4 Common Phrases That Make Dementia Behaviors Worse

0:00What time is my appointment? Two o 'clock. Five minutes later, what time is my appointment? Two o 'clock. And then three minutes later, what time is my appointment? Two o 'clock. Before you realize it, out comes, I already told you, it's at two o 'clock. Now, Careblazer, if you've ever had an experience like that, you are definitely not the only one. Somebody repeating the same question over and over or the same story, it wears on you. us, especially when we're already exhausted and tired and depleted of our energy. Last week, in last week's video, I talked about six common caregiver behaviors, like actions that we do that make dementia worse.

0:47And it sparked the idea for this video, which is four common phrases, things that we say that make dementia worse. Careblazer, real quick, if you learn better by watching things, then you can hop on over to my YouTube channel where I post these podcasts in video format, sometimes have different visuals to help people learn even better. You can just type in Careblazers into YouTube and I will pop up. All right, let's get back to today's podcast. So these phrases, four common ones, they each reveal a communication trap that I'm going to share with you. The reminding trap, the highlighting deficits trap, the repetition awareness trap, and then the explanation trap.

1:32I will break all these down for you. None of these traps, phrases, if you find yourself doing them or you have done them, which I guarantee you probably have, we all have, it doesn't mean you're doing something terrible. It doesn't mean you're horrible. They're just so easy to say and so easy to do. And for most of us, they are likely habits that we're not even aware of. So my goal with this video is that we increase awareness of these traps, explain why they make dementia behaviors worse, and then go over what we can do instead. And similar to the behavior videos, these statements we would say are things we would totally say to anybody else who doesn't have dementia.

2:10We would say these in normal conversation, which makes them that much more difficult to break. If you are new here to this channel, Hello, welcome. I'm Dr. Natalie Edmonds, a board-certified geropsychologist and the founder of Dementia Care Blazers. Every single week, I do a new video dedicated to dementia and caregiving in hopes that it supports you on your journey. So let's get started with today's video, and we'll start with probably what is the most common phrase. I already told you, this is the reminding trap. Your mom asks what time the appointment is. You tell her a few minutes later, she asks again, you tell her, she asks again, you tell her, eventually you say, I already told you.

2:52It is at two. And we do this out of frustration, but there's probably also a part of us in our brains that are thinking, well, maybe if I remind her that I've already told her, it will help her remember, which of course is not true. Because dementia interferes with the ability to store information, literally consolidating memory, then the person is likely not going to remember the information they keep asking about. Our reminding them does nothing to restore the missing information. Something we can do in this situation is literally just repeat the information very neutrally without a lot of emotion, similar to the person saying, what color is the sky today?

3:32And we just keep repeating it. Another thing we can do if it is the same question over and over and it's becoming a pattern is you could direct their attention to somewhere where you have written it down. Perhaps it's a whiteboard or a piece of paper, something within their viewpoint. You walk by, they ask you the question, and you can say, oh, I wrote it right down here for you. Here's the thing I really want you to remember when it comes to the person with dementia repeating the same question. For you, this might be the 15th time you've heard the question today. For them, it feels like question number one.

4:05So simplest way, they ask you what time the appointment is. you just answer, it's at two, freshly, neutrally, without a lot of emotion. You just move on until they ask you again. Second common phrase that often leads to dementia behaviors or not a great interaction is the phrase, don't you remember? Or do you remember? So this is the trap of highlighting their deficits. Whenever we say something like, remember I told you, or we talked about this yesterday or come on, you remember. We're usually trying to help. We're trying to like get their brain to do something that their brain is not able to do anymore.

4:44We're hoping that our encouragement and our prompt will somehow be able to pull it out of their brain. Many times in dementia, the information is just not available to them because it has never been encoded in their memory. It never landed in their memory. It's not stored anywhere for them to be able to pull back up. And that's where this phrase of, don't you remember? Come on, you remember? Do you remember? It really becomes a problem because now we're not simply giving them the information. We're asking them to confront their deficits, their weaknesses. We're asking them to do something they are not able to do.

5:18Imagine you struggling with something specifically and having somebody repeatedly point directly at the thing that you are struggling with. That's kind of what this phrase does. You don't remember, still don't remember, come on, remember now. We're literally just like poking the button of you don't remember, you don't remember, you don't remember. So instead of testing whether or not they have the information, just give them the information. Kind of similar to last week where we don't want to test them. This phrase of do you remember, instead of do you remember that Sarah's coming today, it's just Sarah's coming to see us today.

5:57Okay. Phrase number three, you just asked me that. So basically this is a repetition awareness trap where this one is subtle. What we're really hoping is that if we point out to the person with dementia, they are repeating themselves, maybe they will realize it and stop. Again, somehow we are assuming that their brain has this ability to remember something that it never stored. The brain changes that are happening in dementia that are causing the person to repeat information is exactly the same problems that interfere with the person's ability to remember that they just asked you that same information.

6:38Or this is very similar to you just told me that, or you already told me that. Again, the repetition awareness trap. So it's not just about questions. They might repeat the same story over and over again. And remember, some of this literally might be, we just need to provide the information again. Some of it, especially in the cases of them repeating the same story over and over, this is an opportunity to connect with them instead of correcting them. Fourth and final phrase that we mean well when we say, but it usually doesn't land well, is a phrase along the lines of why did you do that? This is kind of the explanation trap where let's say maybe your loved one put all of their clothes in a pile by the front door or your mom emptied every single drawer in the kitchen or something ended up being in a place that absolutely makes no sense.

