The most basic and important thing to remember when caring for someone with dementia is that, there is always a reason behind the behaviour. The person with dementia may not know what is making them feel agitated or anxious and/or not be able to communicate what’s going on (which adds to the agitation and frustration), so it’s up to their caregivers to investigate and ask “why?”
“Why is Barb cranky and uncooperative today?”
“Why is Mary refusing to take her pills”
“Why is Michael “all of a sudden” exit-seeking today? He has never done that before.”
“Barb’s Hunger Strike”
Barb was scheduled to have a shower at 10:00 in the morning – right after her breakfast and before she went for lunch. This was her “routine.” She woke up excited that morning knowing it was her shower day. She got her clothes, shampoo, body wash and deodorant ready.
10:00 came and no one showed. Immediately, she started to get upset.
Staring at the door and continuously checking her digital clock, she watched it go from 10:15 to 10:30 and finally, around 11:00, they came to invite her to take her shower.
At this point, she was fuming from anger. She yelled at the staff and was completely uncooperative and inconsolable. The staff apologized and they were able to finally convince her to take her shower. Although Barb enjoyed her shower, the whole day, she refused to eat lunch and supper. She continued to remain in a bad mood after her shower. She later admitted that the whole experience made her feel disrespected and unimportant.
The Meaning Behind Barb’s Behaviour
The staff learned that Barb equates sticking to schedules and commitments as a way of demonstrating respect and showing appreciation to her. Routines and keeping appointments were critical to Barb’s sense of self, value, and well-being. Growing up and later on, as a young professional, Barb learned the value of people’s time and as a way to show the other person they are important.
In Barb’s words, she shared “I know I’m old, but I still remember important things. I know today is my shower day and it’s always at 10:00 am. I want to get showered and dressed and rest before lunch. This is my schedule and I expect you to respect it!”
Routines and Well-being
As caregivers, it is sometimes possible that the decisions you make “on behalf of the person” in your care, can trigger responsive behaviours such as agitation, anxiety, and even anger and aggression.
It is not always “their dementia talking.” Communication and finding a way to communicate, consult with, and keep the person informed about what to expect or any change of plans, all help them feel safe, secure, and valued.
We can help prevent their stress and anxiety, by simply remembering to communicate with them (notes can sometimes make a positive difference), whether they seem to understand or not.
Consciously or not, everyone has their routines they follow on a daily basis. Routines reduce stress and anxiety because they provide a predictable structure and plan for the day.
People living with dementia who are already experiencing challenges in memory, recall, and organization, need their routines, not only to prevent or reduce their stress and anxiety but overall, enhance their well-being.
What You Can Do as Caregivers
As caregivers, one of the best things you can do for the people you are caring for is to help set them up for success and affirm their value and importance to reduce conflicts. Predictable routines help achieve these goals.
Being able to stick to routines is one of the most effective antidotes to all of these. Routines can help them remember, and feel successful in completing tasks and therefore prolong the feeling of independence for as long as possible.
If you have concerns about a loved one or a friend and don’t know what to do, you are not alone. Reach out and ask for help. We can help by brainstorming ideas with you that will best suit your situation. Begin by contacting us through our website www.DementiaSolutions.ca to arrange your free 20-minute consultation with one of our Dementia Care Advisors.
DISCLAIMER:
The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.
One Response
Also changes in environment, such as travel, hospitalization or the presence of houseguests. Changes in caregiver arrangements, Fear and fatigue resulting from trying to make sense out of a confusing world.