Dementia is a common condition in the elderly. It is often difficult for both the older person and those around him to deal with this. In this article, tips and ideas about how to approach someone with dementia. How can you best communicate with someone who is starting to develop dementia, how do you deal with his/her emotions?
Dealing with Dementia
Perhaps the most important thing for someone confronted with a partner or parent with dementia is: don’t do it alone. Seek help in the area, other family members or professional help, both can provide help. As dementia develops further, professional help will often become unavoidable, but the most important thing is that there are people around who help or at least offer a listening ear to the informal caregiver. The second very important point is that the person with dementia wants to be treated with respect. The fact that someone needs more and more help does not mean that this is not an adult person with their own history and background. So don’t treat someone ‘like a child’!
Dementia and Practice
Staying active is very important for someone with dementia, although this may become increasingly difficult. Try to be patient with the fact that things happen slowly or perhaps not in the desired way. Of course, danger must be prevented, but don’t take the things that he/she can still do out of someone’s hands. It is also better if the standards of decency are taken more flexibly, this prevents a lot of frustration. The patient often only has partial control over these things and it usually does not help to scold someone. Try to adapt things to the level of the older person and involve him/her in what is happening, this will prevent someone from feeling isolated and withdrawing even further. It is not recommended to test people to see what someone can do or know. People become insecure about this. It is important to keep things organized and always keep the same order. Regularity is a key word, fixed habits become extra important and it is important to go along with them.
Communication with someone with dementia requires extra patience. Speak slowly and clearly in short sentences so that the older person understands what is meant. To avoid confusion, do not ask more than one question at a time. As much as possible, try to do what you say immediately, because things are quickly forgotten. If you say that someone is coming to visit, say it just before someone comes over. If necessary, use photos when talking about acquaintances whose names have escaped the person with dementia. Patience is a key word here, because it often happens slowly and it may not be clear what the person means. Body language can help to find out what the older person means. Your own body language is also important, eye contact and talking with hands often works well. If someone keeps making the same comments or asking the same questions it can help to distract someone, this behavior is often due to restlessness. When it is difficult to talk to a person with dementia, because so many things are no longer open to discussion, it can help to talk about the past. This is usually the period that the older person remembers best and is therefore often good ‘food for discussion’. Such a conversation about what went well in the past also boosts the confidence of the person with dementia. Talk a lot about clear things, such as things that someone is hearing or seeing at that moment. The food someone eats, what happens to be on television, are a few examples of topics for discussion.
An elderly person who is in the dementia process often suffers from emotional moods and is unstable. If you notice that the person with dementia is becoming frustrated, try to remove him/her from the situation or distract him/her. Do not engage in discussions, as this will lead to tensions and even more frustration. If you see sadness, try to comfort the older person, even if it is something you may not understand. The emotion is real. Accusations can also be part of the process, try to see it as something that is not directed against you and do not enter into a discussion. The person with dementia may also struggle with anxiety and depression and want to die. Don’t brush that aside, try to understand and show that you heard it. Talking about these feelings is usually impossible, but try to be ready with an arm or a comforting word. Sometimes there are hallucinations, do not deny them, but say that you do not see things. Try to radiate calmness and offer someone an arm, this often helps against anxious feelings.
Although aggression is of course also an emotion, special attention should be paid to this, because it is often very shocking for the caregiver. Aggression can also be part of the emotions that the person with dementia struggles with. Try to remain calm (however difficult it may be), the anger is often not properly directed and can arise because someone feels overextended. Responding angrily can lead to even more anxiety or fear. Sometimes the problem also lies in shame and frustration, especially when someone needs a lot of physical care. Sometimes aggression manifests itself in shouting and threatening, but sometimes there is also physical violence such as hitting or kicking. This is very difficult to deal with. Try to find out (if necessary with expert help such as a GP) what the reason for the escalation was. Sometimes it is not clear, but aggression often occurs during physical care. If you know what the ‘trigger’ was, you may be able to prevent it next time.
Dementia and Grief
Dementia is not only difficult for an informal caregiver because of the way the person with dementia behaves, there is also usually sadness. Sadness that most resembles a grieving process. The person we knew exists less and less. There is often confusion, both for ourselves and for those around us, because the person is still with us. Especially at the beginning of the dementia process, there is often the hope that things will ‘get better’ or we try to deny reality. The second phase is often accompanied by anger and feelings of guilt, because are we doing enough for the person with dementia? It is important that we recognize the process, this does not make the feelings go away, but it can help to accept the situation.
The further someone is in the dementia process, the more disappears, such as:
- the person as we knew him/her
- social contacts, which are often lost
- when it comes to a partner, equality in the relationship is lost
- when it comes to a partner, a shared future often disappears
Because the grieving process due to dementia is often not clear to those around you, it is important to talk about it with others. Whether it concerns a care provider or a family member or friend.
As an informal caregiver, it is important that you take good care of yourself. And that you ask for help if you need it, from family or care providers. Let us know how you are doing. Make sure you eat well, get enough sleep and exercise. This is certainly important if you have full-time care for a person with dementia. Provide an outlet to prevent stress. The dementia process is very frustrating and difficult and that is why it is important that you talk about it with others. In some places local partner groups and peer contacts can be found. It often helps to talk about it with people who are experiencing the same thing.