Dementia clients have holes in their brains, so they can't act normal. I get it. We are told not to think they are being slow or resistant on purpose. It's the holes in their brain slowing their processing & making them feel unsafe & hesitant or confused. OK.
But when I walk away momentarily to control my frustration, suddenly they want to cooperate and start to do the very thing I asked them to do for 20 minutes (such as walk to the toilet).
So, is this holes-in-the-brain, or is it passive-aggressiveness for prolonged companionship/attention or even spitefulness over having someone else manage their time? This particular client falls asleep after dinner in unsuitable locations like head-on-dining-table and if we don't get him/her to bed quickly, he/she won't have the physical strength to get there later. So, I think s/he resents being corralled for bed.
We are told dementia clients are not really being slow or resistant on purpose, but we all know that passive-aggressive behavior can be engrained in every human being, dementia or no dementia. So just because a client has dementia doesn't mean they also don't know how to be difficult just to get attention or get back at their care giver for a perceived offense.
It can take that long to process a reply or comply with the command or request.
So if you ask someone with dementia to lift their leg so you can put their pant leg on it might take 2 minutes for them to lift that foot.
yes frustrating.
That is why you lift the leg for them and slip the pant leg on in a "nano second" compared to what they would do.
Now I don't know about you but when I am talking to someone and I ask a question in 40, 60 seconds or more I am onto an entirely new topic. So when I was dealing with my Husband there were some VERY frustrating days.
But...I learned to be more patient.
I learned when I was doing something for him I would explain everything I was doing so he actually began to relax because he was being told what was happening. And there were times that he would be right with me in the process, he would get his hands under the faucet before I would ask him to, he would take the shower wand and wet his legs, he would hold on to the bar on the Sit to Stand when I would hook the sling in. So doing things became easier.
Patience is rewarded..either things are a bit easier for you or because you are more patient you are more relaxed and in general that just makes you calmer, that makes the people you work with calmer.
A caregiver can't apply your approach of letting the client/resident take all the time in the world to get the work done. CNA's in a care facility and even in homecare are on a clock. In a care facility the aide also has several other residents to be responsible for and it all has to get done before a certain time of day.
Even when it's one-on-one in a private home the aide only gets a certain amount of time and usually has other clients to go to.
If Mrs. 'A' has a two-hour homecare aide coming in that has to get her fed, showered, dressed and make sure the laundry is done and the house is straightened up, there isn't enough time to get the work done at the client's snail pace.
So we have to hurry and rush them. CNA's (both in home and in a care facility) get in trouble if all the tasks don't get done in the alloted amount of time. You're considered a 'poor-job performance' in the employee review and often lose your job.
When I worked private care cases I only put in the amount of time I was paid for and not a second more. So if Mrs 'A' or her family refused to pay for additional time so I could get everything done at her snail's pace, then tasks went undone.
People often make the mistake in thinking that when a person has dementia they have no self-awareness and are not capable of deliberately causing trouble on purpose. I've had many dementia clients over the years who were spiteful, nasty, and snide on purpose and who still possessed the capacity to understand that they were this way and wanted someone to fight with.
Many elders will be difficult for the sake of being difficult. They are bored or lonely or just don't have anything better to do.
If you're a caregiver for someone with or without dementia you should never cater to and accept bad behavior. Never get pulled into their drama games or intrigues. You're on a clock. If someone is deliberately moving slowly, then they must do without if you have other residents to care for.
Always be nice and pleasant enough, but don't be a pushover. You are the one in control of the situation not your care client or resident.
My mother is a difficult person. She enjoys spreading misery and ruining things. She also loves to insitgate fights.
She developed a habit of walking right past the bathroom in the morning so she could use the portable commode downstairs rather than the flushing toilet. This was purely to spite me.
I made it clear that the commode was for emergencies only and that I will get rid of it if she's going to abuse it. She stopped abusing it.
I'm going to link some Teepa Snow videos that I found very helpful when I was learning about dementia
https://www.youtube.com/playlist?list=PLVl8vTLjje8ESAEvpjVoVTEK-_6X2jTdl
https://www.youtube.com/watch?v=xNznZ2MnV3I
https://www.dementiacarecentral.com/video/video-brain-changes/
First of all there are different types of Dementias. Each have common characteristics and characteristics only their Dementia has.
