Watching your parent or spouse decline from worsening dementia is heartbreaking. Alzheimer’s disease is one of about fifty varieties of dementia, and depending upon the type of dementia and the area of damage in the brain, you will see a variety of symptoms and changes.
Except for some major physical and behavioral markers, there is no way to predict how your loved one will react to this disease or how fast (or slow) they will decline. Therefore, dementia care is an ongoing process of learning to provide the care needed which will help you cope and prevent burnout.
Their Behavior: Generally, short-term memories and those with little emotional relevance are the first to go: a phone call earlier in the day, where the tube of toothpaste is, how to work the new stove, remembering to take a bath. Long-term memories that do have an emotional component are retained the longest, but sometimes people will need a prompting reminder.
Your Action: If your loved one becomes upset by their inability to recognize something they know they should remember, try to change the subject. Like small children, people with dementia are easily distracted and it’s best to do that with something you know will make them smile, such as a joke, funny story, or a suggestion to put on some of their favorite music.
Get used to the fact that you will need to constantly remind your loved one of just about everything. Learning to accept this reality will reduce your irritation with them. Talk to your loved one calmly without barking orders, giving one piece of instruction at a time. Wait for the completion of that task before giving them the next instruction. Never give choices. They will always do better following your stepwise direction. It’s better to say, “Let’s go get you a shower,” than “Do you want a shower or a bath?”
Delusions and Hallucinations
Their Behavior: A common theme is the accusation that someone is stealing from them. This often happens because they can’t find what they are looking for or can’t remember what belongs to them. Many times they will believe they saw someone or something hiding near them. These situations will cause them to become distraught.
Your Action: Always show them you are taking their concerns seriously. Letting them watch you search for what they think they have lost will calm them down and make it easier for you to distract and redirect them to another topic or activity. Or even better, you will find the missing object and put them at ease.
Constant Pacing or Walking
Their Behavior: Pacing is a common activity among people with forms of dementia. It could be caused by confusion or agitation, by the need to move and do something, or it could be a form of repetition they find soothing.
Your Action: As long as it’s not harmful, don’t try to stop them. Instead, make sure they are in a safe to do this, such as a flat hardwood surface. Encourage them not to pace in rooms with rugs or near a staircase. If you find this activity occurs at night, consider their lifetime sleep habits before trying to make them stay in bed. People who have been night owls their entire lives aren’t going to easily go to bed at 9 just because that’s what you as the caregiver wants.
Their Behavior: Many times, physical problems can be the cause of unwanted behaviors. A headache, toothache or even or ingrown toenail are examples of painful situations that will be expressed as agitation. Look for telltale signs such as holding their hand to their head, putting fingers in their mouth, or kicking their shoe off.
Your Action: Your body language and attitude is the most important tool. Keep your attitude positive and loving with a genuine smile. Ask questions and try to understand what’s causing the discomfort. Keep background noise to a minimum, such as the TV or radio, when you are talking. They are so sensitive to loud sounds, it alone can cause unwanted behaviors.
Take your loved one to the bathroom on a schedule of every 2 hours which will prevent incontinence and the agitation associated with their discomfort and unrecognized need to void.
It is distressing to watch your parent or spouse change into what seems like a different person, many times losing all connection with them by the end. The best dementia care means not trying to change the person, but rather provide a loving, safe and supportive environment.