Remember, the dementia patient is not giving you a hard time. The dementia patient is having a hard time.”
– Kerry Kleinbergen
General Characteristics and Advice
While those who are diagnosed with mild cognitive impairment (MCI) have memory issues, a dementia diagnosis does not necessarily mean that a person has problems with memory. Recall that the term “dementia” is an umbrella term for brain disorder. For a diagnosis of dementia, impairment in just one of the following six cognitive domains is necessary: memory, attention, language (spoken and understood), executive (ability to organize, plan), social cognition, and spatial (visual/motor). Difficulty with managing activities of daily living, such as cooking and eating, hydrating, bathing or various other routine responsibilities must also be noted in order for a physician to make a diagnosis of dementia.
Book a date and time with me for your FREE 15 minute Get Acquainted Call.
Coping with Challenging Situations
Whether the diagnosis is MCI or dementia, it is easy to get frustrated when someone’s actions are inappropriate, even if you know they are not intentionally being inappropriate. It takes practice to consciously separate the illness from the individual because we are used to holding ourselves and others accountable for personal behavior. The best internal response for everyone is for you to remind yourself again and again that it is the illness causing the behavior.
As you read earlier, dementia can be either temporary or progressive. In addition to the temporary dementias we have already discussed, dementia caused by an accident, stroke or other medical event may be totally or partially reversed, or it can be permanent.
One of the most common frustrations family members experience is feeling overwhelmed and unsure that what they are doing, or asking others to do, is best for the care recipient. The compromised brain does not receive messages as it once did, and what works to cope with challenging situations one day may not work the next. This is when learning more about the behavior brought on by dementia and discovering what to do when challenging situations occur is particularly important. Equally important is our own internal and external response to these situations.
Unfortunately, taxing situations become worse when dementia is intensified by vision or hearing problems, an adverse reaction to medication, chronic pain, or acute illness.
We can ease some of these troubles by cutting down on noise and clutter, having hearing aids fitted, making sure lighting and visual contrasts between floors and walls is good, and ensuring that medications are monitored and adjusted for a body that metabolizes them differently as it ages. These are concrete things we can do, and being able to do something about difficult situations is empowering.
We need to be proactive about observing changes in behavior and seeking medical help when behavior suggests physical discomfort. Infections of any type are acute illnesses and can cause a person with neurodegenerative disease to act out simply because the person may not be able to verbalize their discomfort. As pain or discomfort is relieved, behavioral issues tend to subside.
Sometimes, not doing something is the way to handle things. For example, keep in check the urge to test a person’s memory by asking if they know what day it is or if they remember something else. Doing this only sets them up to feel like a failure when they have to admit they do not remember. Correcting is a recipe for stress, too, and can make problematic behavior worse. It does not matter that you went to lunch on Wednesday rather than Tuesday as your loved one said – choose peace over being right.
A person with dementia is less able to reason, and arguing to make them see your point of view only produces tension. Confrontation does not work!
Kathy C. Faenzi MA is a Clinical Gerontologist and Senior Care Consultant based in San Mateo, CA.
JC Spicer, M.Ed. is a Freelance Social Science Writer and Developmental Editor based in the U.K.