loved one's reply. If she is struggling for an answer, it's okay to suggest words. Lookout man for nonverbal cues and body language, and respond appropriately. Always strive to heed for the meaning and feelings that underlie the words.
Break down activities into a serial of steps. This makes many tasks much more manageable. You lot can encourage your loved 1 to do what he can, gently remind him of steps he tends to forget, and assist with steps he'southward no longer able to reach on his ain. Using visual cues, such every bit showing him with your paw where to place the dinner plate, can be very helpful.
When the going gets tough, distract and redirect. If your loved ane becomes upset or agitated, try changing the subject or the environment. For example, ask him for help or suggest going for a walk. Information technology is important to connect with the person on a feeling level, before you redirect. Y'all might say, "I meet you're feeling sad—I'one thousand sorry you lot're upset. Let'south get become something to eat."
Respond with affection and reassurance. People with dementia oft feel confused, anxious, and unsure of themselves. Farther, they often get reality confused and may think things that never really occurred. Avert trying to convince them they are wrong. Stay focused on the feelings they are demonstrating (which are real) and reply with exact and physical expressions of condolement, support, and reassurance. Sometimes holding easily, touching, hugging, and praise will get the person to respond when all else fails.
Call back the good old days. Remembering the past is oft a soothing and affirming action. Many people with dementia may not call up what happened 45 minutes ago, but they tin clearly recall their lives 45 years earlier. Therefore, avoid request questions that rely on short-term retentiveness, such as asking the person what they had for lunch. Instead, try asking general questions about the person'due south afar past—this data is more likely to be retained.
Maintain your sense of humor. Use humor whenever possible, though non at the person's expense. People with dementia tend to retain their social skills and are usually delighted to laugh along with y'all.

Handling Troubling Behavior

Some of the greatest challenges of caring for a loved one with dementia are the personality and behavior changes that often occur. You can all-time run into these challenges past using inventiveness, flexibility, patience, and compassion. It as well helps to non take things personally and maintain your sense of humor.

To start, consider these ground rules:

We cannot change the person. The person yous are caring for has a brain disorder that shapes who he has go. When you effort to command or change his behavior, you'll most likely be unsuccessful or be met with resistance. Information technology'south of import to:

Try to accommodate the beliefs, non control the beliefs. For example, if the person insists on sleeping on the floor, place a mattress on the floor to make him more comfortable.
Remember that we can alter our beliefs or the concrete environment. Changing our own behavior will often effect in a change in our loved one's beliefs.

Cheque with the doctor kickoff. Behavioral issues may have an underlying medical reason: perhaps the person is in pain or experiencing an agin side effect from medications. In some cases, like incontinence or hallucinations, there may exist some medication or treatment that tin aid in managing the problem.

Beliefs has a purpose. People with dementia typically cannot tell us what they want or demand. They might practice something, like accept all the dress out of the closet on a daily basis, and we wonder why. It is very likely that the person is fulfilling a need to exist busy and productive. Always consider what demand the person might exist trying to meet with their behavior—and, when possible, try to arrange them.

Behavior is triggered. It is important to understand that all behavior is triggered—it occurs for a reason. It might be something a person did or said that triggered a behavior, or it could exist a change in the concrete environs. The root to changing behavior is disrupting the patterns that we create. Try a different approach, or effort a unlike consequence.

What works today, may not tomorrow. The multiple factors that influence troubling behaviors, and the natural progression of the disease process, hateful that solutions that are effective today may need to be modified tomorrow—or may no longer work at all. The key to managing difficult behaviors is being creative and flexible in your strategies to address a given event.

Get back up from others. You are not alone—in that location are many others caring for someone with dementia. Locate your nearest Area Bureau on Aging, the local chapter of the Alzheimer's Association, a California Caregiver Resources Eye, or visit the Family Care Navigator (world wide web.caregiver.org/family-intendance-navigator) to find back up groups, organizations, and services that can help you lot. Expect that, like the loved one you lot are caring for, yous will have good days and bad days. Develop strategies for coping with the bad days.

The post-obit is an overview of the most common dementia-associated behaviors, with suggestions that may be useful in treatment them. You'll find additional resource listed at the cease of this fact sail.

Wandering

People with dementia walk seemingly aimlessly, for a diverseness of reasons, such as boredom, medication side effects, or to look for "something" or someone. They as well may be trying to fulfill a physical need—thirst, hunger, a need to apply the toilet, or exercise. Discovering the triggers for wandering are not e'er easy, but they can provide insights to dealing with the behavior.

