If you’re caring for loved ones who suffer from a brain disorder, you’ve experienced the frustration and embarrassment that occur with some of their attendant behaviors.
Nataly Rubenstein, a geriatric care manager, licensed clinical social worker and former dementia caregiver says that sometimes the problem isn’t so much with the behavior as it is with us and our response to the behavior.
Rubenstein is the author of Alzheimer’s Disease and Other Dementias: The Caregiver’s Complete Survival Guide. “Sometimes, the new normal is more a problem for you than for your parent. For instance, you—not your loved one—is the person who tends to get upset when the same question is asked over and over again. I’m not saying it’s easy, but the best thing to do is get into the patient’s world and provide the answer over and over again.”
Rubenstein offered some thoughts on troubling behaviors—and caregivers’ responses—in an interview with http://www.agingcare.com:
Mom asks the same question or tells the same story over and over again.
Aging and dementing diseases are conditions of forgetting. As these illnesses progress, patients lose the ability to think and process information. For someone in this situation, repetition—whether it’s asking a question, stating a fact, or telling a story—is comforting.
SOLUTION: It will take patience on your part, but it’s usually best for everyone if you answer the same question or listen to the same story again and again. Handling repetitiveness in this manner doesn’t hurt you, and it helps your loved one by preventing agitation, confusion, or aggression.
Dad keeps taking everything out of his wallet and putting it back in.
Constantly checking to see if the door is locked, packing and re-packing clothing, etc. are manifestations of anxiety. The person with Alzheimer’s or dementia knows he has something important to remember but has forgotten what it was and this causes his repetitive behaviors.
SOLUTION: First, ignore the behavior and remember that although it seems strange to you, it’s probably not doing any real harm. Giving cease-and-desist advice to your loved one will only spark stress and arguments. Do all you can to help the patient cope with his anxiety. Speak in a calm, gentle voice, and don’t be afraid to touch or hug. Remember, the person is seeking reassurance. Your job is to show him that he is safe, loved, and respected.
My mother thinks that we’re trying to poison her.
Paranoia boils down to fear. People who are suffering from memory loss have a lot to be afraid of. As time goes on, dementia patients lose the ability to recognize their homes, their friends, their family, and even their own reflections in the mirror. In the midst of this unfamiliarity, they’ll struggle to make some sense of their situations, and they can hold on to the ideas they form for quite some time. Even though your loved one’s belief that you’re trying to steal her jewelry may seem irrational to you, it’s reality to her.
SOLUTION: Dealing with paranoia is tricky. The best things you can do are to remember that your loved one isn’t trying to hurt you, and to try not to take things personally. Know beforehand that rational explanations and clarifications probably won’t work, so don’t pin your hopes of returning to “normal” on them.
As Rubenstein says, it’s a matter of the caregiver re-framing what could or should be with what is. “Keep in mind that while many of the behaviors that result from memory loss can be difficult to deal with, it doesn’t mean all the joy is gone from your life and that of the patient,” she adds. “Caring for my mother wasn’t always easy or enjoyable, but I can assure you that we did share plenty of smiles, laughs, and yes, love. You, too, can have a positive impact on the patient’s quality of life—and you can definitely still enjoy special moments with your loved one.”
Caregivers and patients should describe the “who, what, when, where and why” of specific behavioral problems that the person with Alzheimer’s might be dealing with, including times of day they may occur, circumstances or situations that trigger them, and the level of distress that they cause. If someone becomes agitated and tends to pace in the evenings after the TV set is turned on, for example, that information should be conveyed to the doctor.
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