Sometimes people with dementia get stuck on repeat like a scratched record back in the day. Lift that needle, so to speak, and put it done on another topic.
· Do not reason and argue · Do not demand that they reason or problem-solve · Do not demand that they remember · Do not demand that they get their facts straight · Do not correct their ideas or scold them · Do not reorient them · Do not think that they are being uncooperative on purpose · Do not think that they really do remember, but are pretending not to · Do not use a “bossy” dictatorial attitude in care · Do not act with impatience
The "Do's"
· Enter into their frame of reality, or their 'world' · Be aware of their mood or state of mind · Use few words and simple phrases · OR use no words, just friendly gestures and simple motions · Do everything slowly · Approach from the front · Wait for a slow response · Constantly reassure them that everything is 'OK' · Keep people with dementia comfortable 'in the moment' - every moment · Maximize use of remaining abilities · Limit TV or radio programs which they may feel are frighteningly real · Maintain privacy · Provide a safe physical environment
Language Needs
· Use short words · Use clear and simple sentences · Speak slowly and calmly · Questions should ask for a “yes” or “no” answer · Talk about one thing at a time · Talk about concrete things; not abstract ideas · Use common phrases · Always say what you are doing · If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information · Wait patiently for a response · Be accepting of inappropriate answers and nonsense words · Speak softly, soothingly and gently
Care Needs
· Recognize that receiving personal care feels intrusive · Reassure with your tone and manner · Do one thing at a time · Talk through the care “play-by- play” · Be aware of your body language and use it to communicate relaxation and reassurance · Be sincere · Use a soft, soothing touch · Be aware of the individual’s unique triggers · Be aware that a person with dementia may not accurately judge whether a situation is threatening to them · They may respond to fear, pain or anxiety by defending themselves with what we call “aggression” · If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away You need to change your behaviour to adapt to the dementia because the person with the disease cannot.
Issues that worsen in the late afternoon & evening hours for a person suffering from Alz/dementia is known as Sundowning; my mother had a terrible time with it herself and nothing anyone did for her seemed to help much. I eventually got the doctor to agree to prescribe her .25 mg of Ativan which DID calm her down some, but that eventually wore off too and had to be increased to .50 mgs. In mom's case, she was obsessed with 'finding her mama' or 'finding her sister' who was 'supposed to come visit' but she 'could not find'. It was heartbreaking for me to hear her going on and on about this topic, night after night, so I'd try to distract her to the best of my ability. I'd tell her that 'mama wasn't able to make it tonight' but that she'd try to visit 'tomorrow night'. Anything to get her OFF of the present moment, was the objective. When a dementia sufferer is stuck in a thought loop, that's your goal: to distract them to another topic or lead them to believe the desired goal will happen 'tomorrow'. When tomorrow comes, the desired goal will again happen 'tomorrow' if it's something that CANNOT happen, like a visit with a deceased loved one.
Ask mother why she is calling out the person's name? Is she looking for the person? Find out what the problem is, in other words. You can't try to 'fix' something until you know what it is you're trying to fix! When I would show my mother a video of her great grandson, she thought he was THERE in the room with her (she had advanced dementia), and she'd furiously look for him next to her wheelchair and ask WHERE DID HE GO? So you have to enter the mind of your mother, in a sense, to figure out what is going on. Best to ask her and she may be able to tell you what's happening in her world.
Your goal, once again, is to create calm for mother, nothing else, so if that means you tell her therapeutic fibs, that's what you do. If it means you feed her a snack, a snack it is! Oftentimes a dementia sufferer cannot vocalize their needs which come out as a moan or a cry which is difficult to decipher. Which is when we need to get detective-like once again & try to figure out WHAT they really want or need. Maybe a hug is what would comfort your mom when she is calling out these names. Or if you sang her a song or put on her favorite genre of music; music is EXCELLENT for a person with dementia who's agitated. Baby dolls are often known to help as well; especially for women who were once mothers to small children. They often find comfort in caring for a baby doll, especially when their dementia is advanced. If you can get your hands on a doll and a swaddling blanket, give it to mom to see how she reacts. Mom had one in her room and so do all the other residents in Memory Care Assisted Living; some carry them around all day (some men do, too!). Caring for a baby is a job that some people find very productive!
