Alzheimer’s can come with a slew of additional complications.  One of them includes anger and aggression.  While these can be difficult to handle there are a number of tactics you can use to get the situation under control.  The quicker you identify the underlying problem to assist your loved one, the sooner the frustration will subside for everyone involved.

When you first begin to notice the individual becoming upset and/or agitated there are a number of responses you can try:

• Try to identify the cause – One of the best tactics is to consider the events that happened just before the individual became upset. Recognizing the culprit in these instances can help in avoiding them in the future.
• Are they in pain? – Pain is a common cause of aggression and can often come from unseen conditions such as urinary tract infections. If you think they may be the cause you should schedule your loved one to see a doctor as soon as possible.
• Consider their feelings – We often try and focus on facts in frustrating situations when instead it is the emotions that should take center stage. When working through a fit of aggression or anger consider the feelings behind why they are angry instead of focusing on the event that upset them.  Alzheimer’s can sometimes prevent individuals from being completely rational.  What may seem like a small incident to most can be a trigger for those with Alzheimer’s and dementia.
• Remain calm – It can be tempting to lose control and get angry as well but that will only complicate the issue. Try instead to remain calm and positive.  Speak in a slow relaxing tone to help deescalate the situation.
• Recognize familiar triggers – After a while, you will begin to recognize situations that bring on the aggressive behavior. Once you start to recognize them you can avoid and circumnavigate them.
• Identify soothing techniques – For many there are certain self-soothing techniques that can help to calm and relax. Some of the favorites include pieces of fabric that they enjoy the feel of or that have positive memory association, music, massage, and stretching.
• Do not use restraints – Unless your loved one is in immediate and serious danger you should avoid restraining them. Restraint will only further aggravate them and can actually lead to physical harm even when that is not the intent.  Instead, try and use your relaxing voice technique to calm them.

These are only a few of the strategies you can use to mitigate aggression in seniors with Alzheimer’s disease.  To learn more about managing Alzheimer related aggression visit http://santarosaseniorliving.com/dementia-alzheimer/aggression or call owner Mary Garcia, RN at (707) 695-2937.  If you are searching for memory care for your loved one who exhibits aggression visit Wild Rose Care Home for a tour.  We can explain our approach to memory care and show you our private assisted living community.

Many of us have jobs and other life activities that keep us busy and social.  For your loved one with Alzheimer’s it is also important for them to stay connected and feel like they have events and activities to look forward to.  Adult daycare centers give them the opportunity to interact with others and form friendships with other individuals like themselves.  Even if you feel like you are giving them enough attention and stimuli at home it can always be nice for them to have somewhere that is just for them.

Once you’ve decided that you would like to look into an adult daycare center there are a number of questions you should ask the staff before choosing one in particular.

What should you ask?

These are a few of the basic questions that will get you started.  If you feel that there are any special needs you would like to discuss, this meeting would be the time to bring those up as well.

• What are your hours? – The hours they are open will make a difference with your schedule and could potentially cause problems if they enforce minimum attendance.  If it is difficult for your loved one to make it regularly they may not be allowed to continue attending.  In addition to asking about the hours, you will also want to ask about their fees and what type of services they offer.
• Ask about the programs – Adult day centers are used to providing specific programs and activities for their visitors. Some Alzheimer’s sufferers will need extra care when it comes to activities and will need to avoid some altogether, knowing ahead of time about what they will or will not be able to do is helpful for planning.
• Are some individuals separated? – This can be important whether your loved one has dementia or not. In some cases, dementia can be disturbing, or even dangerous to those living with it and those around them.  Knowing what to expect can help you determine if this is the right care facility for you.
• Is the staff trained? – The adult day care you select should have staff that has been specially trained to handle the variety of illnesses they come in contact with on a daily basis. If they do not have special training or are not trained in dealing with hallucinations and dementia then you will want to select somewhere else.

Encourage Positive Recollections in Seniors With Dementia

It is tempting to correct seniors with dementia when their version of reality conflicts with our own.  Many caregivers who are new to dementia care attempt to reorient the senior back to reality by challenging the senior’s belief and stating the actual version of events.  For instance, if a 90-year-old woman with dementia tells her caregiver that her father came to visit her yesterday, the caregiver may say “no he didn’t.  You were here yesterday.  Remember?”  This reorientation back to reality may bring temporary lucidity for a short period of time, but more often than not only aggravates undesirable dementia behaviors such as agitation, confusion, and disorientation.  How would you feel if someone was constantly challenging your genuine belief of what happened?  Wouldn’t you feel confused and disoriented?  Do you think your self-esteem would suffer?  What about the crushing blow of remembering that your father is dead; that he didn’t come yesterday, in fact, no one came yesterday.

