Strategies to Handle People with Dementia
Distraction Is One Method of Working with the Disease
Working with people who have dementia can leave you feeling as if you were trapped in "Alice in Wonderland." They operate in a universe all their own, and the more we try to fight it, the more they retreat into their world and the more frustrated we become with ours. But two strategies can help:
1. Work with the disease, not against it. People with dementia have great difficulty learning new information. Techniques that focus on "teaching" or asking them to remember are doomed to be yet another failure for both you and care recipient.
Dementia's hallmark feature is the inability to remember. This lack of memory can become a tool for caregivers who regularly have to handle problem behaviors. For example, if seniors are repeatedly opening and shutting doors and cabinets, instead of telling them not to, redirect their attention elsewhere. They won't remember the door episode, and you can move them to a more calming activity.
Distractions can take many forms. Be creative! When I was an intern at an adult day care center, one client became really agitated at the end of the day - every day. He would stand by the door, becoming more agitated as he pushed it open and I closed it to keep him from leaving. We danced like this for days.
Then one morning in exasperation, I blurted, "Do you want a cookie?" He turned from the door and followed me to get the cookie. The next day when he returned to the door, I followed him and, instead of battling as I had done for the past week, I offered another distraction: "Do you want to dance with me?" It worked.
Music soothes the soul. It penetrates the mind that cannot remember and the mind too stressed to care. I never ceased to be amazed by clients who couldn't remember their spouses' names but could sing all the words to an old standard. When tempers flare, play some music. Good choices include classical, standards from the senior's era, ethnic music of the senior's culture and music you shared as a family. Put on the music, sing at the top of your lungs, dance and let go of the tension. Lose yourself in the melody and the moment. Enjoying music with another brings us closer together and reminds us of our shared humanity. It reminds us of the beauty of life, replenishing our spirit and strength.
Like music, animals have a special way of distracting a person with dementia. They also lift you out of current struggles and let you focus on the moment. I was responsible for some of the activity planning at the day care center I mentioned. The routine for my "activity," unfortunately, was that I stood in the middle of a circle desperately trying to engage the participants. They responded by walking away or talking to their neighbors or themselves.
One day I brought in my noisy cockatiel, Nezek, whose name means "annoyance" in Hebrew. This was the only activity I planned in which participants became actively engaged. They held him on their fingers and talked to him. They smiled as they focused on this little creature. They talked of pets they had as children. Even more amazingly, some participants - who couldn't even remember where they were - approached me the next day to ask about Nezek.
If you do not have an animal of your own, contact your local branch of the Society for the Prevention of Cruelty to Animals and ask about programs it may have to bring animals into the lives of seniors. These programs bring animals to visit both private homes and facilities.
2. Do whatever you can to reduce your own stress. Take time for yourself every day. It will help diminish problems with the care recipient. When caregivers become overwhelmed with stress, they become reactive. They don't think clearly, which sounds a lot like the behavior of a person with dementia! You need to remain calm and clear to keep behavior problems from escalating. A classic example is the repetitive questions so common with people with dementia. When caregivers are under duress, they will snap at the care recipient. The result will be an increase in the questioning and a new set of problems.
Problem behaviors in people with dementia won't magically disappear. But if you use distraction and lower your stress, you achieve two important goals. You will snap the senior out of unpleasant moments, and you will snap yourself back into awareness of the tremendous gift you're giving as a creative, compassionate caregiver.