Esther C. Kane, C.D.S.If you’re caring for someone with dementia you may have experienced the very frustrating moments when they become distressed and begin acting out. This could look like screaming, banging, throwing things, etc.
We get many requests from family members about how they can help someone with dementia or Alzheimer’s disease. Especially if they are demonstrating aggressive behavior.
They realize that they cannot take care of their loved one like they used to and they want to do everything in their power to make sure that they can live a long, happy life as well.
If you are at this point with your loved one’s life, I am here to tell you that you can certainly help.
Just remember that there are many contributing factors to why someone with dementia or Alzheimer’s may be agitated or lashing out.
Depression and anxiety are two of the most common reasons.
It is estimated that 50% of people with dementia experience some symptoms of depression, which can decrease quality of life, worsen dementia symptoms and increase carer stress. Anxiety is also common in people with dementia and has a similarly negative impact.
Alzheimers.org.uk
What can you do to calm someone with dementia down? – The answers are as unique as each individual person. But there are some general tips that I can give you.
On thing that family caregivers should know is that dementia does not JUST cause memory problems. The way someone thinks is also affected.
Their reasoning and judgement are often one of the very first signs (along with some memory problems) that someone is suffering from some type of cognitive decline.
The list of dementia behaviors that are common include:
- aggression
- confusion
- delusions
- depression
- apathy
- hallucinations
- wandering
- sleep problems
- paranoia
- anxiety
- sexual inappropriateness
- sundowning
These difficult behaviors tend to become more exaggerated and frequent as the disease progresses.
Anyone who is is in the midst of dementia care is most likely well aware of how this disease changes over time.
Be aware that what might work for someone in the early stages of dementia may not end up being the best way to work with them a few months later.
So, as a caregiver of someone with dementia or Alzheimer’s disease, be prepared to be flexible and change your approach when needed.
12 Tips To Help Calm Down Someone With Dementia
Here are 12 very helpful tips on the different ways that may help you and your senior loved one suffering from dementia or Alzheimer’s to get through these moments of agitation.
1. Keep Your Cool
In other words – stay calm – don’t add to the stress.
I know that can be very difficult at times so if you find that you are beginning to lose your temper – it’s a good idea to take some deep breaths and do your best to redirect to another topic or task.
If possible, step away from the situation and help them to step away as well.
Talk to them in a positive manner. No matter what you do, it is important to remember to use a positive and calm voice when talking to your loved one.
Don’t use negative words or phrases or a loud voice. Instead, talk to them in a loving way and give them a little time to respond.
Of course, it’s difficult to do this on a constant basis so please make sure to get the respite care that you need to help you keep your stress levels down so that you can help your senior loved one.
2. Check To Make Sure They Are Not In Pain
You want to make sure that your senior loved ones angry outburst is not due to them being hurt or some kind of discomfort or some issue with health problems.
Maybe they are hungry or thirsty. Maybe their shoes are tight, their diaper is twisted, maybe the lighting in the room is too bright.
Fevers, arthritis pain or urinary tract infections would also create pain and discomfort.
It could be any number of things or a combination of things that could be causing them some form of discomfort.
It may also just be that they are not able to express to you that they are not comfortable or in pain so they end up expressing it via agitation and anger.
Anxiety and agitation may be caused by a number of different medical conditions, medication interactions or by any circumstances that worsen the person’s ability to think. Ultimately, the person with dementia is biologically experiencing a profound loss of their ability to negotiate new information and stimulus. It is a direct result of the disease.
Alzheimer’s Association
If they are not able to verbalize their pain, try to read their facial expressions. At the same time, do you best to communicate with them with YOUR facial expression.
If you appear worried or afraid, that may make the situation worse.
Even seniors with dementia who face difficulty with verbal communication tend to still recognize facial expressions. Having a caregiver who looks relaxed and kind can soothe a lot of outbursts.
homecareassistanceorlando.com
3. Listen To Your Senior Loved One
If your loved one is able to verbally communicate with you – take some time to listen to what they are angry or frustrated about.
Here are some tips on how to actively listen:
- Pay one-on-one attention to your senior loved one
- Make eye to eye contact with him/her
- Avoid asking open-ended questions.
- Be patient and give them time to respond to you
- Do not patronize or ridicule them in any way. You may think you are making a joke but they may not be able to comprehend the nuances of your humor.
- Acknowledge what they are saying by casually rephrasing their statement and responding to it
- If they can tolerate physical touch put your hand on them which can show them that you are paying attention just to them
Make sure to listen carefully to what your loved one is saying. This will allow you to determine what their needs are.