Instead of reorienting seniors with dementia back to reality try encouraging positive recollections through validation.  The validation method encourages the caregiver to acknowledge the senior’s perception of reality, empathize with the emotion underlying their statements, and steer the conversation in a direction that elicits positive memories and emotions.  In the above example, the caregiver would say “that’s nice that your dad came to see you.  What did you two talk about?”

Some caregivers feel that the validation method entails lying and is therefore unethical.  In response it is important to remember that Alzheimer’s related dementia is degenerative; the senior with Alzheimer’s disease will not recover.  Therefore, reorientation has no lasting benefit but will elicit negative dementia behaviors such as confusion, agitation, and loneliness.  In contrast, validation focuses on the senior’s quality of life by eliciting positive emotions.

Go With The Dementia Flow

Rather than fight the current of dementia through reorientation, go with the flow through participation and steer the conversation toward positive memories, whether real or imagined. Many senior living facility Administrators still subscribe to the outdated model of dementia care that is reorientation. According to the reorientation strategy, whenever a resident with dementia espouses a memory or recollection of events that is untrue, the caregiver ‘reorients’ the resident to reality. For instance, if an 85-year-old resident with dementia told you that she went to Europe yesterday with her mother, you would tell her that she did not go to Europe with her mother. She stayed in her room yesterday and watched TV. Remember? The object of this questioning is that the resident will remember that they did in fact stay in their room yesterday, and no, they did not go to Europe with their mother. This brief orientation may produce the unintended and unfortunate result that the resident will also recall that their mother is dead and that they live away from their friends and family. The consequent negative emotions that can follow reorientation have given rise to a different dementia care strategy: go with the flow.

How Do You ‘Go With The Flow’

Participating in a happy ‘recollection’ is easy. Instead of reorienting the senior with Alzheimer’s disease or dementia back to reality, ask them some follow up questions that will lead to another happy ‘recollection’ or affirm their memory of the positive event. How was your trip to Europe? Tell me more about your mother. Steer the conversation toward positive events and memories. The happy recollection will enhance the resident’s quality of life and mood. Residents of http://santarosaseniorliving.com have enjoyed happy recollections that while untrue have therapeutic value in the form of positive emotions. Residents who firmly believe that they did not see that movie do not experience the frustration that follows being told that they did in fact watch that movie the night before. Remember? Don’t you remember seeing the movie? It’s the one where…

This tactic does sacrifice the brief lucidity that may accompany reorientation, but the ultimate result steers clear of negative emotions in favor of positive ones. The suitability of this tactic is reinforced by the fact that dementia is progressive; there is no cure, only a steady decline. Reorientation will not last and your loved one’s memory will continue to worsen over time. At this stage focus on bringing happiness to your loved one. There is no need to confuse them with reorientation, but there is always value in enhancing quality of life.

Be Patient And Let Your Loved One With Dementia Perform Their Daily Activities

Caring for the elderly with dementia can be a difficult job. It takes time to deliver personal care, and there is always the temptation to do deliver care as fast as possible so that you can move onto another task. In practice, the staff at SNFs and larger senior living communities must attend to many residents and have little time to do so. As a result, care is often delivered in a rushed manner. Oral care is delivered in seconds and feeding takes only minutes. The norm becomes the actual delivery of care rather than supervising the resident as they perform their own tasks to the extent of their ability. Instead of allowing residents to maximize their independence and maintain their skills, the staff delivers care in the easiest and most expedient way possible. In the end, residents, especially those with dementia, do not thrive in an environment where care is treated as a task and resident-Independence is marginalized.

Good Dementia Care Takes Time

There is no expedient way to deliver quality dementia care. Residents suffering from memory loss require patience and supervision, a requirement of dementia care discussed on http://santarosaseniorliving.com/ and a norm at Wild Rose Care Home. If care is to be a process of supervision while the resident performs their routines (eating, dressing, brushing) to the best of their ability, the caregiver must have ample time to supervise the routine. In essence, quality dementia care requires an effective staff to resident ratio so that staff is available during peak hours. This requirement of ample time and patience is one of the leading reasons why families seek quality assisted living communities for their loved ones. In fact, after placing their loved one in a large assisted living facility, many family members are unhappy with the quality of care and transition their loved one to a smaller care home with a better staff to resident ratio.