Brand fourth dimension for regular practice to minimize restlessness.
Consider installing new locks that require a cardinal. Position locks high or depression on the door; many people with dementia will non think to expect beyond eye level. Keep in mind fire and prophylactic concerns for all family members; the lock(southward) must be accessible to others and not take more than a few seconds to open up.
Effort a bulwark like a curtain or colored streamer to mask the door. A "cease" sign or "do non enter" sign besides may help.
Place a black mat or pigment a black space on your forepart porch; this may appear to be an impassable pigsty to the person with dementia.
Add "child-safe" plastic covers to doorknobs.
Consider installing a home security arrangement or monitoring organization designed to go on watch over someone with dementia. Also available are new digital devices that can be worn like a watch or clipped on a belt that employ global positioning systems (GPS) or other applied science to runway a person's whereabouts or locate him if he wanders off.
Put away essential items such every bit the confused person's coat, purse, or glasses. Some individuals will not get out without certain articles.
Have your relative wear an ID bracelet and sew together ID labels in their clothes. Always have a current photograph bachelor should yous need to study your loved ane missing. Consider leaving a re-create on file at the police department or registering the person with the Alzheimer'southward Clan Safe Return program or other emergency tracking service.
Tell neighbors about your relative'southward wandering behavior, and make sure they have your phone number.

Incontinence

The loss of bladder or bowel control often occurs as dementia progresses. Sometimes accidents result from ecology factors; for example, someone can't remember where the bathroom is located or tin't get to it in time. If an blow occurs, your understanding and reassurance will help the person maintain nobility and minimize embarrassment.

Institute a routine for using the toilet. Try reminding the person or profitable her to the bath every two hours.
Schedule fluid intake to ensure the confused person does non go dehydrated. Know that some drinks (coffee, tea, cola, or beer) have more of a diuretic outcome than others. Limit fluid intake in the evening earlier bedtime.
Use signs (with illustrations) to indicate which door leads to the bathroom.
A commode, obtained at whatever medical supply store, tin be left in the chamber at nighttime for easy access.
Incontinence pads and products can be purchased at the pharmacy or supermarket. A urologist may be able to prescribe a special product or handling.
Use like shooting fish in a barrel-to-remove wearable with rubberband waistbands or velcro closures, and provide clothes that are easily washable.

Agitation

Agitation refers to a range of behaviors associated with dementia, including irritability, sleeplessness, and verbal or concrete aggression. Often these types of behavior problems progress with the stages of dementia, from balmy to more astringent. Agitation may be triggered by a multifariousness of things, including ecology factors, fear, and fatigue. Most often, agitation is triggered when the person experiences "control" being taken from him or her.

Reduce dissonance, clutter, or the number of persons in the room.
Maintain structure by keeping the same routines. Keep household objects and article of furniture in the same places. Familiar objects and photographs offer a sense of security and tin can suggest pleasant memories.
Reduce caffeine intake, sugar, and other foods that cause spikes in energy.
Attempt gentle touch, soothing music, reading, or walks to quell agitation. Speak in a reassuring vocalization. Do non try to restrain the person during a menstruation of agitation.
Keep unsafe objects out of achieve.
Allow the person to do as much for himself equally possible—support his independence and ability to intendance for himself.
Acknowledge the dislocated person's acrimony over the loss of control in his life. Tell him you understand his frustration.
Distract the person with a snack or an activity. Allow him to forget the troubling incident. Confronting a confused person may increment anxiety.

Repetitive Speech or Actions (Perseveration)

People with dementia will oftentimes echo a give-and-take, statement, question, or activity over and over. While this blazon of beliefs is ordinarily harmless for the person with dementia, information technology can be abrasive and stressful to caregivers. Sometimes the behavior is triggered by anxiety, boredom, fear, or environmental factors.

Provide plenty of reassurance and condolement, both in words and in bear upon.
Effort distracting with a snack or activity.
Avoid reminding them that they only asked the aforementioned question. Try ignoring the behavior or question, and instead endeavor refocusing the person into an activity such as singing or "helping" yous with a chore.
Don't discuss plans with a dislocated person until immediately prior to an upshot.
You may want to try placing a sign on the kitchen tabular array, such as, "Dinner is at half-dozen:30" or "Lois comes home at 5:00" to remove anxiety and uncertainty about anticipated events.
Acquire to recognize sure behaviors. An agitated state or pulling at clothing, for example, could indicate a demand to use the bathroom.

Paranoia

Seeing a loved one suddenly become suspicious, jealous, or accusatory is unsettling. Remember, what the person is experiencing is very existent to them. It is all-time not to argue or disagree. This, also, is office of the dementia—endeavor non to have it personally.

If the dislocated person suspects coin is "missing," allow her to go on pocket-sized amounts of coin in a pocket or purse for easy inspection.
Assist them await for the "missing" object and so distract them into another activity. Effort to learn where the confused person's favorite hiding places are for storing objects, which are frequently assumed to exist "lost." Avoid arguing.
Have time to explain to other family members and home-helpers that suspicious accusations are a part of the dementing illness.
Try nonverbal reassurances like a gentle touch or hug. Respond to the feeling behind the accusation and and so reassure the person. You might try saying, "I see this frightens y'all; stay with me, I won't permit anything happen to you."

