Barb Nadeau –
Throughout our lives, most of us have had instances when we have had to deal with someone aggressive or accusatory, whether in a work situation or a family situation. Dealing with the elderly or the infirmed, caregivers often find themselves in uncomfortable situations, too, when they try to navigate through the unchartered territory of dementia. There are techniques to keep in mind that apply in both scenarios.
In dealing with any angry person in work or in the community, it’s important to have a calm demeanor. Do not respond in kind to the aggressor, and do not feel you need to apologize. Recognizing that everyone deserves dignity is the first step to diffusing a charged situation. If someone is accusatory, it is a good strategy to try to use his or her name, look in the person’s eyes, and listen intently to what is being said. Responding with personal connection, but remember to hold on to your own personal dignity is important, too. Keep boundaries, and feel free to step away from or take your time before responding. Basically, always try to be as dignified as possible, and by using silent moments and patience, you can focus your words and actions to improve the situation.
Many of the same bits of advice listed above will work in dealing with a person who has dementia or in caring for any family member in distress. As caregivers, we often try to be fixers. We want to handle issues as quickly as they come up, and bring the household back to normal. But sometimes you cannot just fix things. As time goes by, caregivers find themselves often accepting a new normal in the downwards spiral of the disease. This can result in anxiety, depression, and exhaustion of the caregivers and little relief for the family member in need.
Responding in a way that can alleviate a charged situation starts by realizing, first of all, that you may not know what caused an outburst or aggression from your loved one. There are many possible factors that could cause an outburst. In that moment, your loved one may not recognize you or your role, or purpose, whether as caregiver, family, or friend. The person may believe to be in an unfamiliar place, living in another decade, in another home, or in another situation, and may feel very justified in is or her actions.
Emotional outbursts might be associated with physical problems, as well. Your loved one might be suffering from a headache, a rash, constipation, hunger, or fatigue. He or she may be unable explain what’s bothering him or her and may express the problem in the only way possible, even if that is in having a temper tantrum. This behavior might be explained as depression or a chemical imbalance. However, if the world suddenly turned and was confusing to you, if people did not listen to you, or see or feel your pain, or help you with your problems, you would probably be depressed and angry, too.
While all forms of dementia are progressive, and emotional outbursts are identified as one of the problem associated with the progression of dementia, there are many positive things caregivers can do to help.
Try to always stay calm, allow the individual dignity, talk to them by name and use eye contact, accept whatever circumstance they may find themselves in that moment. Don’t argue or give reasons for greater anxiety. Meanwhile, try to find opportunity for your loved one to be helpful to you. Try to get the person involved in some type of activity which will help him or her feel comfortable and happy. Find ways to allow them companionship. Find things to be useful or to feel connected with you, whether that’s watering flowers, completing a simple household task such as folding laundry, or organizing some family photos. Find things to talk about during these activities. Play music that he or she has enjoyed in the past. Be cognizant of the places they lived and the people in his or her life. Remember, that at any given moment, that person may be living in another year or location. Be patient with repetition and do not grieve over it as, tiresome as it may be. Remember, your loved ones memory might be so short that he or she does not know it is repetition.
Remember that the depression, the messiness, the repetition, and the anger are all part of the disease. Respond with kindness and understanding. Feeling the pain of the individual in distress will help you withstand your own exhaustion and frustration. Reach out to friends who will listen and be patient with you, and give yourself time to grieve for the situation but not for the person.
Barb Nadeau works for Senior Services Associates of Kane, Kendall, & McHenry Counties as a Retired and Senior Volunteer Program (RSVP) & Transportation Coordinator. She is a freelance writer and television host. She can be reached at bnadeau@seniorservicesassoc.org.