The more I read here the more and more I see posts relating to dysfunctional behaviors coming from the afflicted. I have not yet been able to do research on this, however in my home (my Father has not had the official diagnosis yet but all the baseline symptoms).
I have seen caregivers bullied, attacked, etc. In my home now it seems to be more of the passive-aggressive BS. So is the Dementia causing this or is it the old age? How do we respond to it all?
I have seen many post responses that recommend placement. I haven't' seen any real strategies to deal with the dysfunctional behaviors and I think there should be.
I have tried ignoring. That usually doesn't' work because he will find something else or he kicks it up a notch to create even more issues.
I am also wondering if Dementia is comorbid with Psychiatric Disorders. I am seeing a lot of symptoms of these in my home. I am also reading a lot about others who see behaviors that mimic Psychiatric Disorders.
I thought it would be a good idea if there were some strategies that we could pool together to help minimize the behaviors. I did it with my oppositional defiant teen and it worked. My Son has ASD and his behaviors are well under control.
It doesn't' feel right to me to just throw up my hands and say I am not dealing with this. I would rather try and solve it. At a minimum I would like to implement some behavioral strategies to reduce the level of dysfunction. I am thinking this could help many who are here.
I wonder sometimes as well if they seem to "enjoy" the dysfunction created. WIth my Dad I offer solutions to problems and he never implements them. I really want to get a handle on this, but sometimes it seems so crazy I have to wonder if it is EVEN POSSIBLE to get a handle on it.
You'll find coping mechanisms to deal with your loved one but with dementia sometimes one strategy will work one day but not the next day. Dementia is fluid, it's ever changing.
Sometimes medication helps but this is where you have to work with your loved one's Dr. Sometimes medication is indicated when the person becomes agitated but again, this is something that has to be figured out with the Dr. based on your loved ones symptoms. Many times implementing medication is trading one problem for another.
If you read the articles and previous posts on this site you'll read about caregivers who come to the realization that they can't change the behavior of someone who has dementia. All they can change is how they deal with the behavior of their loved one. We can't tell our loved ones with dementia to straighten up and fly right. It's not a behavioral disorder. It's brain damage and little can be done to change it.
There are a few tips and tricks in dealing with someone with dementia. Redirection is one of them. When the person is obsessing or repeating the same thing or maybe on the way to becoming agitated we find something else for them to focus on in that moment. Sometimes this works, sometimes it doesn't. And while it may not sound like much, keeping someone with dementia redirected is emotionally, mentally, and physically draining.
Trying to reason with someone with dementia is futile because they don't have the ability to reason anymore. Your son retained his ability to reason when he was having behavioral problem but people with dementia can't be reasoned with and trying to get them to make sense will drive you crazy. If they insist that the sky is red trying to explain to them that it's really blue will take up your entire day because they can't understand. It's just easier on us if we say, "Oh yes, what a lovely shade of red" and then try to move on. Arguing with someone with dementia is useless and maddening.
You don't have to throw up your hands and refuse to deal with it but understand that you won't solve it either. You'll find coping mechanisms that help with your loved one and some days they'll work and other days they won't. And if you find coping mechanisms that work for you then you must come here and tell us about them!
Regarding your comment about wondering if they "enjoy" the dysfunction: Yes, I absolutely think that happens. Sometimes it's the original personality coming out, even more magnified. And sometimes it's the only time they get to feel that, in that one moment at least, they have your attention and they're controlling things. Even if the situation is actually getting out of control, they know, in a very "toddler-ish" way, that your reaction is due to their behavior, and I can see how that might be satisfying to them. Absolutely maddening when it gets in the way of their care, though.
The dementia emphasizes, exaggerates, and amplifies the psychiatric behaviors. She lived with us for 3 1/2 weeks while her apartment was being readied in the residential facility. In less than a month, she had all 4 of us hiding from her, dreading her theatrics, her demands, her negative domineering talking, her tantrums. We couldn't even relax in our own house anymore. She refused to let me or anybody else assist with her medications. She had 19 different meds to take, and she had it so mixed up there was no way she had the right things at the right times which helped nothing!
Were her behaviors from her psychiatric disorders or her dementia? I struggled with that for a long time. I figured out that dementia had taken away her reasoning skills, so anything process related or that had more than one or two steps was gone. What little emotional regulation she ever had was gone. Her ability to process visual and auditory information correctly was gone.
Her angry and negative responses to everything was not dementia. Her attention seeking stunts were not dementia. Her hissy fits and tantrums were also not dementia. Her mean spirited way of talking to any of us was not dementia. Her trying to hit me in the head with her cane while we were driving down the highway was not dementia.
