Caring for someone with dementia: Tips for reducing the stress

This can be scary, particularly if your loved one still has access to a vehicle. Follow these tips to prevent and handle wandering episodes:

• Let neighbors and local police know your loved one with dementia tends to wander.
• Keep a recent photo or video of the person handy to help police.
• Add additional mechanisms to prevent easy exiting when unsupervised.
• Make sure the person wears an ID or medical bracelet.
• Consider enrolling your loved one in the Alzheimer’s Association Wandering Support Program.

People with moderate stages of dementia often can’t articulate why they don’t want to do what we ask of them. You may need to do a little sleuthing. For example, if your loved one consistently refuses to take showers and gets angry when asked, it could simply be that the bathroom is cold. If this is the case, you may try to warm up the shower for five to 10 minutes to create a more comfortable environment.

Here are a few more tips:

• Try to focus on one thing at a time.
• Provide reassurance of your support and their safety.
• Try not to take mean comments defensively. Focus on the feelings behind the outbursts rather than the words.
• Don’t try to argue or reason with them.
• Try not to show your anger or frustration.
• Allow them to get up and move if it helps them think. We call this “providing space to pace.”
• Try humor, singing, or playing music to redirect mood changes.
• Reward desirable behaviors with compliments or a pleasant event, such as going for a walk, watching a movie, or having a snack.

We’ve worked with many patients who yell and demand things they need, such as snacks, drinks, or help getting up from a chair. It’s normal to get angry in return, but that will only escalate the situation. Instead, acknowledge their needs with a calm and pleasant tone and try to help them.

Some patients may become physically aggressive, throwing items or hitting, kicking, and biting. In these situations, keep a safe distance until the behavior stops. Try to move items out of their reach that they could use to hurt you, themselves, or others. Of course, if this behavior creates an acute safety issue at home, you may need to involve emergency services or call 911.

Here are a few more tips to manage agitation and aggression:

• Build quiet times into the day along with activities.
• Ask their doctor if medication can help reduce outbursts.
• Try to find and address the cause of the behavior. Perhaps they are feeling lonely, sad, uncomfortable, or in pain, which can cause agitation.
• Distract the person with their favorite snack or activity until they feel calm.
• Speak calmly and listen to their frustrations.

These episodes can come on without warning and can cause a spectrum of emotions, from freezing up to crying, hiding, or lashing out. Use these tips to guide your response:

• Comfort and distract them if they are afraid.
• Turn off the TV when violent or upsetting programs are on.
• Make sure they can’t reach anything that could be used to harm themselves or others.
• Try not to argue or react if they blame you for something you haven’t done.
• Ask their doctor if medication can reduce their symptoms.

Don’t argue with your loved one about this habit; it is out of their control and they likely won’t remember doing it. Instead, try these strategies to reduce harm and avoid conflict:

• Lock up dangerous objects, such as knives or firearms.
• Remove valuable items that could be misplaced or hidden.
• Search the house to find frequent hiding places and remove items you find there.
• Keep all trash cans out of sight or covered. Check them before emptying in case something was hidden there or thrown away by mistake.

Changes to a consistent routine can be particularly stressful for people with dementia who already struggle with their role in time and space. Help them prepare as much as possible for upcoming changes with these tips:

• Use a large calendar with words and pictures to help them anticipate activities.
• Try not to rush them in moving from one activity to the next.
• Provide written and visual directions for daily activities and new tasks.
• Set up medication reminders. There are many options, from digital calendar reminders to automatic dispensers and medication management assistance from a home health service.