Alzhemiers falls under the Dementia umbrella but is very different from the rest. Its more the neuron thing. Then there is vascular. Lewy body which gets its name because lewy bodies are the cause of the Dementia. Frontal lobe is probably the worst because that is where our emotions are and these people can have very violent tendancies. There are many other types but these are the ones most discussed on our forum.
All Dementia's are unpredictable. No rhyme or reason to them. Short-term memory, being able to reason, no empathy, and processing what is being said show up in the early stage. And, I feel, as time goes on the become like small children. Some members call it a broken brain, I call it a dying brain. I might say their brains are like swiss cheese but there is really no holes as such, holes in their memory yes if u want to look at it that way. In most Dementias its a plaque that travels thru the brain killing it off.
Do you ask your clients if they want to shower? Of course their first response, like a child, is going to be No. Then they finally process what you say and they say yes. Don't ask just say "Mrs Jones time for a nice bath" or don't say anything till u get to the bathroom and then say "bath time". Make sure the room is warm. Use a handheld shower head, rinse the person down, suds up, rinse again. I always had a hand towel on the toilet seat and sat Mom down to dry her off.
I had a big problem in dealing with the unpredictability of Dementia. I work better in a structured, organized place. I had a MIL who had a personality disorder. Just when I thought I had her all figured out and I could deal with her she would do something different. I ended up not having much intervention with her especially if my husband was not around.
Your profile says you have 3 yrs working in caregiving. Mostly with Dementia and Mentally ill people. Not saying you won't get frustrated caring for these people but if your frustration is more than just occasional, maybe you should not be working with mentally ill and Dementia people. Believe me, patience is not my forte. I have very little. These people need someone caring for them with the patience of Jobe. Who has the ability to just let things run off their backs.
Caregivers burn out. So do aides, LPN and Nurses. My daughter, RN, has had different jobs because of burnout. Three years is a long time to deal with someone suffering from Dementia. If you find you are getting more and more frustrated, then it might be time to change who you care for.
A broken brain perhaps, but not one with holes in it.
Everyone who suffers from this horrific disease is different and can't be lumped into the same group, nor will they act the same. Depending on the type of dementia one has will often determine how they will act.
It sounds like you might benefit from doing some more research on your own about dementia, so you can get a better understanding about it since it sounds like you are in a care setting for folks with it. And hopefully it will help you be a more understanding and compassionate caregiver because of the knowledge you've gained from your research.
Those of us who are caring or have cared for someone with dementia can tell you that knowledge is key, and the more you know about this disease the better able you're equipped to handle whatever comes your way.
But those with dementia don't have well-functioning brains, so they suffer disinhibition, that is to say their brains don't function anymore to inhibit "socially unacceptable behavior.
They may still be capable of "doing as you say" when they put together, in their poor brains, that a failure to do so will make you move away from them.
Mentally ill patients (as an RN I used to "float" to the psyc unit) are much the same. They will come around the nurse station to socialize, and often be totally inappropriate, and admonishions to behave won't work, but just tell them that they will move to their own rooms and they behave beautifully.
I think what I am trying to demonstate to you is that even a very injured brain can still function (tho irratically) occasionally.
I hope this makes sense. Study up on the impaired brain. I suggest everything that Oliver Sacks ever wrote. His study was the brain, indeed the impaired brain. Start with The Man Who Mistook His Wife For a Hat.
The brain is a fascinating thing. Try to remember that these folks aren't out to get you. The simply are operating on a brain very different than yours, one hard to understand and a source of continuous frustration for those of us still well.
I wish you the very best.
I get him out of his wheelchair and put him in his recliner. Then I make sure to give him something to do...like a game or movie to distract him while I get stuff done. I yell from the other room multiple times to let him know that I'm almost done.
The only way to break this pattern is to stick to your guns and set boundaries.
Dont give in and eventually it will get a lil better.
He gets insecure when he can't see what I'm doing. So I constantly reassure him that I'll be there in a few min.
IMHO it is better to treat them mercifully, meaning to l@@k at them as people whose lives have been commandeered by this damned disease, rather than people who are playing mind games with you. The Golden Rule is still the best rule.