Dementia Care: Understanding What To Do and When

One of the most challenging tasks that caregivers for people living with dementia face is understanding certain behaviors and needs. Toxic changes in the brain destroy neurons and affect the behavior and emotional state of the person living with the disease. These changes can be stressful for the person and their caregivers alike and can lead to unnecessary conflicts.

Teepa Snow MS, OTR/L, FAOTA, suggests not thinking about dementia as a situation where there is only loss. “It’s not all about people who don’t do things and are not able to,“ said Snow in a recent Relias webinar. “It’s not inability — it’s a different ability. If we look at things that way, we might realize what they’re trying to do or the unmet need we could help with.”

Below are a few situations caregivers encounter when caring for people with dementia and how to manage them better.

Listen carefully

Caregivers may find it frustrating to hear repetitive stories from those they care for. Rather than expressing their frustration, said Snow, caregivers should recognize that people with dementia don’t remember that they told the story before. They are trying to connect and engage with their caregivers. “We need to shift our interaction skills,” she said. For example, when the person asks, Did I ever tell you I was from West Virginia? you can say something like, Oh, West Virginia? Tell me about it, even if you have heard the story multiple times. Snow recommends listening carefully to the stories and telling them back to the people when they need to feel more comfortable and less agitated.

In the late afternoon and early evening, some people with dementia experience sundowning and express their wish to go home or to see a loved one. These are familiar places and people that bring comfort to them, explained Snow. When caregivers can talk to them about their home and family with the information they’ve learned from listening to their stories, they can help reduce their stress levels. “Trying to figure out what the unmet need is, what comfort I can offer — that makes a difference,” said Snow.

Validate the person’s point of view

Sometimes people with dementia may feel that caregivers try to take control over them when they ask them to complete a task, like getting up and going somewhere with them, for instance. They may want control over the situation and don’t want caregivers to tell them what to do. “You are probably going to get a pushback,” said Snow. When the resident is distressed, Snow suggests not saying, calm down and instead saying, Wow, I made you angry. By doing so, you recognize and acknowledge that the person doesn’t like what you are doing, and you validate their point of view.

Keep activity areas separated

Repetitive behavior in people with dementia can also be expressed by repeating the same actions. When you use the dining table they had lunch on for arts and crafts, they might view the beads and strings as food and put them in their mouths. “You may not want to do craft activities on the same table. We want more clearly defined [areas],” said Snow.

Understanding and managing situations in dementia care is essential for healthcare professionals in every care setting. Caring for people with the disease holds many possibilities for improving their experiences. Skilled clinicians and caregivers should recognize the challenges that people with dementia encounter and be prepared to employ strategies to ease their uncertainty, distress, and fear. Equipped with good dementia care knowledge, caregivers can provide comfortable, safe care and create positive experiences for persons with dementia every day.