Anger in the Dementia Victim
By: Starr Calo-oy
The most important fact you will need to accept when caring for a dementia victim who leans toward an angry behavior pattern is that they truly have no control over their actions, or the way they express their feelings. It may be very difficult for you to accept this change.
If they were usually angry when their mind was well, you may feel they are just being extra mean and stubborn now. You may only detect a small change at first and believe they are acting this way on purpose and could control their temper if given the proper incentive. You may try and lay a guilt trip on them to no avail. If they were normally pleasant before and now it seems their personality has changed, you may feel mixed emotions in your new perception of them.
If a doctor has informed you that they do indeed have dementia, then you must accept that you are dealing with an entirely different person who desperately needs your patience and kindness.
Listed below are some distraction techniques which have worked for us in the past. Keep trying the different methods until you have successfully tasted sweet victory and you will be proud of yourself. Whatever you do, don’t react in anger or you will compound the problem and then feel guilty when all is said and done.
Tip # 1:
Above all, don’t argue or debate with your Loved One (LO). You can’t possibly win. Now, you will really want to, especially if you’re caring for a parent who always had the last word and got their way and disregarded your opinions and feelings when you were young and too little and helpless to assert yourself. You may feel that you have the upper hand now that they are the helpless one and that it’s payback time.
Please understand this- if you are considering going this route, it borders on abuse. Try and bring peace through forgiving them. After all, how much satisfaction can there possibly be in winning a senseless argument with a mentally challenged and helpless individual, anyway? Your own self image will go in the dunker very quickly if you behave immaturely and lash out at your LO.
Rationalize your acts of patience and kindness by telling yourself that your LO won’t remember how brilliantly you debated with him in 5 minutes anyway! That will give you pause.
Tip # 2:
Entice your LO into another room or to go with you outside, if weather permits. If they are wheelchair bound, this can be fairly easy. If they are ambulatory it may require a little more persuading so do yourself a favor and smile as you speak softly, make the suggestion and take them gently by the hand if they will allow it. Sometimes a change of scenery is all that’s needed to turn their mood around. They can completely forget they were angry.
Tip # 3:
Don’t laugh at this one until you try it- it really works! Change your clothes and/or hair and then walk back into the room and say something like “Well, hello! How have you been?” In other words, start over again. The changes will often times cause them to forget that it was you their anger was directed toward.
We keep a couple of nurses’ smocks on hand and a stethoscope to hang around our necks so we can “check them out.” Even the most obstinate person will respect “the uniform.”
Tip # 4:
As soon as the conversation gets hot, head for the freezer. We keep emergency bowls of ice cream made up for such times. Our motto is “Ice cream makes the world go round.” If their passion is candy, pie, whatever it is, keep it close by and serve it right up to alter their mood.
Tip # 5:
Eliminate all noise within their earshot if possible. Noise can bring on catastrophic reactions faster than any other outside stimuli. If you are in the living room and the TV or radio is on very loud and there are several family members talking, laughing or arguing, it can really set the dementia victim off. Remember, their brain can’t filter out the overload to the senses like a well-minded person can. They become confused when they can’t process what is going on. Take them to a quiet room, free from all movement and noise and then slowly and quietly sit with them until they are calm. If they will allow you to, stroke their hair and tell them how much you love them. Speak softly and remember to smile. Speak in no more than 5 word sentences and get at their eye level and above all, remember to smile.
Tip # 6:
Many angry reactions can be prevented by simply explaining what you are doing before working with your LO. For example: if they get angry at bath time, ask yourself if you are jerking them around roughly and not taking time to explain each step of the process as you go. Tell them “I am going to help you bathe. Now I am going to take your shirt off. Now let’s take off your pants.” And “I am going to put water on your hair to wash it.”(I have found it useful to make sure they remain covered by a towel as I bathe different parts of their body. This way they still keep their dignity and don’t feel molested and give me an argument.) Don’t assume that they should know the routine by now and that they don’t need any warning as to the steps of the process. They need to be told each and every time. Their memory is no where near like yours is. Treat them as such.
Tip # 7:
Don’t rush them. Take your time to move in slow motion. To move at a normal pace can be devastating to them. Again, I can’t say it enough- speak softly and slowly in 5 word or less sentences.
Tip # 8:
Don’t expect them to do anything if they are tired or not feeling well that day. We don’t like to be forced to do even the most simple tasks when we feel bad. They have lost all social awareness and they wear their hearts on their sleeves- they have a lack of self control and will physically and /or verbally let you know if you are displeasing them. Their emotions are greatly amplified above ours and are extremely sensitive.
Tip # 9:
Don’t overload them with instructions. If they have to think of too many things at the same time and remember how to do them, regardless of how easy they seem to you, they can get frustrated and lash out at you as an act of self defense. Lead them one step at a time in short sentences, speaking softly and smiling all the while, telling them what you want them to do. When they complete one step, then slowly move to the next.
Tip # 10:
How about just leaving them alone? What a novel idea! Give them their space. If you are trying to get them ready to go somewhere or to take a bath, wait 10 minutes and then try it again. OR, you could try having another family member take a shot at it- but again, after at least 10 minutes have passed.
Above all, express your love in words, by touch and by your facial expressions. Mercy, grace, forgiveness and love are the most effective ways to handle anger and will quench even the most fierce, raging fire within your LO.