My father had dementia when he died. My mother, who is 93, is showing signs of it. That’s the problem with dementia — it doesn’t appear full-blown and clear. It’s insipid and creeps up on you. Sometimes it’s not evident to friends and distant relatives, just to you the caregiver, which can make you feel like you are the one losing your mind. Besides forgetting events and people, some of the signs of dementia that I have noticed are crankiness, irrational opinions, distrust of strangers and the inability to answer a straight yes or no question. It becomes difficult to have a clear discussion about anything important.
So, how do we caregivers handle this erratic, irrational behavior? People with dementia can get facts, dates, and locations wrong and refuse to accept the truth. The best way to deal with this is: Don’t correct or argue. You don’t need to be right — my new mantra. It’s much better to redirect a conversation, make a light-hearted joke, or say something encouraging like “You’ve got a point,” or “That’s interesting.” And remember, a squeeze of the hand or a hug can lighten any moment that is heading for the dark side.
As my father became more and more demented, he responded to compliments for doing simple tasks, like sitting in a chair at the table. “Good job, Dad!” (We all respond to compliments. It just makes us feel good.) He also dealt much better with simple instructions than with long explanations. And when he was suddenly confused and not sure what he was supposed to do, I would sing instructions. Sometimes I’d put my hands on his hips and pretend to do a conga line, with him leading the way with his walker, “Let’s go in the kitchen. We’ll sit at the table.” He would start bouncing his hip and smiling.
Kicking, biting and hitting can all be fueled by fear or helplessness. If this happens, give your loved one space and allow her to reset herself. A little space, time and redirection can work. If your loved one is too agitated and confused, talk to your health care provider about medications like Ativan or Xanax — which are used for anxiety. Haldol and Seroquel are prescribed for agitation.
Final advice, which can be easy to give but takes real effort to do, take care of yourself. Take five minutes to sit in a chair and take deliberate, deep, soothing breaths. Close your eyes for just one minute. Take Vitamin D. Walk around the block. Have your refrigerator stocked with healthy snacks. Find fun things to do with your loved one — listen to music, look at scrapbooks or photo albums. Go slowly.
Special note: If there is a sudden onset of confusion or combative behavior, it could be caused by medications, depression, dehydration, excess use of alcohol, or a urinary tract infection. The UTI can be treated with antibiotics. Sometimes crankiness can mean the patient is in pain, but doesn’t really realize it. Try giving her a painkiller, like aspirin, Tylenol or Alleve.