The Dementia Primer: 6 Tips for Working with People with Dementia

Dementia, Alzheimer's, Help for Senior Caregivers, Non-Medical Senior Care, Respite Care for Caregivers, Senior Citizen Care, Affordable Home Care“Doris” loved washing dishes.  She was in her eighties with advanced dementia, but she loved washing the dishes.  The problem was that the dishes usually went from the table to the sink to the drying rack with bits of dinner still stuck to them.  Doris was also a pincher.  If things didn’t go the way she wanted them to, she’d pinch anyone in her way.

The solution to this was that caregiver Debbie let Doris wash and dry her dishes.  Then, when Doris was occupied in another room, Debbie would wash the dishes again to make sure they were sanitary for the next meal.  It was a win-win solution.  Doris and her husband were living in sanitary conditions, and Doris wasn’t spending her life agitated about not being able to wash her own dishes.

People with dementia live totally in the moment.  When their children come to visit, people with dementia may not always remember them, but they feel the warmth of their love.  If Grandma feels loved for thirty minutes because her daughter is there visiting, it makes that visit very meaningful.  Unfortunately, it’s easy to spend those moments arguing with Grandma over her age or what month it is instead of spending quality time with her.

In the ten years that we’ve been providing home care services for seniors in the Twin Cities, we’ve cared for many clients with dementia and Alzheimer’s disease.  Here are just a few tips to help you maximize the time you have with your loved ones who have dementia:

1.  Understand that memory loss and confusion is not a choice.

No one chooses to experience memory loss or confusion.  The resulting effects—anger, frustration, emotional displays, argumentativeness—are natural outcomes any one would have if placed in a similar situation.  No actions on the part of the family caregiver will ever change dementia.  Punishments (such as time outs or yelling) are ineffective and should never be used.  Also do not attempt to argue with a person who has dementia.  Their reality is just as real to them as yours is to you, so it will not be fruitful.

2.  Establish a relationship.

If the person with dementia doesn’t recognize you, get to “schmooze” with that person before starting to help her.  Treat her like a friend, and realize that you will be able to do more for her if you have a bond with her.  You would never let someone provide standby assistance for you in the shower two seconds after meeting her, but you might if you had some time to get to know and trust that person.  Don’t hesitate to butter her up.

3.  The person with dementia is always right.

It is not helpful or useful to make people feel bad about their memory loss.  Don’t contradict their memory loss or ask them to recall details.  Never use phrases such as, “Don’t you remember that we were going to go to the store?”  There is no point in making them feel bad about forgetting.

There is also never a point in arguing with a person who has dementia.  You will never win the argument about today not being garbage day or that they no longer go to work.  It is more effective to distract or divert them.

4.  Therapeutic Fibbing

It is okay to fib to people with dementia to avoid arguments and power struggles.  Do what you can to distract, divert, or validate their concerns so that you can help them and move on.

Some examples:

Grandma, age 83, is insisting that she must wait for her mother to pick her up.  Instead of arguing with her that her mother has been gone for many years, tell her, “Oh, your mom asked me to take you home for her.”

While at the store, Grandma insists you buy syrup even though she has five bottles at home.  Allow her to put the syrup in the cart, then take it out when she’s not looking.

Grandpa is concerned about someone stealing his money.  Instead of trying to argue with him, try saying, “You know, I’ve wondered that same thing.  I’m going to call the bank later today and ask them about it.”

5.  They like to help you.

Everyone wants to feel needed and valued.  Ask Grandpa to help you with simple tasks that he is still capable of performing, keeping in mind that he may not be able to attain perfection.  Ask Grandma to teach you her favorite hobbies, such as knitting or playing cribbage.  Asking for help can also be a way of distracting those with dementia from their concerns or worries.

6.  Respond emotionally.

If someone is having a hallucination or a re-occurring fear, you will not be able to reason the fear away.  Instead, respond by meeting the emotional needs that are rooted in the fear.  If Grandma is seeing tigers coming at her, assure her that you are there to keep her safe.

Please keep in mind that what works for one person with dementia may not work for another.  Due to the ever-changing nature of the disease, tactics need to be constantly assessed and reevaluated as behaviors change.  A good book to reference is The 36-Hour Day by Nancy L. Mace and Peter V. Rabins.

 

Be sure to check out our primers on the 8 Things You Need to Know About Dementia and Alzheimer’s, 7 Pitfalls of Caregiving for People with Dementia and Alzheimer’s, and 12 Tips on How to Get Someone with Dementia to Eat.

Read caregiver Jody’s personal journey of facing her own mother’s dementia diagnosis for additional insight.

If you’ve been caring for a loved one with memory loss, we’d love to hear your tips for helping people with dementia.  Please comment below.

Julie Ellingson, LSW

January 6, 2012


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Comments (4)

 

  1. Donna Duchene says:

    Loss of appetite is very common for those with memory loss and it is often a challenge to get them to eat. If they are to have a snack or a meal while in my charge, I always sit with them and have a couple of bites too. I never put something in front of them and leave them to eat alone. Seems to encourage them to eat and it is a time for bonding.

    This is a wonderful article!!!

    • Julie Ellingson says:

      Donna, you are so right! Loss of appetite and then actually forgetting to eat are both very common and challenging. Actually sitting down with the person and eating with them is an excellent idea—even those of us without dementia don’t like to eat alone!

    • JimMiles says:

      To add to Julie’s comments, we had a client who simply refused food anytime anyone offered to make it. To avoid a power struggle, the solution was to make lunch without asking her. The caregiver set it in view of the client, and eventually, she would see it there and eat it.

  2. SmartyMarti says:

    It’s true about a person with dementia living in the moment. You just have to make time with them happy and active. When they are bored, it’s like a kid, they start doing things that they shouldn’t be doing. Make sure the person with dementia has things to do that they enjoy. Also with eating, they won’t remember when they last ate or will say they are not hungry when they are. Put some food in front of them – they will eat.

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