Dementia Solutions – Caregiving Advice, August 2015

Dementia expert, Karen Tyrell, offers answers to www.carp.ca visitors for their situation-specific questions. Karen is a dementia consultant who can point you in the right direction, giving quick insight and personalized answers to help you with dementia care challenges.

Do you have a specific question relating to dementia that you need answered? Please submit your questions by email to: [email protected]

August, 2015 Update

1.   Family Pictures Stress – Is It Okay to Remove the Family Pictures from my Mom’s Bedroom?

 Dear Dementia Solutions:

“My mom, who has dementia, gets upset whenever she sees the family pictures displayed in her bedroom. Instead of bringing a smile to her face, they seem to trigger feelings of loneliness. Due to her dementia, she forgets family visits and therefore believes no one has come to visit her. Should I take the pictures down?”

 ~Daughter’s Dilemma

Dear Daughter’s Dilemma,

Pictures of family often kindle feelings of warmth and happiness. They are reminders of good memories, special people, and meaningful moments. Yet, at times, these heartwarming images can also trigger feelings of nostalgic sadness, a longing to go back in time and be in the company of loved ones. The dementia affecting your mom is heightening these negative feelings by impairing her ability to recall recent family visits. Sad as it may be in the short term, removing the family pictures from your mom’s room may be necessary to ensure her comfort.

If you feel any guilt about removing the pictures, remember that you are removing the trigger fueling your mom’s unhappiness. To avoid any negative reactions your mom may have to removing the pictures, test the waters by replacing a few of them with images that evoke pleasant feelings, such as nature scenes or photos of animals. Relaxing imagery such as this can have healing effects on the mind. They can also act as conversation pieces to direct your mom’s attention towards positive topics (for example, you could say “Oh look how cute the puppy in the picture is!”).

Remember that keeping the peace is the best way to help your mom. The memory lapses she is experiencing due to dementia will cause her to forget family visits, whether they occur every day or only from time to time. Arguing with her about this will only increase her anxiety. Avoid these arguments and instead try directing the conversation towards a happier topic.

A bedroom should be an environment that feels relaxed, happy and safe. Taking the steps needed to make your mom feel more comfortable in her space will enhance her quality of life, and seeing her at ease will add to your own peace of mind.

2.   Staying in His Pajamas- How Can I Get my Husband to Change his Clothes Every Day?

Dear Dementia Solutions:

“Every day I’m faced with the challenge of getting my husband to change his clothes. He stays in his pajamas till late afternoon and refuses to change. I am assuming that this behaviour is due to dementia, and that he’s not choosing to be difficult, but I can’t help but feel frustrated. What should I do?”

~Pajama Battle

Dear Pajama Battle:

Forcing someone to do something they don’t want to do is like fighting a losing battle, and the same is true when it comes to someone with dementia. I fully understand your desire to see your husband appropriately dressed but I wonder if this situation requires a different tactic.

Dementia can cause a variety of challenging behaviours that manifest themselves differently depending on the individual affected. It is therefore important to individualize your approach in addressing a challenging behaviour. Think about your husband’s reactions to various forms of persuasion. What seems to motivate him? What ways of communicating (tone, language used etc.) does he usually respond to best? What has worked in the past? What doesn’t seem to work for him?

There is no harm in using an array of tactics in finding what works. If telling him to get dressed in a direct and straightforward manner does not upset him or put him in a negative mood, then try it. If your husband responds negatively, by arguing or showing signs of physical or verbal aggression, then veer away from this approach and try an opposite one. Perhaps, a less direct mode of communicating could prove more effective. For example, you could say “Hey honey, let’s go put on some clean clothes” or maybe, “What shirt would you like to wear today, the blue or the white one? You always look great in the blue shirt; that colour really suits you!”

In some cases of those with dementia, an unwillingness to get dressed can be due to someone forgetting the actual process of changing clothes. Cuing, which involves hints and gestures that show him how to get started, is often a good way of jogging the memory and helping to stay independent. Alternately, if you feel that depression may have a hand in his behaviour, consulting a doctor about your concerns would be helpful.

It is not easy being a caregiver, and frustration is common. The best way to navigate through this journey is to be as flexible as possible in adjusting communication and finding ways to keep your husband content. Keeping him in a calm and peaceful mood will benefit both of you in terms of reducing stress and enhancing well-being.

Do you have a specific question relating to dementia that you need answered? Please submit your questions by email to: [email protected]

Karen Tyrell CDP, CPCA is a Dementia Consultant & Educator for Personalized Dementia Solutions Inc. (www.dementiasolutions.ca) and the author of the book “Cracking the Dementia Code – Creative Solutions to Cope with Changed Behaviours.” She offers her expertise on dementia care through speaking engagements, workshops and by working one-on-one with families and caregivers.