We might have a hard time believing this – studies say that 50 percent of family caregivers demonstrate abusive behavior towards the family member with dementia that they are caring for. In the past, abuse has been seen as a problem for caregivers being paid to provide care. Research and culture change has focused primarily on those who receive compensation for their time with someone with dementia. Often the assumption has been that those with dementia are safer with their families than in long term care settings.

The research finds that 50 percent of all caregivers admit to occasionally screaming or yelling at their loved ones, while 33 percent admit to frequent insulting or cursing at the loved one in their care. 1.4 percent admits to physical abuse.

Although abuse should never be tolerated, it is easy to see how caregivers can feel pushed into a corner and make such a critical mistake. The stress of providing care 24/7 can be overwhelming. Often the care of the person with dementia will fall onto just one caregiver, even in a big family.

The stress of being with a person who isn’t able to remember current events, becomes paranoid or agetated, or isn’t able to provide care for himself can be more overwhelming than caring for a small infant.

Check daily to ensure that the caregivers in your family are not feeling stressed out or in a dangerous situation. Watch for signs such as anger, anxiety, social withdrawal, depression, exhaustion, sleeplessness, and irritability. These are all warning signs that more help is needed.

Here are a few tips to remember:

1. Schedule one day off a week. Ask for help from family, friends, adult daycare centers, or companion services.  Participate in activities that are not related to caregiving.
2. Be an informed caregiver.  Attend educational seminars or other events that provide education about dementia and teach how to make the days more enjoyable
3. Don’t be a Supermom or Super-daughter.  It’s okay to ask for help. Visit your doctor regularly as well as having your loved one visit his/her doctor regularly.
4. Take credit, not guilt, for all of the good work you are doing!

If you are feeling stressed or burnt out because of caregiver stress, please let us know.  We’re your local experts. Contact us and let us know what would give you a little relief.

The biggest problem families encounter is that they don’t accept these two things. They try to fight, deny, and ignore the changes that they know are necessary, and they trap themselves in a battle they can’t win this way by expecting the person with Alzheimer’s to change. It’s not going to happen!

The greatest thing you can learn as a family is that you must begin with education about the person who has the disease – like what upsets them, makes them happy for the moment, or what agitates them. Keeping a daily journal and noting the things you learn about the person who has the disease is a great place to start…start learning, that is!

Your desires to have things turn out differently, be different, or even to control everything, have to be set aside when caring for someone with Alzheimer’s disease. The guilt you take on when things don’t go the way you’d like will wear you out! Most of the time, it’s the way we talk to ourselves that actually makes us feel guilty. You can determine how you talk yourself into guilt feelings by taking a deeper look into your thoughts. Thoughts which produce guilt result in statements about your personal.

Attacking your character instead of your actions is what makes you feel guilty. To end this negative cycle, find a new way to say things to yourself. Rid your mind of self-condemning statements. Remind yourself of your intent to make the days and nights go better – for the whole family. See yourself as an “assistant” to your loved one. This will help you remember that you are helping them help themselves; this will be better for them and you.

From time to time, your parent who has dementia might be sharp or demanding with their words. Try not to take these sharp words personally. It’s not what’s in your parent’s heart – it’s really just a symptom of the disease. Realize your parent is frustrated, redirect him to a more interesting activity (one you know he enjoys), and give yourself a break. Sometimes a little time and distance provides relief for the whole family. Leave the guilt behind, and live each day one meaningful moment at a time.

• *Simplify and clarify the task.  Clothing garments with simple fasteners or a permed hairstyle any go far in enabling the person to complete a task independently.  Clarify the task with environmental cues such as a comb and brush set out by the makeup mirror.
• *Reduce distractions such as background noise to confusing cues (such as clutter or similarly colored toilet and dressing stool covers.)
• *Keep a regular routine.  A regular routine makes life more predictable and easier to cope with.  This reduces confusion and improves the individual’s cooperation and ability to perform self-care.
• *Be flexible and patient.  It is important to remain flexible and patient because the first attempt at getting a task done often will not work.  Also, remember to not take refusals personally, the person with Alzheimer’s disease cannot help his/her behavior.
• *Use good communication techniques.

Techniques for Helping

• *Break the task into steps that are small enough to match the person’s abilities.  For example, a person may need to have tasks broken into smaller steps such as:  put toothpaste on the toothbrush, brush your teeth, rinse your mouth, and dry off your mouth.
• *Demonstrate the step.  For example, when you say “wipe your mouth” you can wipe your own mouth.
• *Help begin the action.  Even when you demonstrate a step, the person may still not be sure what to do.  You can help by beginning the action until he/she remembers what to do.
• *Give the person time to finish the step.  Rushing a person with Alzheimer’s dieses usually will increase confusion, embarrassment, and resistance.

