aranoia is one of the many possible challenges of dementia. It’s a blaming belief or suspiciousness that a person with dementia holds onto, despite explanations or lack of proof of this belief.
Sometimes people with dementia will accuse others in the household of stealing something that they themselves have misplaced. It is very tempting to try to convince the person otherwise when they are are sure that something has been stolen. But arguing doesn’t get us very far when a person has dementia. It usually causes stress, frustration and upset for all concerned! It is more productive to “cross to their side of the street” in order to see things compassionately, from the person’s point of view. Sandra McGurran, social worker with Fairview Home Care and Hospice Senior Services, recently shared with me the idea that “Compassion = Empathy + Action”. This concept can be applied here.
Here are some DO’S and DON’TS to guide you in giving a compassionate response in these sorts of situations.
DO NOT TAKE OFFENSE on behalf of the accused person.
DO LISTEN to what is bothering the person with dementia, and VALIDATE their feeling, i.e., “That’s not a very nice feeling, to think someone would just take something from you.”
DO RESIST THE URGE to get into an argument with the person.
DO ACKNOWLEDGE the upset. “I can see why you’re upset. I would be too, if that happened to me.”
DO NOT offer a lengthy opinion or a list of reasons why they shouldn’t be upset.
DO OFFER A SIMPLE IDEA. “I wonder if your blouse is in the wash.” Or… “Maybe your wallet was left in a pocket?”
DO BE HELPFUL and action-oriented. “I will go check the laundry room.” “Let’s check your pockets”.
DO ASK QUESTIONS. “Let me get this right. What color was that shirt?
DO BE REASSURING. “Don’t you worry. We will get to the bottom of it.” ‘I’m sure we’ll find it.” “I’m good at finding things.”
DO SHIFT THE FOCUS. “Let’s have a cup of coffee; coffee always helps me think more clearly!” Be sure to offer something you know the person will be interested in!
DO DUPLICATE items that are repeatedly misplaced. For example, if a person often loses their wallet, obtain several of the same kind to keep on hand. Make copies of cards that are in the original, so you can stuff the replacement wallets with those.
But what if YOU are the person being accused directly? This can certainly be tricky.
It’s hard not to feel hurt by such an accusation. What can you do?
DO LET THAT ROLL OFF YOUR BACK in favor of remembering that your family member is functioning with a brain that is doing the absolute best it can possibly do under the circumstances of dementia.
DO TRY IGNORING THE ACCUSATION. Instead, simply validate the person’s feelings, i.e., “Oh no! Your favorite blouse is missing? Of course you’re upset. That’s a beautiful blouse!”
Maybe this will distract the focus from YOUR culpability, or maybe not. Depending on the level of the person’s upset and suspiciousness, you might need to step away and if someone else is available to assist. In that case, try, “I can see you’re upset with me. I’ll go see if Ann will help you look.”
DO THINK AHEAD. For things that are frequently misplaced, it could be helpful to establish and clearly label a home base in the room where a purse can hang or a wallet can sit. You might initiate a routine of checking that spot every night together.
Finally, it can really help in any sort of frustrating situation with a person with dementia to MAINTAIN A SENSE OF HUMOR AND GOOD WILL towards the person. Is there a way you can turn that uncomfortable situation around and actually give the person a compliment? Maybe you can remind them of advice they once gave you! “You know, Mom, I remember you telling me when I lost stuff that I would forget my head if it wasn’t attached. You were so right! You also said that lost things usually turn up if we are teensy bit patient! That was always so helpful!”
For more info on coping with paranoia as well as other challenges that can arise with dementia, see Coping with Behavior Change in Dementia: A Family Caregiver’s Guide, by Beth Spencer and Laurie White.
--Marysue Moses, Ebenezer Dimensions Program Coordinator
Many older adults want to stay in their home as long as possible. There is an assumption that staying in your home means you are independent, but the reality is it can often lead to loneliness and isolation. The health effects of long-term isolation are measureable and include chronic health conditions, depression, anxiety, dementia and even premature death. One study reported the negative health effects of long-term isolation are equal to smoking 15 cigarettes a day.
Loneliness is on the rise overall, but those most affected are those 80 and older according to a 2016 study.
Older adults who are most at risk are often:
The best remedy for loneliness is staying connected. Staying connected, interacting with others, and staying socially engaged with friends and your community can help keep fight loneliness and the health risks that are associated with it.
How can a move to Senior Living help fight loneliness?
When people move into a senior living community, the older adults often tell us, “I wish I would have moved sooner.” And their family members tell us, “We’ve seen our loved one blossom in the last few months!”
We invite you to visit an Ebenezer community. Talk with our residents to hear how their health and their lives have changed for the better after moving to senior living.
For more information about loneliness and isolation, the AARP Foundation offers its online resource Connect2Affect. There you can find a self-assessment to determine your risk factors and tips on how to stay connected. Click here to take your self-assessment. Resources that informed this article include Government’s Role in Fighting Loneliness by Emily Holland, as published in the Wall Street Journal, and the Blue Zones Power 9 ® by Dan Buettner.
Apathy. It’s one of the approximately 500 symptoms you might well find under theumbrella term of dementia. According to Microsoft Word, apathy’s synonyms include lethargy, boredom, unconcern, droopiness, and dispiritedness. For a person with dementia, this state of being may result in the inability to initiate activity, and/or spontaneous thought. Many of us, when feeling bored or droopy, have the ability to switch gears, maybe go for a walk, call a friend, or otherwise think of some activity to cheer ourselves up. Persons with dementia may not be equipped to do that. Instead, they’ll need structure, routine and activities figured out by others.
Initiating activity involves planning, organization and motivation. Planning can be complicated, involving lots of steps. For a person with Alzheimer’s disease (whose short-term memory is very limited) or for a person with frontotemporal degeneration (whose executive function is seriously compromised) “complicated” can easily translate into “overwhelming." When things are too hard for a brain with dementia, frustration often results, and motivation dissipates.
To be sure, it can be hard to observe and absorb these changes when a family member was formerly a champion self- starter; creative and keeping busy all the time. We have to remember that the changes of dementia are disease-related, and brain-based. It is not because the person is just being stubborn, difficult, rebellious, or is out to exasperate us. The person is simply reacting to their situation with the brain that they have to work with today, not from the brain they used to have. We must have compassion for the reality of a broken brain, if we are to give care and responses that will encourage and accept the person where they are at, and in so doing continue to strengthen our relationship with that person, and best serve their needs.
Here are ten tips from the Association for Frontotemporal Degeneration about what you as a care partner can try when your family member with dementia exhibits apathy. These suggestions were created specifically for persons who care for those with frontotemporal degeneration, but I believe there is much here that can be helpful to those who care for persons living with other forms of dementia as well:
--Marysue Moses, Ebenezer Dimensions Program Coordinator
by Cindy Swanson
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