Remember that they are often confused and may be having a hard time understanding words.
Don’t push your own agenda. Just concentrate on what THEY are saying.
If they aren’t able to verbally communicate and are just ranting nonsensical words or sounds then work on comforting them by any of the following techniques:
- Keep your body language calm and receptive to them by facing them, direct eye to eye contact and placing your hand on them (if they can tolerate it).
- Try your best to show a pleasant and happy look on your face.
- Keep your tone positive and friendly.
- Approach your loved one from the front.
- For some seniors with dementia, personal space is an issue so respect that.
4. Physical Activity
Sometimes the best thing to do to relive stress and anxiety is some type of physical exercise. It’s a great way of relieving stress and anxiety which can help greatly to help calm down someone with dementia.
Give your loved one the opportunity for some type of physical activity, like walking around a mall or going on walks in their neighborhood with you!
It’s important we find ways where older adults can still get moving.
It could be as simple as taking a few steps in their own home every day or helping with laundry or other daily activities. Anything to keep moving.
Try not making things too complicated. Simplify each task into something achievable.
5. Quiet Down The Environment
It’s much easier to calm someone down when there isn’t a lot of noise around. At least a lot of loud noise.
For some, soft, melodic sounds can be used as music therapy to help calm them down.
For many of us, being in a noisy environment can be stressful – so you can only imagine how much more stressful that can be for someone with dementia or Alzheimer’s.
Of all the senses, hearing is the one that has the most significant impact on people with dementia in terms of quality of life. This is because dementia can worsen the effects of sensory changes by altering how the person perceives external stimuli, such as noise and light. As hearing is linked to balance this also leads to a greater risk of falls either through loss of balance or through an increase in disorientation as a result of people trying to orientate themselves in an environment that is overstimulating and noisy.
Social Care Institute For Excellence
So keeping the environment as “pleasant” as possible for your senior loved one may actually help to decrease the number of outbursts that he/she may be experiencing!
Don’t forget that lighting is a sensory stimulation as well. But this can be tricky because older adults need more light to see as well as they did when they were younger.
Yet, if the lights are too bright – that may cause them some discomfort. You will have to play with the lights to see what works best for your loved one.
6. Stick To A Routine
It’s important to create a routine for your senior loved one who has lost their memory or ability to make decisions, because it will help them to feel comfortable and more independent.
Sudden changes in daily routines, such as taking a vacation, can bring about anxiety and fears and cause someone with dementia to lash out.
A good way of incorporating routines into people’s lives is through setting up daily activities like chores, shopping trips with friends (or family), and taking medications at set times each day.
Anything you can do consistently on an everyday basis so they know what comes next in their day!
7. Clean Up The Environment
Along with a noisy surroundings you also want to simplify and declutter the surroundings as well.
I’ve spoken quite a bit about decluttering and the benefits of that for all seniors – but for the ones who are living with dementia – it holds significant importance.
The reason that a decluttered environment is more important for seniors with dementia is because of the effects that this disease seems to have on someone’s perception.
Meaning that their ability to distinguish one object or color from another may become distorted.
What makes decluttering a home of someone with dementia a bit more difficult is that hoarding is a fairly common symptom of dementia.
Persons with dementia experience memory loss, mental confusion, disorientation, impaired judgment and behavioral changes. One of these changes may include “hoarding”. While hoarding is often harmless, it can become a health and safety issue for the person with dementia.
Alzheimer’s Association
8. Redirect To Another Topic
When I worked in nursing homes I often worked with patients with dementia and they would sometimes become agitated.
One trick that I used that usually worked well was to redirect my patient to a new topic and sometimes even to move them to a different room.
If I knew them and knew of a topic or task that they enjoyed then I would redirect them to that.
Here are some tips on how to use the Redirection Technique:
- Don’t dismiss their feelings. If they are talking that they have to get to the doctor’s appointment (when you know there isn’t one) the thing to NOT do is to keep telling them that there isn’t an appointment. Instead, talk about what needs to be done at the appointment which is later. Ask them questions about what do they need from the doctor? How do they expect the doctor to help them?
- Change the environment. If you can go into another room to work on a project or if you can go outside for a walk – that sometimes helps to get their mind off whatever they may be obsessing and becoming agitated about.
- Present a new meaningful activity. It’s sometimes helpful to redirect your loved one to a meaningful activity. You could say something like, “Mom, I need these towels folded, can you do that for me please?”
