6 Normal Habits That Make Dementia Behaviors Worse

0:00You're on the phone with a family member and you are updating that family member on the most recent doctor's appointment that your loved one just had. You're going on and on. You've been on the phone for about 20 minutes. Your loved one with dementia is sitting nearby, but isn't really doing anything, saying anything, doesn't even seem to be tracking the conversation and what you're saying. In those situations, it's easy to think a person with dementia isn't really following, isn't really understanding what you're saying. But what if that's not necessarily the case. What if your loved one with dementia understands enough to know that you are talking about them?

0:43This is one of six super common behaviors that I see loving, kind careblazers do, and they unintentionally can make dementia behaviors worse. They can lead to more agitation, resistance, mistrust from the person with dementia toward you. 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 I want to break down these six common behaviors what they look like, why they can lead to increased behaviors, and what you can do instead.

1:34Also, I want to be clear. These behaviors are ways that we would normally talk to people in our day-to-day lives. People who don't have dementia, these are so common and normal and expected ways to communicate, which is why it's so hard for us to realize with dementia, it actually backfires and why it's easy for us to fall into this habit of communicating this way because we communicate with most people in our lives this way. It's just that when somebody in our life has dementia, we have to start making some tweaks. Hi, I'm Dr. Natalie Edmonds, a board certified geropsychologist. And every single week I post a new video on dementia and caregiving and tips that can help.

2:21All right, let's dive in to this week's video. Let's start with one common behavior that you may have already done this week, and that is correcting. You're caring for your dad. Your dad says, I have to go to work today. And you say, dad, you've been retired for 15 years. You're right. But we likely just made the situation much worse. Ask yourself, start training yourself. Is it really necessary that he get the right information right now? Is it really necessary for me to correct what he thinks is true? Because if correcting him didn't solve an imminent safety concern, didn't solve some sort of problems, what did your correction actually do?

3:05What did it accomplish? For many caregivers, they will discover that it accomplished making the person with dementia confused, agitated, not believe you, lead to a conversation that doesn't really go anywhere productive. The goal of many, most interactions with somebody with dementia is to connect with them, not correct them. Focus on connecting, not correcting. So in this example where your loved one thinks that they need to go to work, instead of correcting them exactly in that moment, you can focus on what is underneath what they believe. What is another way, a meaningful way that we can connect based on what is on their mind.

3:47So if work is on their mind and you want to connect with them and we drop the need to correct, it might sound like something you're thinking about work right now. What did you like most about your job? Or if you really want to get them to shift, you could say something like, oh, it's Sunday. You don't work today. Or, oh, you have today off. In general, if safety issues are not a concern, focus on connecting, not correcting, which leads me into common mistake number two, which is reasoning. Let's say you're caring for your loved one at home and your loved one needs medication. And your loved one doesn't really want to take medication.

4:25They don't think they need medication. From your perspective, you want to reason by explaining all the important reasons why they should take medication. Remember, the doctor said this is important for your health. Remember, you missed your medication last week and you got really confused. We use reasoning from our perspective to try to get them to take the behavior action that we want them to take. And from your perspective, it makes complete sense. You're basically laying out the evidence so that the person with dementia can reach the same conclusion you have reached. That's how reasoning works.

5:03We take information, we connect the dots, we use those dots to make a judgment. But dementia impacts the parts of the brain that are able to connect those dots. So the judgment they come to in the end is often different than the judgment we come to. For many people, they may not even believe that they have problems or that they have dementia or that they're no longer able to do certain things. We've talked about this before on the channel. It's called analcygnosia. So basically, giving more evidence does not create more understanding. If anything, it typically just creates more frustration and resistance.

5:39So here's where I want to encourage you to think about how do I get them to see my perspective? How do I get them to understand that I'm right and shift it into how do I help them reach the outcome I want them to reach? How do I get them to meet the requirement I want? How could I do that? A lot of times it doesn't require them understanding what we understand at all. I already did this a little bit in the first example with correcting. when somebody thought that they needed to go to work, we could have spent all morning telling them they've been retired for 15 years, not going to do the trick, or the person reasoned from the person with dementia's reality.