Sleeplessness/Sundowning

Restlessness, agitation, disorientation, and other troubling behavior in people with dementia often go worse at the end of the twenty-four hour period and sometimes continue throughout the night. Experts believe this behavior, commonly called sundowning, is caused by a combination of factors, such as exhaustion from the day's events and changes in the person'due south biological clock that misfile day and night.

Increase daytime activities, particularly physical exercise. Discourage inactivity and napping during the mean solar day.
Watch out for dietary culprits, such as sugar, caffeine, and some types of junk food. Eliminate or restrict these types of foods and beverages to early in the twenty-four hours. Plan smaller meals throughout the solar day, including a lite meal, such equally half a sandwich, before bedtime.
Program for the afternoon and evening hours to be quiet and calm; however, structured, quiet activeness is of import. Perhaps take a stroll outdoors, play a simple bill of fare game, or listen to soothing music together.
Turning on lights well earlier dusk and endmost the curtains at dusk will minimize shadows and may assist diminish defoliation. At minimum, keep a nightlight in the person's room, hallway, and bathroom.
Make sure the firm is safety: block off stairs with gates, lock the kitchen door and/or put away unsafe items.
As a final resort, consider talking to the doc almost medication to help the agitated person relax and sleep. Exist aware that sleeping pills and tranquilizers may solve one problem and create another, such as sleeping at dark but existence more than confused the adjacent day.
Information technology's essential that you, the caregiver, go plenty sleep. If your loved i's nighttime activity keeps you awake, consider asking a friend or relative, or hiring someone, to take a turn and so that yous tin can go a practiced dark's sleep. Catnaps during the day also might help.

Eating/Nutrition

Ensuring that your loved 1 is eating enough nutritious foods and drinking plenty fluids is a challenge. People with dementia literally brainstorm to forget that they need to eat and drink. Complicating the issue may be dental problems or medications that subtract ambition or brand food sense of taste "funny." The consequences of poor nutrition are many, including weight loss, irritability, sleeplessness, bladder or bowel problems, and disorientation.

Brand repast and snack times part of the daily routine and schedule them around the same fourth dimension every day. Instead of 3 large meals, endeavour five or half-dozen smaller ones.
Brand mealtimes a special time. Try flowers or soft music. Plough off loud radio programs and the Tv.
Eating independently should take precedence over eating neatly or with "proper" table manners. Finger foods support independence. Pre-cut and season the nutrient. Try using a straw or a child'due south "sippy cup" if property a glass has become hard. Provide assistance but when necessary and allow plenty of fourth dimension for meals.
Sit down and eat with your loved one. Often they will mimic your actions, and it makes the repast more pleasant to share it with someone.
Set foods with your loved one in mind. If they accept dentures or problem chewing or swallowing, use soft foods or cutting nutrient into seize with teeth-size pieces.
If chewing and swallowing are issues, effort gently moving the person's mentum in a chewing motion or lightly stroking their throat to encourage them to consume.
If loss of weight is a problem, offering nutritious high-calorie snacks between meals. Breakfast foods loftier in carbohydrates are often preferred. On the other mitt, if the problem is weight gain, keep high-calorie foods out of sight. Instead, keep handy fresh fruits, veggie trays, and other healthy low-calorie snacks.

Bathing

People with dementia often take difficulty remembering "skilful" hygiene, such every bit brushing teeth, toileting, bathing, and regularly changing their clothes. From childhood nosotros are taught these are highly private and personal activities; to be undressed and cleaned by some other tin can feel frightening, humiliating, and embarrassing. As a result, bathing often causes distress for both caregivers and their loved ones.

Remember historically of your loved one's hygiene routine — did she prefer baths or showers? Mornings or nights? Did she have her hair washed at the salon or exercise it herself? Was there a favorite scent, balm, or pulverization she always used? Adopting—as much as possible—her past bathing routine may provide some condolement. Remember that it may non be necessary to bathe every twenty-four hours—sometimes twice a week is sufficient.
If your loved i has always been minor, enhance that feeling past making sure doors and curtains are closed. Whether in the shower or the bath, continue a towel over her forepart, lifting to wash as needed. Have towels and a robe or her clothes gear up when she gets out.
Be mindful of the environment, such as the temperature of the room and water (older adults are more sensitive to heat and cold) and the capability of lighting. It'south a expert idea to utilise safety features such every bit non-skid floor bath mats, grab-bars, and bath or shower seats. A hand-held shower might also be a good feature to install. Remember—people are often agape of falling. Assistance them experience secure in the shower or tub.
Never leave a person with dementia unattended in the bathroom or shower. Accept all the bath things you need laid out beforehand. If giving a bathroom, depict the bath water first. Reassure the person that the water is warm—peradventure pour a loving cup of water over her hands before she steps in.
If hair washing is a struggle, arrive a carve up activity. Or, apply a dry shampoo.
If bathing in the tub or shower is consistently traumatic, a towel bath provides a soothing alternative. A bed bath has traditionally been used with only the most frail and bed-ridden patients, soaping up a bit at a time in their beds, rinsing off with a basin of water, and drying with towels. A growing number of nurses in and out of facilities, however, are first to recognize its value and a variation—the "towel bath"—for others too, including people with dementia who detect bathing in the tub or shower uncomfortable or unpleasant. The towel bath uses a large bathroom towel and washcloths dampened in a plastic bag of warm water and no-rinse soap. Large bath-blankets are used to keep the patient covered, dry and warm while the dampened towel and washcloths are massaged over the body.

