One of the hardest things to figure out when it comes to dealing with dementia is whether your loved one is responsible for their mood swings. Or, more likely, the illness has made them confused, frightened or unsure of those around them. Combine this with fear, or uncertainty about how fast they’re going to lose their long-term memory, ability to recall certain objects or even the power of speech and it’s no wonder that someone’s behaviour can be a little hard to predict.
What needs to be said right off the bat is that dementia patients aren’t children. They may at times exhibit childlike emotions such as crying easily, lashing out or sulking but they aren’t and should never be treated as such. If you’re involved in the care of someone with dementia or indeed have spent any time at all in a care home / assisted living center for those with dementia then you may have seen, or heard the following; A doctor, or nurse talking over / or about your loved one like they aren’t in the room. Care home personnel talking to them in a singsong or ‘baby voice’ and then staff getting annoyed as ‘we aren’t being very co-operative today are we’.
The simple fact is that many people living with dementia may struggle with speech or movement but their hearing itself is still good. Unless their medical chart has labelled them hard of hearing or they’re deaf then you don’t need to shout at them! Neither do you need to speak to them like a child, they are grown adults and deserve the dignity and respect, often in short supply when dealing with the elderly, that being an adult is given. Let’s remember a child is learning everything for the first time and is expected to hit their developmental milestones such as talking and walking sooner or later. A child is also unable to do certain things for themselves and so needs an appropriate adult to help them with cutting up food, helping them cross the road and getting dressed etc.
An adult diagnosed and dealing with dementia has already learned these things and has probably lead a long independent life, had an illustrious career and raised a family of their own before getting to this point. Unfortunately, a mentally-based illness caused by the slow degradation of brain cells has robbed them of their ability to function as they once did. It certainly doesn’t mean that they’re stupid, simple or being difficult on purpose but instead that dementia has altered their cognitive understanding. A child is also expected to make progress, go to school, pass exams and eventually leave home while someone living with dementia knows they have a terminal illness. Sadly, there can only be a decline from here on in and each passing day means they’ll gradually get worse. It is no secret that those living with the disease are encouraged to make plans for ‘end of life care’ while they can because the truth is they won’t get better. A child knows that if they make a mistake it’s not the end of the world, after all they have the rest of their lives to make up for it but adults with dementia have already lived their lives. To the point that in many cases people have deemed that they are no longer useful.
However, with all this being said how do you manage behaviour that’s normally seen in a three, or four-year-old but instead is being exhibited by your ageing mother or father? The fact is that caring for someone with dementia means taking each day as it comes and being kind, patient and understanding. Often they are lashing out because they are angry or embarrassed! After all, they once took complete care of you and now it’s become the other way round. Many people with dementia, depending on the stage, will show signs of confusion and become easily agitated. They struggle to find the words for things or can be slow in expressing when they are in pain or discomfort which is why agitation is often seen around mealtimes or when needing the bathroom. It’s also very easy to become frustrated when you’re bored so if they aren’t being mentally stimulated, either by being read to or perhaps playing a simple game, then it’s likely behavior will worsen.
You may feel like raising your voice, even shouting when your loved one lashes out but unlike a child they have simply forgotten, through no fault of their own, what social niceties are. It’s important to stay calm, speak in a soothing tone and try to figure out what’s upset them as opposed to getting into an argument. Remember, in advanced cases of dementia there’s a high chance that the person won’t remember why you’re angry and so will become even more confused. Another tip is to look around their environment to see if you can pinpoint anything that makes them angry or upset. For instance, an open window may be making them anxious due to loud noises outside or if they’ve misplaced a treasured possession helping them look will calm them down. We know it isn’t always easy to keep calm, especially if your loved one is shouting, or repeatedly doing the same activity such as counting or opening cupboards and drawers. Unfortunately, they are now unable to control certain impulses and so distraction is often the best tool in these situations.
Many people living with dementia can experience hallucinations occasionally and these can either be frightening or quite pleasant depending on what they’re seeing. Unlike a child who’s often quite aware that ‘imaginary friends’ are just that imaginary- your loved one may be fully convinced the hallucination is real and it’s not always helpful to suggest otherwise. For instance, if they are seeing something nice and are happy describing it to you then let them do so. Obviously, if it’s disturbing you should reassure them that you’re there, you understand their feelings and that it will soon go away.
Remember, someone’s behaviour isn’t static and dementia is an extremely fluid disease so they may be better one day and worse the next. On good days they may be able to do things they couldn’t yesterday, surprising everyone by their clarity or suddenly being more ‘aware’. We know it can be difficult to hear that your loved one doesn’t trust you, believes that you are deliberately withholding something or accusing you of being false but dementia is complex. You can be reassured that were they well they probably wouldn’t say those things in a million years. In conclusion, by treating someone with dementia like a child you aren’t just doing them a disservice but also yourself. Why? Effectively you are lowering the chances of them reacting positively on the good days and also further removing what little dignity they may have left.