6:24If somebody believed they had to work, what would get them to settle down and realize they don't have to go to work today? Oh, it's Sunday. Oh, you have the day off. Oh, the boss called. You don't have to go in today. We often hear don't reason, which is exactly what this mistake number two is, avoid reasoning, but you can reason when it is from their reality, if it makes sense in their mind, not on ours. Let me give another concrete example from a careblazer that I worked with once. Her loved one needed to be supervised. We couldn't be left alone. It was a safety hazard for her loved one, her husband, to be left home alone.

7:02And so whenever the Careblazer needed to run errands, go to the grocery store, whatever, she always ran into this issue of her husband saying, I don't need to be watched. I'm fine. You can leave me here home alone. And would get really angry and threatened to hurt any caregiver who would come in. What we ended up discovering is that, well, her daughter-in-law, who lived really close by and worked from home, was always willing to come over and just sit and visit with, the daughter-in-law would visit with her father-in-law, you know, the Careblazer's husband. We phrased it in a way that didn't involve the daughter-in-law coming over to watch her loved one with dementia.

7:38We phrased it in a way of, oh, the Wi-Fi is acting up. My Wi-Fi at home is acting up. I need to get some work done. I'm going to come over here and borrow your Wi-Fi. The person with dementia, he didn't need to know she was really there to supervise because the Care Blazer needed to run errands. She was just there to use the Wi-Fi. So we're all of a sudden no longer trying to reason with the person with dementia that they need more help. Now, Care Blazer, I'm going to pause right here because we are only on mistake two of six. And I am realizing right now, you and your mind are probably thinking about several different situations you are facing where you're like, well, how would I do it in this situation?

8:15How would I do it to get them to take a shower? How would I do it to get them to stop driving? How would I do it to get them to go to the doctor's appointment? As you can see, the best solutions require knowing something about the person with dementia, their personality, the reality and resources you have at hand. Even if you think there are none, there's always something we can do. And so this is where it's really helpful to have a community that you can show up to, ask your questions, get feedback from other people so that you can think through how some of these strategies would work for you.

8:50Hopefully you have something like that in your community through local support groups, ask your loved one's primary care provider, ask your primary care provider, or you can check out our care collective program by going to our website. That being said, let's move into common mistake number three, which is arguing. Here's what I really want you to remember about this because we can all pretty much on the surface acknowledge arguing isn't a good idea to do with somebody who has dementia, yet we find ourselves doing it anyway. So I want you to keep in mind that you can win an argument on facts, but you still end up losing.

9:27You end up losing the interaction. You end up creating a negative interaction and people with dementia have emotional memory, even if they don't have the memory for details and facts and what happened and who said what. They build up the emotional memory of you and the negative feeling they have when you come around the more we do these kinds of mistakes. So for arguing, you don't win even if you have all the facts right. So your loved one maybe blames you for something. You stole my wallet. What did you do with my wallet? And you say something like, I didn't take your wallet. You probably misplaced it again.

10:02And then they say, no, you're always doing this. Like it's just this back and forth that leads nowhere. But let's think about this for a moment. What does arguing require? Arguing requires the person with dementia to have memory, factual memory of events that transpired. It requires the person with dementia to be able to remember what happened, juggle all the pieces of facts in their mind. It requires them being able to weigh another person's viewpoint, take a look and evaluate all the evidence. These are things that most people with dementia beyond the very early stages are not able to do. So even if your explanation is completely logical, the person with dementia isn't able to lean on logic anymore.

