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Research-based tips for reducing agitation and aggression due to dementia in a mindful way
Caring for a loved one with dementia can feel like a daily battle. You are dealing with the loss of the person you once knew but at the same time you still love them despite this change and new episodes of agitation and aggression. And you may find it difficult to predict which behaviors will arise.
The challenges of dementia caregiving can break your heart on a regular basis. Executing simple tasks and scheduling events for a loved one can turn into a disaster. Dementia is cruel to both the person with dementia and to the caregiver but there are strategies that can help you respond to the challenges of dementia in an effective and mindful way. One of the best things you can learn is effective communication strategies for helping your loved one.1
Learning how to handle the difficult behaviors seen in dementia gives you the ability to enjoy time spent with your loved one. One of the things that dementia cannot steal from you is love. Research has shown that people with dementia will still feel love and happiness long after they have forgotten an actual visit or experience.2 Love remains and that is your secret defense. These five methods to calm agitation and aggression give you a way to focus on the love in your relationship and continually build on the bond you share.
Agitation and aggression are contagious. It is very natural when you are talking to somebody who is getting agitated to feel upset yourself. This natural phenomenon is called mirroring and can work to your benefit.
When you stop and take a deep breath to calm yourself, you are demonstrating calmness to your loved one. This helps to make him or her feel safe and reassured.3 Take a step back and see if you can identify a cause for the agitation. Remember that your loved one is not trying to give you a hard time – he or she is struggling as much as you are.
Stop whatever you are doing and slow down. Listen to what your loved one is saying, even if it doesn’t make sense! Don’t correct as that just makes the agitation increase. Take in a deep breath and remember a positive memory you share with your loved one. Allow that warmness to enter your eyes and look directly at him or her. Smile gently and try to ask for permission for what you need to do or offer help. For example “can I help you wash the dishes?” Calmness often reassures those with dementia, which allows you to make a positive request like “will you walk with me to the store?”
Focus on Feelings not Facts
Dementia can impact a person’s ability to reason and speak but feelings still remain strong. You need to respond to your loved one’s feelings instead of their words. Trying to reason and argue with a person with dementia will only frustrate both of you!4
Listen to the expression of frustration even if the actual words don’t make sense. Your loved one might be saying “I need the car to take the ball!” You could respond to that expression by saying “you really are wanting the car today?” Then try to provide clear reassurance, for example “I will take you out in the car today and we can get what you need.”
Treat your loved one with love and respect as these are feelings that can bridge communication problems between yourself and someone with dementia. An even bigger thought to keep in mind is to continue to interact with your loved one with dignity. Although you may see behaviors that remind you of a child, your loved one is not a child. Guarding his or her dignity will prevent hurt feelings that lead to agitation. The reality of your loved one with dementia may not agree with the reality that you see. But the feelings that he or she is experiencing is something you can agree on.
Set your loved one up for success. Dementia causes damage to the brain that makes it difficult to express thoughts and perform tasks. Background noises, clutter, crowds and even lights can overstimulate the brain and bring on feelings of restlessness.5 Develop an environment of calm in your home. As much as possible choose smaller gatherings over crowds. One or two visitors will be easier to handle than a room full of talking guests. Turn off the TV when talking to your loved one. The noise of the TV can be difficult for your loved one to block out.
Reduce the amount of non-essential items in your home. Bright, distracting patterns and moving objects can confuse your loved one. One or two meaningful, personal pictures will offer a more calming décor than 20 frames.
Lights are another stimulating presence. Particularly in the evenings and late afternoon, it is important to switch from bright overhead lights to smaller, dimmer lights. The glare and reflections from lights off windows, mirrors and picture frames can be startling or even frightening for your loved one.
Always aim to simplify your surroundings when you notice signs of agitation. Use simple sentences. Move into a quieter space. A calm environment will often calm your loved one.
Check for Discomfort
Your loved one’s difficulty communicating means that they will have trouble telling you if they are uncomfortable. One sign of physical discomfort may be that your loved one is having trouble sitting in one place and is constantly on the move, fidgeting and irritable. Below is a thorough checklist to help you identify physical discomfort:
– When did your loved one last eat? Could they be hungry? Try offering a small, nutritious snack. Better yet, sit down with them and have a snack yourself. Keep yourself at your best!
– Could your loved one have an infection? Urinary tract infections and bladder infections can often develop or worsen symptoms of confusion, decreased mobility and agitation.6
– What has your loved one had to drink in the last 24 hours? Dehydration is common in seniors due to a decreased sense of thirst. Dry eyes, mouth and skin are symptoms to watch for along with confusion and forgetfulness. Make your loved one a hot or cold cup of non-caffeinated tea, offer a slice of juicy watermelon and make sure to add water dense foods into their daily meals. Or gently remind your loved one to sip on water throughout the day.
– Do you know when your loved one last had a bowel movement? That’s an important discomfort to address!
– Don’t forget to do a quick glance of the clothes your loved one is wearing. A waistband that itches, the tongue of a shoe that is rubbing, socks bunched at the toe, a collar that is too tight, a fabric that scratches. All of these minor irritations can be distracting and irritating.
Making sure that your loved one is physically comfortable will drastically reduce aggression and agitation.
Dementia can be a frightening and a stressful time for both you as the caregiver and for your loved one. The most important thing you need to keep in mind while working through the aggression and agitation is connection. Dementia CANNOT steal the love from your relationship. It only has the power to change that relationship.
Always look for ways that you can cherish your loved one instead of focusing on the more frustrating aspects of caring for him or her. If the immediate situation or activity seems to be triggering your loved one, try to be proactive in changing the situation or activity. Redirect to a more peaceful and relaxing activity. If a conversation is upsetting either of you, acknowledge what your loved one said and then move to a different topic.
Aim to say yes as much as possible, if your loved one mentions that she saw someone who has passed away years ago. Agree with how lovely that would be to talk to them again. Even build on it and ask what they talked about. This gives you both a connection and comfort with one another.
Remember that you can only count on today. Enjoy the moments that you have. Listen to music together, dance (if you can!), play an instrument, offer a massage or brush your loved one’s hair. Go for a walk outside and listen to the bird’s songs or look at flowers. As Alzheimer’s and dementia progress, the world is largely experienced through senses. Express your love through touch, sounds, sight, tastes and smell.
Dementia, particularly dealing with the aggression and agitation, can be challenging for caregivers. Remember the importance of your connection with your loved one. Provide a soothing environment and aim to remain calm and loving. Empathize with your loved one’s feelings and always emphasize love. When you need help, look for caregivers that are trained in Alzheimer’s and dementia care.