…just like anyone else, people with dementia need meaningful activities to fill their days. The family is in the best position to help them find purpose in their day, even through small things.
aarp.org
9. Enter Their World
Try to engage in conversation with whatever thoughts they are expressing.
If they are talking about going to the prom with someone then talk to them about being at a prom, dancing and about high school, etc.
The most important issue caregivers need to understand is seniors with dementia are experiencing their own realities. In order to appease a senior’s agitation and aggression, caregivers need to tap into this reality and embrace it.
fivestarseniorliving.com
If they begin talking about a deceased loved one as if they are still alive – don’t remind them that the person has died.
Instead ask them about their memories of that person, be specific if you can.
An example could be, “Dad, what kinds of games did you and uncle Mark play when you were kids?”
Try to keep conversations at a level where they will be able to understand them. By doing so, you are also helping them to relax.
This will in turn help them function better once they begin to remember things. This is especially true if you have been assisting them with a difficult task for quite some time.
Sometimes – getting busy with a simple and fun activity may be helpful.
10. Be Careful With Touch
Some seniors with dementia can be calmed down with a gentle touch. A hug or simply hand holding.
But others with dementia may not like being touched at all. So, please be aware of what your loved one can tolerate.
Some types of massage can help to calm someone down and improve overall mental and physical health.
The key is to find the right one for the particular needs of the person you are trying to help.
11. Pet Therapy
Don’t discount the many great benefits that pet therapy can do to help calm down someone suffering from dementia or Alzheimer’s disease.
Even a stuffed animal like these robotic cats and dogs have been very useful in helping to calm down patients with issues related to cognitive decline.
There is substantial research supporting the notion that activities involving pets (and in some cases stuffed animals) can be beneficial to people living with Alzheimer’s. These activities usually reach those in the latest stages of the disease—even when they no longer talk or recognize loved ones.
usagainstalzheimers.org
Read about how to take away a pet from a dementia patient if they can no longer care for them.
12. Don’t Be Shy – Ask For Help
Finally, don’t be afraid to ask for assistance. That means getting some respite care. It may be helpful to ask for help at various stages of your caregiving journey.
This could be something that a professional such as a therapist or even your doctor can help you with.
There are also many online support groups that you can look into for help.
The bottom line is that while you need to know how to help someone with dementia, you do not have to do it alone. The longer you wait to do something, the harder it will be.
A Little Bit About Sundowning
If your loved one with dementia is demonstrating elevated behavior changes in the late afternoon or early evening, they may be suffering from what is called “sundowning syndrome“.
This is when someone with dementia or Alzheimer’s disease experiences heightened confusion, irritability, agitation, etc. later in the day. It can also happen near the end of life and after a hospital stay in someone with or without a cognitive decline.
It occurs in about 20% of the patients with some type of cognitive decline, so it’s not terribly common.
What Should You Not Say To Someone With Dementia?
Dealing with dementia is no easy task. The cognitive processes of the mind that control verbal communication and the organization of thought and memory are particularly susceptible to deterioration with the progression of the disease.
That’s why it isn’t uncommon for conversations with a person diagnosed with dementia to turn into heated confrontations, angry outbursts, and outright hostility.
It’s difficult sometimes to remember that when speaking to someone with dementia, there are certain things that you should try to avoid saying.
Generally speaking, you should do your best to keep your temper level whenever you are talking to them, especially when they are angry or upset.
Your tone of voice, your gestures, and your conversation should remain as calm and courteous as possible at all times.
You also want to keep your comments and questions as specific as possible and avoid using third person pronouns like “him” or “her”.
Even if you are in the middle of speaking about a specific person, continue using that person’s name.
It may also be helpful to use gestures and point at items and places to draw their attention to something you are talking about.
This can help your elderly loved one to associate what you’re talking about with a physical object.
Here are some examples of specific phrases to avoid when speaking to someone with dementia.
Can Cognitive Behavioral Therapy (CBT) Help?
There is some research being done on the benefits of using Cognitive Behavioral Therapy (aka CBT) in helping seniors in the early stages of dementia to deal with depression and anxiety.
CBT is a specific type of talk therapy that works to help the patient become aware of their thoughts and feelings as well as their physical sensations and how all of these are promoting the negative thoughts and feelings that they are experiencing.
CBT practitioners are specifically trained to help their patients to change these negative thoughts and attitudes into positive ones.
Basically, CBT works to change your outlook from a glass half empty to a glass half full type of thinking. It does not work for everyone – but it has been useful for many adults.
In addition, speech therapy is often beneficial for people who have certain forms of dementia.