10:48So instead of listening to their specific words, you stole my wallet, you want to listen to the emotion that is underneath that accusation. Literally, you can't find your wallet. That's upsetting. Let's look together. They could have literally said, you stole my wallet. What did you do with my wallet? And you can say, you're missing your wallet. That's upsetting. Let's look for it together. So much about dementia communication is learning a new way to speak. That is so different than the way we speak to everybody else in our lives, which is why it feels uncomfortable and natural, and it takes some practice, but it's worth practicing.

11:26And notice what that kind of response does. It doesn't correct them. It doesn't say they're wrong. It takes out any fight or argument because there's nothing for the person with dementia to continue arguing about. And here's the big thing to remember and keep in mind with this kind of approach. You do not have to agree with their version of reality to respond to their experience. We don't have to agree with what they think is factual in order for us to respond to their experience. Their experience to them is factual. Okay, common mistake number four, testing. Do you remember who this is? What did we eat for breakfast today?

12:04Where did we go yesterday. What's my name? Many times, well-meaning caregivers do this because they are trying to understand how much the person remembers. And I can understand that temptation, but what ends up happening when we do testing is that we increase the chances that we are putting our loved ones in a situation where they are going to struggle with the answer. They are going to feel like they are on the spot. They are going to have a situation where they are getting something wrong, where they don't feel good about themselves and they don't feel good about the interaction they're having with you, which I will say over and over will make all future interactions more difficult.

12:49So instead of quizzing their memory, testing their memory, a visitor comes through the door. hey mom do you remember who this is? You can literally say hey mom Sarah your granddaughter is here. Just give them the information you want them to have and do not manufacture quizzes to figure out how much they know. Everyday interactions do not need to turn into memory tests especially if you want to keep the best positive interaction with your loved one the best positive relationship with your loved one. Number five I mentioned this in the beginning of the video acting like they are not there or acting like they don't understand what you are saying if they are there.

13:31People with dementia often become quieter, less engaged, have difficulty finding words, difficulty keeping up in a conversation. And it's easy to take what you see on the outside as not much engagement and to assume that means that they're not understanding anything or that there's not much going on inside. But that's not the same thing and that's often not true. So when we start talking to other people about their problems, they're having trouble toileting, they're not taking care of their medication, oh, she thinks the neighbors are spying on them again. When we are saying these things out loud in front of them, thinking they're not picking up because they're not responding or saying anything or engaging, we are rupturing the relationship and harming that relationship.

14:22Just because a person with dementia doesn't show emotion on the outside doesn't mean they're not experiencing emotion. If you're ever unsure about how much they are really taking in, a beautiful rule of thumb, the golden rule in dementia care, I would say, is to err on the side of dignity. What would be the most dignified way for you to have this conversation about your loved one? Whether or not they are there. And if you are having a private conversation about them, just make sure it's private. We all have things we want to get off our chest and complain and vent and do all these things. That's normal.

14:59It doesn't mean there's anything bad about you or negative about you. It just means we all need an outlet. So truly find a way to make it where they are not within earshot. Don't assume a lack of an outward reaction equals a lack of an inner experience. All right, final common mistake that happens a lot is reminding the person with dementia of everything they cannot do. This sounds like something you can't cook by yourself anymore. It's not safe for you to do that. Somebody needs to come over because you're not safe to be home alone anymore. You can't drive alone anymore. All of these things may in fact be true, but we want to find ways to keep our loved ones safe without having to call attention to their limitations.

15:51Repeatedly highlighting somebody's weaknesses or abilities lost doesn't make that any easier for them to accept. There's many things we can do when it comes to this, but one of the things we can do if our loved ones are struggling with something is we can try to adapt the environment around them, adapt the environment to match their ability levels. So for example, if they struggle with the remote control, we find a simpler remote control or we just go ahead and turn on the TV to the program we know they're going to want to watch. We don't have to call attention to it. We don't have to let them know why we're doing it.