 For more information contact 317-218-5111 or www.behomelivelife.com

Self care activities (such as dressing and grooming) are not just tasks that have to be done in order to remain physically alive.  They are opportunities caregivers have to help individuals with Alzheimer’s disease maintain their physical, mental, communication, and social skills, as well as their dignity and self-respect.  Using effective approaches to these activities can help enhance an individual’s overall well-being for as long as possible.

Encourage the person to do as much as possible for him/herself.  If your family member can comb his/her hair, allow him to do so while you make the bed or complete another quick household chore.  You may need to finish (such as combing the back of the head) but it strengthens self care independence while maintaining individual identity and self-esteem.

• Be alert to verbal and nonverbal warning signs of possible problems developing.
• Stop and think about the situation
• Use the problem solving approach to help prevent problems, as well as to respond more effectively when problem behaviors occur.

The first step in problem solving approach is to try to identify the cause of the behavior.  What happened before the person began getting upset?  Talk with the person to see if she/she has any physical discomfort or unmet needs.  Try to identify the emotions he/she is feeling.

The second step is in the problem solving approach is to look for possible solutions or changes that will meet the person’s needs.  Once identified, some needs have clear solutions.  However, response to other problems may require creative thought and repeated efforts.  When unable to identify the cause, start with the basics, a drink, snack, or a trip tot the bathroom.

Also keep in mind that a response may work on time, not the next time, and work again later.

For more information contact 317-218-5111 or www.behomelivelife.com

What do difficult behaviors occur?

An environment can be bewildering, threatening, or frightening to a person with dementia.  For example:

• Too much noise and stimulation
• Inadequate lighting
• Too much clutter
• Confusing, insufficient, or confliction cues as to how specific spaces such as a bathroom, hall or dining room are to be used.

Any of these factors can make the environment seem bewildering, threatening or frightening to a person with e dementia and can lead to problem behaviors.

People in your home can contribute to the development of problem behaviors as well:

• A lot of visitors or holiday gathering with many family members can feel overwhelming to a person with Alzheimer’s disease.
• Verbal communication may be unclear
• Nonverbal communication may conflict with words that are spoken or may be negative.  Emotional communication is particularly important for person with dementia who readily pick up on feelings of anger, happiness, frustration, ect.

Adapting daily activities to the person’s retained abilities is also key to preventing problem behaviors.

For more information contact 317-218-5111 or www.behomelivelife.com

Improving you own communication:

There are several things you can do to improve your own communication

• Explain what is going to happen
• Use short, simple sentences, being specific and direct about what you mean.
• Use contract and common words, not abstract or fancy words.  For example say “use” instead of “utilize.”
• Avoid clichés such as “A slip of the tongue” or “Don’t cry over spilt milk.”
• Use the proper names and common nouns.
• If the person has trouble understanding what you are saying:  repeat what you said twice.  Revise and restate using different words.
• Assume the person can understand more than he or she can express.
• Avoid logical discussions or debates.  Instead, respond to the feeling that the individual is expressing.
• When asking a question, limit the number of answers or choices.
• When giving instructions, give one direction at a time, breaking the task into small steps.  Allow time for completion of each direction before you go on.

For more information contact 317-218-5111 or www.behomelivelife.com.

Although people with Alzheimer’s disease gradually lose the ability to use words to express and understand ideas, they do retain the ability to communicate emotionally.  They can comprehend the meaning of a hug, a handshake, and a loving or disapproving glance.

Often a person with dementia will pay more attention to the nonverbal communication than the words used. 

• Evaluate hearing and vision if possible.  Assess the person’s hearing and vision.  If hearing or vision aids are available, be sure they are in working order and are used.
• If the person can’t find the right word, you can:
  • Encourage the individual to act out the meaning:  Demonstrate “want to eat” with an eating motion
  • Encourage the person to “talk around” what he/she is trying to say, gradually “zeroing in” on the meaning.
  • Say what you think he/she is trying to communicate, sort of like playing “20 questions.”  Remember that people with Alzheimer’s tend to recognize words that they hear or see even when they no longer can recall words.
  • Be cautious about correcting wrong words, such as when sugar is referred to as salt.  The purpose of correcting a mistake is to health other person learns the correct way to do or say something.  A person with Alzheimer’s disease may be unable to learn and remember the information you are giving.  Consequently your corrections may only serve to frustrate the person.

For more information contact 317-218-5111 or www.behomelivelife.com.

• *Look for activities that will be failure free.   A craft project with a pre-set outcome or appearance may be too difficult, whereas arranging silk flowers in a vase is a failure free task.
• *Reduce distractions so the person can focus on the task, eliminating things such as background noise from the television.
• *Keep exercise and physical activity part of everyday, as it helps keep sleep and nighttime habits normal.
• *Familiar activities such as setting the table and folding laundry should be part of the daily routine that the person with Alzheimer’s disease helps with.  The tasks are meaningful, familiar activities and assist to remain skills as long as possible.
• *If music, exercise, or spiritual activities were part of your family member’s routine each week, those type of activities should occur frequently during the week now as well.

For more information contact 317-218-5111.