Dementia Solutions – Caregiving Advice, April 2015

Dementia expert, Karen Tyrell, offers answers to 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]

April, 2015 Update

1.  Non-Drug Strategies – How Can I Avoid Using Drugs to Treat Dementia?


“I would like to know what non-pharmaceutical interventions available for a person suffering from a brain injury/dementia as a first line intervention as this seems to be the recommendation of pharmacists. Some of the behaviours such as anxiety or agitation are made worse by the use of drugs like antipsychotics and antidepressants and come with serious side effects.”

 ~ Trish from Winnipeg


It is great that you are being proactive in staying informed. You are correct that medications can be accompanied by serious side effects. Drugs can be a necessary option in treating dementia, but they should not be the first option. I recently wrote about this topic in response to a Globe & Mail article titled Antipsychotics Shouldn’t Be A Default Drug for Dementia. (Click here to read.)

Medications are most dangerous when they start negatively impacting quality of life or increasing the risk of physical harm. Excessive dizziness for example can lead to injuries, Parkinsonism – tremors and rigidity, and social withdrawal. A drug’s side effects can even be fatal by increasing the risk of stroke or decreasing immunity to illnesses such as pneumonia.

To protect those affected by dementia, creative non-drug strategies for dealing with behaviours such as wandering, aggression and agitation, are an important alternative. The first step of a non-drug approach is uncovering the meaning behind the behaviour. To do this, play the role of detective by gathering the facts: are there physical reasons (such as hunger, pain or a rash) that are triggering the behaviour? Are there environmental factors (such as the position of furniture or the lighting in a room) that are causing discomfort? Asking “WHY” the behaviour is occurring will allow you to make the change needed to address the behaviour. A caregiver, for example, may need to change the way he/she is communicating by employing “therapeutic reasoning.” This involves understanding what the person affected by dementia perceives as real (whether it is actually real or not) and reasoning with them within the context of their reality and logic. (More on therapeutic reasoning and other non-drug strategies can be found on my website and in my book “Cracking the Dementia Code.”)

Taking the initiative in investigating non-drug strategies is key to finding the best dementia treatment options. Keep up your detective work and remember to always start by asking “WHY”!

Caregiver Burnout- How Do I Lower My Stress?


“Exhaustion has become my middle-name. I’m a caregiver to my father who has dementia and most days I feel so tired that I can’t wait to crawl into bed. However, recently, I haven’t even been able to sleep well due to the stress. I keep hearing about how caregivers need to take care of themselves—what tips would you recommend?”

 ~Eternally Exhausted Emma


Caregivers need care—as a dementia consultant I repeat this often to both family and professional caregivers. You are experiencing the warning signs of an all-too-common case of caregiver burnout.

Aside from feeling tired and problems sleeping, notice whether you are experiencing other symptoms of burnout. Some red flags manifest physically as headaches, increased blood pressure, lower immunity, or increased forgetfulness. Other effects of burnout are felt emotionally—for example, many overstressed caregivers feel increasingly sad, angry, or guilty. Some feel unable to relax and enjoy social settings, while others experience intense irritability towards the individual they are caring for. Stressors can also lead some to self-medicate using drugs, alcohol, smoking and/or overeating.

To counter these symptoms, we all need to take action! Start by taking “me breaks”—time during which you can rejuvenate. Give yourself permission to take breaks throughout the day and don’t forget to take deep breaths to further relax. Make sure you are eating nutritious food, getting adequate sleep, and going for regular medical checkups. Scheduling mini-workouts into your daily schedule is also important. Try scheduling ten minute exercise sessions into the day, whether it’s doing yoga poses, some “squats” or just dancing to a few of your favourite songs.

A daily dose of fun is excellent medicine as well so take time to do the things you enjoy. Also make sure you are sharing your feelings with others. Talking to someone, whether it is a friend, family member or support group, will remind you that you are never alone and can alleviate the negativity you are feeling. In addition, do not be afraid to ask for and accept help, whether it is the help of a family member, friend or professional help. Finally, remember to keep laughing. Humour is a simple but effective strategy in battling stress.

In taking care of your father, you are giving so much of yourself every day that you are likely forgetting to replenish your own reserves of energy. Caring for yourself and caring for your father are not mutually exclusive. Taking time for yourself will help you immensely in increasing both you and your father’s sense of well-being. You deserve it!

3.  Help At Home – What Resources Are Available to Help Family Caregivers?


“My mother has dementia and I am her primary caregiver. Every day I confront different challenges in caring for her and have realized that I need to reach out for help. What types of services are available to help at-home caregivers of those with dementia?”

~Daughter Looking For Help


Caring for your mother at home means she will be able to stay at home, in a familiar environment, for as long as possible. However it can also be challenging to care for someone with dementia without the aids and resources of those that are found in a professional care facility. As a primary caregiver, who is shouldering the majority of the responsibilities and duties, you are at a greater risk of experiencing caregiver burnout, so I commend you for reaching out for some extra support!

As dementia progresses into its later stages and your mother’s abilities change, it becomes increasingly important to share caregiver duties. Family members, friends, or neighbours can be an excellent source of support. Do not hesitate to ask them for a helping hand with some daily tasks, such as a drive to a doctor’s appointment, a short walk around the block for exercise, or even just conversing with your mother to give her some company while you take a break.

Helpful government programs offered by your local Alzheimer’s Society or Health Authority or Health Unit are also worth investigating. Many communities have Adult Day Programs during which individuals with dementia spend a day away from home, and are given the opportunity to engage in organized activities and socialize. This can also give caregivers a much needed breather for several hours during the day.

Hiring someone to provide care is another useful option whether through a government funded/subsidized public program or a private company. A paid companion can take your mother out for a walk, go out for a cup of coffee or even a short drive. Paid caregivers can also provide help with tasks such as bathing, changing clothes, making meals and light housekeeping duties. You can find a variety of home care companies, both small and large, by asking around or doing a simple Google search for home care support for those with dementia in your community.

Some care facilities (both public and private options) offer respite for overnight stays. Depending on her required level of care, your mother can stay at a facility for one or more days, giving you time to go out of town for a short holiday if you wish.

Remember that you are never alone as a caregiver. Asking for help is the best strategy for finding the support you need and that matches your situation. You can use any or a combination of all the supports I mentioned above. Being proactive in getting the help now, will help to reduce the possibility of burning out from your role in the future. Wishing you the very best!


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. ( and the author of the book “Cracking the Dementia Code – Creative Solutions to Cope with Changed Behaviours” and co-creator of the Dementia Caregiver Solutions App. She offers her expertise on dementia care through speaking engagements, workshops and by working one-on-one with families and caregivers.