16:27We just do it because we know that's what they're going to want or that's what they're struggling with and we're trying to get ahead of that struggle. If they are somebody who loves to cook, wants to cook, they're not safe to cook anymore, so you've taken over all of the cooking, but they like to wind up in the kitchen, you can find a task that is within their ability levels and ask and get ahead of it and say, hey, can you help me with this? And literally have them shred the lettuce with their hands or fold the napkins or stir something in a bowl. A lot of times I think what we are hoping when we remind somebody with dementia of what they can't do, we are hoping that they will stop doing it.

17:06However, that often leads to a lot of negative back and forth. So instead of trying to get them to stop doing something, give them something to do instead. Give them something within their ability levels to do instead. And a lot of times we avoid the resistance and back and forth that doesn't feel so good. So before you go, let's pull all of these six common mistakes together. We had correcting, reasoning, arguing, testing, talking about them as if they are not in the room, and reminding them of all the things that they can no longer do. I do not expect you or anyone to remember all six of these common mistakes and all the specific ways to respond to them in the moment.

17:49This is a learning curve. This is a process. This is a journey, not a light switch we could just turn on and off. But here's a question you can keep in mind when you are facing a difficult situation with your loved one and you're interacting with them. If you find yourself pulled to engage with them the way that you know doesn't go well because you've been down that road before, then ask yourself this question. Is what I am about to say actually going to help them? And you probably know the answer to that question immediately because you've already tried many things. And so you know what tends not to work.

18:31So if what you are about to say isn't going to help them, let that be your guiding light to just try something different. You're not asking yourself, but is this true? Am I right? A lot of the times, yes, what you are thinking is true. Yes, you are the one who is right. Those kinds of thoughts sometimes lead us to take the very behaviors we are trying to get away from. So it's not about being right. It's not about it being true. It's not even about like they should understand this. It's really about is this going to help? Will saying this help in some way? If the answer is no, there is another way to achieve the outcome you are looking for that maintains their dignity, maintains a positive interaction, maintains connection.

19:19And that's the goal we're looking for. That's what we want to practice and be open to experiment with. A lot of these mistakes are totally normal and not mistakes with 99 % of the people we interact with in our lives. But for the person with dementia, they don't work out so well. And so what we're having to do is break a habit, a habit of interacting. And that does take time. And it starts with just raising our awareness of when we do it without beating ourselves up, without feeling guilty for it, just realizing, oh, I did that again. What could I do differently? Now, a lot of these mistakes that I've talked about in this video are things I talk about in my book, The Dementia Care Toolkit, which is available for pre-order right now.

20:07But it's called The Dementia Care Toolkit because it is literally filled with tools, strategies that you can use no matter how difficult of a situation you are facing. You can literally open up the book, point to a strategy and say, what does this one say? Let me give it a try. And so that is available for you to order right now. And there's a whole section. It's three parts. The second part is all strategies for your loved one with dementia. But the third part are all strategies for you, the care pleaser. What do you do with all this frustration, resentment, guilt, grief, loss, other people's judgments?

20:50How do you handle all of that yourself? That is in that book as well. The link to get it is below this video, or you can just go to our website, www.careblazers.com and grab yourself a copy. So before I leave Careblazer, tell me which one of these six is the hardest for you to stop doing. Which one of these six feels like the biggest habit, the most natural thing, like before you even realize what you're doing, it's already out of your mouth. Which one is that for you? Leave it in the comments below. Other Careblazers, every time you leave a comment, you're communicating. We are building a community of Careblazers here.

21:23but I want you to just start with that one habit. Don't focus on six. We don't need to overwhelm ourselves, but that's the one area to focus on. What is one thing you can try to help break that habit? And I promise you, I guarantee you, you are not the only Careblazer struggling with it. I struggled with it when I was caring for my family. Both my parents struggled with all of these things. And there are thousands and thousands of other Careblazers struggling the same. You are not alone. I will be back next week with another video. As always, Careblazer, honestly, thank you for what you are doing for your loved one.

21:58I know that it is not easy. Okay, bye. Sending you love.