Dementia takes several forms, but it is always a source of terrible distress to both the sufferer and the affected family-members. In many cases, a sufferer’s personality can change beyond all recognition, but only after a long and drawn-out period of deterioration, fear and confusion. People who are caring for relatives and friends with dementia should take solace from the fact that many thousands of people are facing same immense struggle. The best way to cope is often to take advice and guidance from those who have experienced dementia first-hand.
The Effects of Dementia
Different forms of dementia have slightly different symptoms and tell-tale signs, but the most common are anxiety, confusion and frustration. According to the NHS website such traits are often signified by constant pacing, asking questions repeatedly, paranoia and sudden mood swings. In some cases, dementia sufferers can become angry, and it is not uncommon for people to suddenly lash out before showing almost immediate contrition. The advanced stages of dementia may include a complete lack of awareness with regard to surroundings and an inability to recognise close family members. It is also common for sufferers to confuse relatives and regress back to an earlier time in their life.
Most dementia sufferers experience a gradual deterioration over a prolonged period, and the care provided will change accordingly. A sudden mood swing, outburst or anxiety attack is a side-effect of confusion and fear; it should never be taken personally. Remaining calm in the midst of such an outburst could put the sufferer at ease, and trying to associate their behaviour with the underlying cause could allow a carer to solve a particular issue.
People react differently to dementia, and being able to spot the early signs of a mood swing or an outburst could allow carers to manipulate specific circumstances. A sufferer may become scared and anxious in crowded environments, for example, so a trip to the local shopping mall may be best enjoyed first thing in the morning – before throngs of shoppers arrive. Some sufferers may become aggressive if they are kept indoors for long periods of time, but scheduling regular walks, gardening activities or even a trip to the local high street could be enough to fend off a serious mood swing before it happens.
A good way to care for dementia sufferers is by controlling their environment closely. Planning a trip to local stores should include speaking with the staff first in order to alert them of the person’s particular condition. The general public are, in the majority of cases, ignorant to dementia, and they often mistake the effects of the condition as rudeness or outright aggression. And in some cases, the reaction of a stranger can exacerbate the sufferer’s condition. Developing a relationship with local shopkeepers and other members of the community will also mean help is at hand if the dementia sufferer ever becomes lost.
Perhaps the most important advice a carer can be given is not to take anything personally. Dementia sufferers have been known to say some very hurtful and seemingly vindictive things, but they never mean them. The carer should always remember that these outbursts are just one of the disease’s symptoms, and in many cases, the sufferer will forget the outburst in a matter of minutes. Staying calm and talking to the person will defuse the situation in the majority of cases. After an episode of aggression, the carer should act like nothing has happened. There may be occasions where aggression turns to violence; these situations are often best dealt with by leaving the room. Under no circumstances should the carer ever confront the person or adopt an aggressive and confrontational stance.
A Case Study
An 86-year-old man was recently admitted to a private care facility at Aranlaw House in Bournemouth. The man had suffered a bad fall in another facility during one of his regular episodes of walking around at night in search of his wife. The obvious solution was to increase his sedation before bed, but this only served to increase the man’s disorientation. It quickly became apparent to the staff at Aranlaw House that this man’s confusion centred around two aspects of his life: his wife and his work.
After studying the man’s case notes in detail, it was decided that the staff would try to engage him. They spoke to him at length about his work, and they even asked for his advise on financial matters – his field of speciality. When the man made obvious mistakes, the staff made a point of not correcting him. Instead, they conformed to the man’s perception of reality, and it wasn’t long before his anxiety and anger subsided. He began to sleep far better, and his relationship blossomed. Dementia sufferers become scared and confused when their reality is questioned, so the staff at Aranlaw House made sure that this never happened.
Seeing a loved-one become increasingly confused, scared and disorientated can be a very painful process. However, by staying calm and being prepared for the effects of dementia, carers and relatives can ensure that a sufferer does not have to endure unnecessary distress.
Nicola is the care manager and nursing professional at Ashton Grange EMI home with more than 21 years experience in psychiatric nursing and is Registered Mental Nurse (RMN) qualified.