In the next answer, I will include a list of Do's and Don'ts, Language Needs & Care Needs for caregivers to elders with dementia, just as a helpful reference for you.
She's probably re-hashing the visit in her mind and re-thinking what she MIGHT have said, instead of what she DID say. Or she could just be overwhelmed by the visits.
Something mild (melatonin?) after the visits and a cup of a warm drink and some quiet time before bed may help her, if this is bothering her.
Keep visits in the evening short. Allow plenty of time for mom to "wind down" after a visit. If the visit at night is unavoidable keep it quiet and low key. And keep the number of people to a minimum. If possible arrange visits earlier in the day. While most people during a conversation will process what is said and respond then move on someone with dementia takes much longer to process a conversation. (I have read that sometimes it takes 45 seconds or longer to hear a question, comprehend it then formulate a response. I don't know about you but I am onto a different topic by that time) So while people have said good-bye your mom may still be processing the conversations that he has heard.
Reassure her that she will have visitors again. If she seems agitated and can not settle down you might want to talk to the doctor about giving her something that will calm her. You mention in your profile that she has a sleep disorder as well. Is she taking anything to help with that?
I'm not sure what kind of help you are looking for, can you tell us a little more? The visitor is on their mind and they want to remember or they have something more to say - people with dementia often get stuck in a verbal loop, while it can drive those around them to distraction it usually doesn't bother them so much, although it can be a sign of agitation and unmet needs. If they are calling out through the night so nobody can sleep that's a different issue, sleep disorders in dementia are incredibly common and difficult for caregiver.
Sometimes people with dementia get stuck on repeat like a scratched record back in the day. Lift that needle, so to speak, and put it done on another topic.
· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience
The "Do's"
· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment
Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently
Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.
Ask mother why she is calling out the person's name? Is she looking for the person? Find out what the problem is, in other words. You can't try to 'fix' something until you know what it is you're trying to fix! When I would show my mother a video of her great grandson, she thought he was THERE in the room with her (she had advanced dementia), and she'd furiously look for him next to her wheelchair and ask WHERE DID HE GO? So you have to enter the mind of your mother, in a sense, to figure out what is going on. Best to ask her and she may be able to tell you what's happening in her world.
Your goal, once again, is to create calm for mother, nothing else, so if that means you tell her therapeutic fibs, that's what you do. If it means you feed her a snack, a snack it is! Oftentimes a dementia sufferer cannot vocalize their needs which come out as a moan or a cry which is difficult to decipher. Which is when we need to get detective-like once again & try to figure out WHAT they really want or need. Maybe a hug is what would comfort your mom when she is calling out these names. Or if you sang her a song or put on her favorite genre of music; music is EXCELLENT for a person with dementia who's agitated. Baby dolls are often known to help as well; especially for women who were once mothers to small children. They often find comfort in caring for a baby doll, especially when their dementia is advanced. If you can get your hands on a doll and a swaddling blanket, give it to mom to see how she reacts. Mom had one in her room and so do all the other residents in Memory Care Assisted Living; some carry them around all day (some men do, too!). Caring for a baby is a job that some people find very productive!
In the next answer, I will include a list of Do's and Don'ts, Language Needs & Care Needs for caregivers to elders with dementia, just as a helpful reference for you.
Wishing you the best of luck.
Or she could just be overwhelmed by the visits.
Something mild (melatonin?) after the visits and a cup of a warm drink and some quiet time before bed may help her, if this is bothering her.
Allow plenty of time for mom to "wind down" after a visit.
If the visit at night is unavoidable keep it quiet and low key. And keep the number of people to a minimum.
If possible arrange visits earlier in the day.
While most people during a conversation will process what is said and respond then move on someone with dementia takes much longer to process a conversation. (I have read that sometimes it takes 45 seconds or longer to hear a question, comprehend it then formulate a response. I don't know about you but I am onto a different topic by that time)
So while people have said good-bye your mom may still be processing the conversations that he has heard.
Reassure her that she will have visitors again.
If she seems agitated and can not settle down you might want to talk to the doctor about giving her something that will calm her. You mention in your profile that she has a sleep disorder as well. Is she taking anything to help with that?