Dementia Care: Identifying Triggers

Increased anger and aggression can be all too common side effects of dementia or Alzheimers.   Bad moods happen to us all, and sometimes we just can’t put our finger on why we feel so down on ourselves.  I imagine something similar occurs when our loved ones with Dementia or Alzheimer’s gets into a bad mood.  The difference is I’m able to vocalize (more like warn!) those around me that I’m just not feeling 100%.  Or if someone did something to upset me, I’m usually able to appropriately direct my feelings towards that person rather than anyone that crosses my path.

So why can’t our loved ones control their emotions?  And what makes them get so riled up that they feel they need to take a swing at you? In my experience, anger is usually a prolonged side effect of frustration.  Resulting from an individuals inability to efficiently get their feelings across and the disappointment that we the caregiver is unable to understand or help them accurately.

While working in the nursing home, it was essential to know and understand each resident’s triggers.  Triggers can be anything from a particular sound to a specific person and although we may not always know why this particular item can cause an adverse reaction we quickly learn to avoid these things at all cost.

A helpful way to learn and remember triggers is to write them down while also noting the time of day they occur and the details of the scenario. For example, Mom may start yelling at breakfast – This only happens on Monday and Wednesdays which just so happens to be the same days she has a shower right before breakfast.  The negative feelings she has towards her shower are carrying over into the rest of the day.  In this case, there are a couple of things we can try: 1. Offer a bit more time in between shower and breakfast, so that she can calm down. Maybe even play a bit of her favorite music in her room to relax too.  2. Change the time of her shower to after breakfast. 3. Assess whether a shower is still an appropriate method of care.

It is important to note that even though someone has dementia, it does not mean that their feelings are unjustified.  More often than not there is a rational explanation for the behavior.  It is our job as caregivers to be their detective.  Figure out what is bothering them and then doing what is in our power to remove these stressors from their environment.  Or add in additional supports to help them manage and calm them after a trigger occurs.

Caregiver Response

caregiver-stress

And let’s be honest, its never always so easy.  The times our loved one is angry, sad, or accusing us of something horrible are probably the lowest points in dementia care.  It is normal to feel frustration or even anger towards our loved one.  Keeping a notebook helps for this as well, recording our own responses allows us to better understand our breaking points and offers more insight while we provide care.

While you may feel overwhelmed and flustered at the moment, it is so important that your loved one is able to calm down.  Prolonged anxiety or anger creates a higher risk that they hurt themselves or even you.  It is important to first rule out that your loved one is in any pain.  If they aren’t able to directly tell you then assess their body language; are they holding a particular part of their body?  Are they wincing or is there a look of discomfort on their face?  If pain can be ruled out identify the trigger as soon as possible.  The Alzheimer’s Association offers a list of potential factors here.

Resources

Anger and aggression are common behaviors, and there is a ton of helpful information out there for you to learn different ways to both help your loved one feel more safe and secure and for you to feel more confident and in-control in these moments.  Below is a list of helpful sites and feel free to check out our Dementia Care and Caregiver Support Tags for more resources from the Upside!

New Approaches for Dealing with Difficult Dementia Behaviors

How can we control my dad’s violent behavior and find a care facility that will accept him?

Why does dementia cause suspicions, delusions and paranoia? 

Dementia Care: The Benefits of Staying in Their Reality 

Handling Dementia-Related Agitation and Paranoia

Hallucinations, Delusions, and Paranoia Related to Dementia

Dementia Care Dos & DOnt’s: Dealing with Dementia Behavior Problems

Caregiver Stress and Burnout: Tips for Regaining Your Energy, Optimism, and Hope

Taking Care of YOU: Self-Care for Family Caregivers

Dementia and Alzheimer’s Caregiver Stress

You Aren’t Alone

You may be the only one providing care for your loved one, but that does not mean you are alone in your experience.  The growing number of family caregivers is astounding, and the need for understanding and tools with Dementia Care is essential to your ability to sustain your role as a caregiver.  Although difficult, when your loved one begins to show signs of anger or aggressive behavior rule out pain and start investigating potential triggers within their environment.

For future reference, be sure to document the behavior, the time it occurred, and possible triggers.  This way you’ll better be able to identify trends in behaviors.  There are a number of ways we can help our loved one in these moments, reading others experiences and their tips and tricks may be a fast way to pick up your own tools for managing these behaviors that will allow a better quality of life for both you and them!

 

 

 

3 Things to Consider as you Devise a Plan to Age in Place

age-in-place

Designing a Plan to Age in Place

The desire to stay in our homes as we age is more popular now than ever. However, there is a growing segment of our population that are being lost by systems due to no longer having access to transportation, a lack of family support, a recent loss of a spouse, or a recent decline in cognition.

Typically the most substantial issues found for this population while aging in place are; falls, lack of accessible transportation, and isolation. These are mostly non-medical matters, which makes it difficult to fully rely on the health care system to meet their largest needs.

The 65 and older community is the largest population receiving health services. But, even if a person is admitted to the hospital with a fall injury, this encounter with the system does not necessarily replace the carpet the person tripped on.

To sustainably age, in place, we should plan for in-home supports, identify resources in our community, and educate ourselves on what to look out for within our home.

Identifying Resources

Our neighbors, family, friends are our primary supports system.  Having conversations about how we would like to age in place, making a point to outline important aspects of our daily routine, and even creating an action plan in cases of an emergency should be priority conversations with those closest to us.

Having this type of support system and educating them on what signs to look for (i.e. mail piling up or overgrown grass) can help ensure we are checked in on at the first evidence of trouble.

We might not always have family or neighbors to count on, and in this case, it is also important to do a bit of research to see what type of resources are available to us in our community.

Partners in Care  in Maryland is a great organization who for over twenty years has supported older adults remaining in the homes they love and keeping them meaningfully engaged in their communities.  Finding a care team like theirs in our community is an excellent way of ensuring reliable transportation, that we receive general repairs when we need them, and even more importantly we can always count on them to brighten our days with a simple conversation.

A Safe and Secure Home Checklist

AGIS- Assist Guide Information Services provides us with an excellent tool to assess our homes safety and security.  The checklist ranges from the General living area to our personal safety as we navigate through our homes.

General Living Areas Yes No Action Taken
Is there adequate lighting throughout the house?
Are there night lights where needed?
Is home well ventilated?
Are all doorways accessible and easy to operate?

Assuring that the physical layout of our homes and the items within are placed in a way that creates a safe and secure living environment for our aging needs is critical to the ability to continue to live in our homes. This type of prevention could also decrease the risk of falls and subsequently trips to the emergency room.

Preparation is key

The aging process, at times, can be unpredictable and of course we cannot always anticipate for all of our future needs. However, we can create a plan and identify how and where we would like to spend our better years.  Spending time to research resources in our communities, having conversations with those closest to us, and assessing our homes ability to meet our future needs are all places we can begin the planning process towards our ability to age where we want.