Additional Problem Areas

Dressing is hard for virtually dementia patients. Cull loose-fitting, comfy clothes with easy zippers or snaps and minimal buttons. Reduce the person's choices by removing seldom-worn wearing apparel from the closet. It'south common for people with dementia to continue layering on clothes even though they are fully dressed. To facilitate dressing and support independence, lay out one article of vesture at a time, in the order it is to be worn. Remove soiled clothes from the room. Don't argue if the person insists on wearing the same thing again.
Hallucinations (seeing or hearing things that others don't) and delusions (imitation beliefs, such as someone is trying to hurt or kill another) may occur as the dementia progresses. Land just and calmly your perception of the situation, only avoid arguing or trying to convince the person that their perceptions are incorrect. Keep rooms well-lit to decrease shadows, and offer reassurance and a unproblematic explanation if the curtains move from circulating air, or if a loud noise such as a aeroplane or siren is heard. Distractions may help. Depending on the severity of symptoms, you might consider medication.
Sexually inappropriate behavior, such every bit masturbating or undressing in public, lewd remarks, unreasonable sexual demands, even sexually aggressive beliefs, may occur during the class of the illness. Remember, this behavior is caused past the disease. Develop an action plan to follow before the beliefs occurs, i.due east., what yous will say and practise if the behavior happens at home, around other relatives, friends, or paid caregivers. If yous can, identify what triggers the behavior.
Verbal outbursts such as cursing, arguing, and threatening ofttimes are expressions of anger or stress. React by staying calm and reassuring. Validate your loved one's feelings and and so attempt to distract or redirect his attention to something else.
"Shadowing" is when a person with dementia imitates and follows the caregiver, or constantly talks, asks questions, and interrupts. Like sundowning, this behavior ofttimes occurs late in the day and tin can be irritating for caregivers. Comfort the person with verbal and concrete reassurance. Distraction or redirection might besides aid. Giving your loved one a job such every bit folding laundry might help to make her experience needed and useful.
People with dementia may become uncooperative and resistant to daily activities such as bathing, dressing, and eating. Ofttimes this is a response to feeling out of control, rushed, afraid, or dislocated by what you lot are asking of them. Break each task into steps and, in a reassuring phonation, explain each step before y'all exercise it. Allow plenty of time. Find ways to have them help to their power in the process, or follow with an activity that they can perform.
Even with these many potential challenges, it'south important to remember that these behaviors are ofttimes coping tactics for a person with deteriorating brain function. At that place's no question that dealing with these behaviors can brand caregiving especially challenging.

Resources

Family Caregiver Alliance
National Eye on Caregiving
(415) 434-3388 |(800) 445-8106
Website: www.caregiver.org
Electronic mail: info@caregiver.org
FCA CareNav: https://fca.cacrc.org/login
Services by Country: www.caregiver.org/connecting-caregivers/services-by-state/

Family unit Caregiver Brotherhood (FCA) seeks to better the quality of life for caregivers through education, services, research, and advocacy. Through its National Centre on Caregiving, FCA offers data on current social, public policy, and caregiving issues and provides assistance in the development of public and private programs for caregivers. For residents of the greater San Francisco Bay Area, FCA provides direct back up services for caregivers of those with Alzheimer's disease, stroke, traumatic brain injury, Parkinson's, and other debilitating health weather condition that strike adults.

FCA Fact Sheets

A listing of all facts and tips is available online at www.caregiver.org/fact-sheets.

Dementia, Caregiving and Controlling Frustration
Taking Care of You: Self-Care for Family Caregivers
Hiring In-Home Help
Community Care Options

What Do You Do With Family Member With Dementia

Heed

Introduction

Ten Tips for Communicating with a Person with Dementia

Handling Troubling Behavior

Wandering

Incontinence

Agitation

Repetitive Speech or Actions (Perseveration)

Paranoia

Sleeplessness/Sundowning

Eating/Nutrition

Bathing

Additional Problem Areas

Resources

FCA Fact Sheets

Other Organizations and Links

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