These things had always been there in mom, I'd lived through it as I grew up, but now, they were a lot closer to the surface because of dementia. She had very little control over it anymore. She used to behave in front of strangers, neighbors, and people in authority, so nobody outside the house really knew what was going on behind closed doors. She can't hold it together anymore, and that is dementia. She's not as clever and devious, which is dementia.
At some point though, it no longer matters what the cause is. The treatment approach is the same. Anti-psychotics and anti-anxiety meds. A secure memory care residential unit where people know what to expect and how to handle it.
You will need to plan ahead for your dad and your family's preservation. Someone will need power of attorney and probably guardianship. He will eventually need to live somewhere other than your house.
Aphena, we tend to think of dementia as a memory problem, but it is certainly a behavioral problem, too. And a decision-making problem. And an executive-functioning problem. As far as I've read, dementia doesn't cause other psychiatric conditions, but can co-exist with them.
There are over 50 distinct types of dementia. With luck the Neuropsych testing will help to at least tentatively identify which kind Dad likely has. That will have guide your research and learn what to expect and to a lesser degree how to cope.
Best wishes to you, and continue to share your journey with us!
Distraction - when they're being argumentative, bring up another subject pertaining to something in their life that made them happy, proud, peaceful, etc.
Delaying -- for example, if they refuse their medications, bathing, eating, and the like. Say 'okay, that's fine' and try again in 15 minutes or so. Chances are they won't remember their little "fuss" a few minutes ago and may be more cooperative.
Tasks - Give them a simple task to do. For example - sorting buttons, tearing up junk mail, folding towels, sorting things by color, finding items in a catalog, looking through magazines or picture books, sorting old photographs, etc. This will make them feel useful and get their minds focused on other things.
Research: What was life like when they were a child? You can find out a lot on the internet. Ask them questions about it, such as what type of music did they like, who were the most popular movie stars, what kind of clothes did they wear, what were the popular books of the time, how many children were in their school, etc. This is a great way for grandchildren to get to know what their life was like, and usually the person really enjoys reminiscing!
Hygiene: Remember that when they were children, people probably bathed only once or twice a week. You can use no-rinse shampoos and pre-moistened towels especially for this purpose as they may be afraid of falling in the shower/tub or embarrassed about their inability. They probably didn't change clothes every day either when they were children, so they don't understand the need to do so now. Unless odors or health issues are a concern, cut them some slack as far as frequency in bathing, changing clothes, etc.
Protect yourself: If their behavior becomes aggressive, combative, or violent, back away. You don't have to subject yourself to injury! Walk away for a few minutes and if need be, ask a friend or neighbor for help.
Speak calmly: No matter how riled you may get, try to speak in a calm and even tone. Watch your posture -- are your fists clenched, are you leaning into their face, are you clenching your teeth, etc -- your care receiver will pick up on these cues and it will escalate their behavior. Go outside for a few minutes and calm yourself before continuing.
Medication: Yes, there is a time when medication is necessary. I was also reluctant to medicate my husband until my daughter pointed out that he would be mortified by his behavior if he had the capability to see himself as we did. This will help in some way to maintain their dignity as much as possible.
Communicate with Doctor: Keep the doctor informed of new symptoms as they develop, even if it's only through e-mail. When you're finding it difficult to maintain quality of care, let the doctor know that you need help.
Hallucinations: You won't be able to convince them otherwise, so it's best to just acknowledge what they're seeing or hearing, then distract.
Take care of yourself: This is so important -- eat healthful foods while sitting at the table (not on the run), get enough sleep, keep in touch with friends and family for support, drink plenty of water, take your own meds and keep up with vaccinations for flu, pneumonia, tetanus, etc, and make time each day to do something that you find enjoyable.
The more tricks/strategies you have up your sleeve, the better. When one doesn't work, you can try another. Don't try to go it alone -- enlist the help of others and keep the medical team in the loop.
I wish you the very best!!
I eventually figured out that she did not want solutions, she wanted problems and to complain about them and try to get people to do things for her, and when they did it was never enough or good enough, so she could complain about that. Last time ( a couple of months ago) she complained to me that "things" were not being handled well, I asked her if she wanted someone else to do it. She changed her tune.
They tend to put you in a lose lose situation - d*mned if you do and d*mned if you don't. Until they do something dangerous to themselves or others I don't think there is much you can do except look after and protect yourself from the criticism, negativity and demands. It has taken a long time to get to this point (((((((Hugs))))))
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