7:37For us naturally, we are curious and we want to ask why did you do this? Why are you doing that? That's a perfectly fair question when we are curious about another person's behavior. But again, think about what you are asking their brain to do. You're asking their brain to remember what they did at some point in the past. You are asking them to remember what they were thinking before they started that behavior. You are asking them to connect those thoughts to the action that they took. and you are asking them to explain that all back to you. There's so much that our brains do naturally that seems so easy, that come just with ease for us, thank goodness.

8:23But for the person with dementia, those connections have broken down. This is a lot to be asking somebody with dementia and they might not be able to explain it. The most accurate explanation they might be able to give you is simply, I don't know. Or they give you an explanation but the explanation makes no sense to you either. It doesn't help give you any more insight into why they did what they did. So a couple of things to keep in mind if this happens where your loved one's doing something strange, you have no idea why, you wish they wouldn't do it, whatever the case may be. Number one, if they are doing something that makes no sense to you but is not calming harm to anybody and is not going to create a super big issue for you down the road, well, we can often just let them do the strange behavior.

9:08because that is a behavior that is keeping them engaged, keeping their attention. It means they are not doing something that is causing disruption. So many times we can just let them be and let them do the strange behavior. If it is something we really do not want them to do, then we can try to remove or replace the triggers. So if they are moving an important item, like let's say their eyeglasses somewhere, and it always ends up in a place that doesn't make sense, We could get ahead of it by one, keeping multiple pairs of eyeglasses around, two, always keeping track of the eyeglasses ourselves, like maybe watching where their favorite hiding spots are.

9:51Maybe just when they take them off here, I'll take those, store them in a place that's safe. We can just kind of try to get ahead of the behavior in that way. Also, what we can do is we become what I call a dementia detective, which is really starting to, instead of asking them the question about why they're doing what they're doing, ask yourself the question about why they're doing what they're doing and think about what were they doing right before the behavior? What was happening right before the behavior? What could this behavior mean? Where else would this behavior make sense? What are the actual steps in this behavior?

10:26What are they? And this can start getting your brain working again to be the dementia detective. And again, I understand in your mind, you might be thinking this is too difficult. call. I don't have time to be thinking about all of this. Can't you just give me the answer? But I'm hoping what you're starting to see is that the same behavior in two different people can be caused by two different things, can mean two completely different things, and most importantly, respond to two complete different ways of responding, which is why it is so important to gather yourself around really amazing, supportive individuals who understand the complexities of dementia care and understand what it requires to figure out what is the best response for your loved one.

11:13Because what is the best response for your loved one might not be the best response for another Careblazer. And that is okay, but it's helpful to have a place, a sounding board to talk through different ideas. But none of that is more difficult than you continuing to try to do the same thing over and over that's getting you the same results that you do not want. One behavior can have many different responses. Let's just take one behavior, the repeated questions, which came up quite a bit in this video. I gave you several possible different ways that you can respond to repeated questions. You can simply just answer the question again.

11:50You can point them toward a whiteboard or a sign that you created with the answer. You can simply offer them reassurance, like maybe the question they're asking over and over again is bringing up some anxiety for them, so you just offer them some reassurance. You could redirect them. You can look for the emotion or an unmet need underneath that repeated question. You can sometimes prevent the question from coming up altogether by giving them the information you know they're going to ask eventually sooner or later. Dementia caregiving is very different from following a recipe where when they do X, you do Y.

12:30Eventually you can get that recipe, but it's very individual to you. It requires you being the author of that recipe. Nobody else has the recipe for you. You will develop it by testing it out. So don't put the pressure on yourself that you have to have like some universally correct response the first time you respond to a behavior. Their reaction to what you did will tell you whether it worked or whether it didn't. If it seemed to put them at ease, if it seem to help the behavior move on, whatever you did is something that worked, lean on it. If what you did seemed to make things worse or made it more difficult, then we can start to pivot away from it.

13:07That's not the approach for your loved one. You're looking for what helps this person in this situation with the brain that they have right now. That's it. So here are the four phrases and the traps that they fall in. Number one, I already told you, that is the reminder trap. Don't you remember, right? That is the highlighting their deficits trap. You just asked me that. This is the repetition awareness trap. And the why did you do that or explain yourself to me, this is the explanation trap. All four of them have one thing in common, and that is we are asking their brain to do something it is no longer able to do anymore.

13:49Here's the thing. Dementia care, it's experimentation and we have to experiment. You are learning the person's brain. You are learning what it responds to. And just as soon as you figured out what it responds to, the brain changes. The cells are constantly dying. So the brain will change and what works now might not work forever. And so then we go right back to experimenting again. It's not that you're doing something wrong or you're getting something wrong just means we are constantly having to adapt, which is another reason dementia caregiving can feel so hard. Now, Careblazer, these are a lot of things to talk about in just one video, but if you would like hands-on practical strategies of what you can do no matter what situation you are facing, I literally go over dozens and dozens of them inside of my book, the Dementia Care Toolkit, which you can order and you can literally flip open a page and try a strategy on that page.

14:49Also, you can access a free digital downloadable workbook with the book that you can start tracking what works for your loved one specifically and literally build your own recipe for your loved one. That is a free gift when you order the book. All right, Careblazer, I hope this video has been helpful to you. I will be back next week with another video and until then, thank you from the bottom of my heart for doing what you are doing for your loved one with dementia.