Is It Jealousy or Dementia? Why They Act Worse When You're Busy

0:00Well, hey there, Care Blazer. Welcome back to the place where we talk about everything dementia. Dr. Natalie here, along with Milo, here to talk to you today about an experience that so many of you have written me about, emailed me about, DMed me about. And so I want to talk about it here with you today. So let me ask you, have you ever noticed your loved one is calm? Things are going okay. Nothing seems to be wrong. And then the moment you shift your attention to someone else, talk on the phone, step into another room, all of a sudden they change. They get demanding. They get upset. They get anxious or jealous that you're not there with them, giving them attention.

0:49It's almost as if it can seem like they can't stand not being the center of your attention. Understandably, that's going to make you feel frustrated, angry, resentful, confused. And so I want to take today's video to talk about what is happening in the brain that causes this and how to manage it if this is going on for you. Care Blazer, 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 Care Blazers into YouTube and I will pop up.

1:32All right, let's get back to today's podcast. First, let me share two real life examples of this happening so you get really clear on how this looks. So for the first example, it was a daughter caring for her mom with dementia. And her husband, so the daughter's husband, recently had surgery. And for the first time in a long time, the daughter's attention was really split. She was still caring for her mom, but she was also caregiving for her husband, who before the surgery was able to care for himself. So what started happening is that the moment she shifted her attention to care for her husband, then her mom became argumentative, upset, mean, wouldn't listen, acted out to the point where now she's unable to give her husband attention.

2:24She needs to shift to her mom because her mom is escalating. The other situation is a wife and a daughter, and they're heating up lunch for the person with dementia. So the wife's husband, the daughter's dad, they're making lunch. And the daughter and mom are talking while they're preparing the food. And suddenly he becomes rude, repetitive. He starts interrupting them. So it's almost like this, the man with dementia was feeling like the daughter is distracting his wife from giving attention to him and from serving him. And so the care blazer starts to wonder, are they just jealous that my attention's not on them?

3:07Is he manipulating? Is this their personality? Is this the dementia? So let's talk about what this really is. Number one, it isn't jealousy, even though it totally can feel like that. It's basically attachment distress. So as dementia progresses, something very important happens psychologically. The caregiver, you, the careblazer, you are their primary anchor of safety. You are their memory backup, their decision maker, the person who orients them, their routine, their stability. In many ways, you become their nervous system regulator. That means when your attention shifts, even briefly, their brain doesn't process, she'll be back in five minutes.

3:58It processes, I'm losing my safe person. And that leads often to anxiety. And when someone with dementia is anxious, it comes off as demanding, interrupting, protesting, escalating, yelling, not because they're trying to compete, but because their brain experiences the separation as a threat, as something scary. Another thing that's going on is that their brain can't hang on to, I'll be right back. So healthy brains, they can tolerate divided attention. We can think to ourselves, oh, she's helping somebody else. I can wait. It's fine. She'll be back. But in dementia, they're not able to have that time understanding.

4:45So dementia, it reduces their working memory. It reduces their cognitive flexibility to understand what's going on. It reduces their ability to regulate their emotions, which means they can't hold the concept of she or he will be right back to help me. All they are feeling is discomfort, fear, uncertainty, loss of control. And the brain, a lot of times, a solution to this discomfort is to protest. It's to display behaviors that other people would interpret as rude, accusatory, disruptive, demanding. But underneath all of that, it's anxiety. Now, complicating all of this is that these behaviors can often feel so personal.

5:33Part of that is because that type of behavior really only happens with you. They only act that way with you. They were fine until I stopped focusing on them. They're punishing me. They've always been difficult. They've always wanted all of my attention. But here's some reframe, a cognitive reframe that can help. They do not feel the safest with strangers. They feel the safest with you. And when someone feels the safest with you, they show you their distress. It certainly does not make things easy, but I hope it makes things a bit more understandable. So let's talk about what can actually help if you are experiencing something like this.

6:18We already know that we can't explain or give them information to try to help calm them down. We can't reason someone out of anxiety when the reasoning centers of their brain are compromised. So instead of trying to convince them that they need to be patient or that they need to wait, we can, number one, regulate before you separate. What does that mean? It means before you shift your attention, give your attention to someone else, pick up the phone, leave the room, shift your attention from your loved one with dementia to whatever else you want or need to do, it means that you slow yourself down first.

6:57If you rush away tense, abrupt, irritated, the brain, the person with dementia, their brain is going to read that as danger. And so your nervous system often sets the tone. We have talked a lot on this channel about how we in many ways are mirrors to our loved ones. And when we look upset, irritated, tense, stressed, they reflect that back to us. So before you separate regulate, which means we want to maybe move deliberately, a bit more slowly, some pleasant soft eye contact, a calm voice. Sometimes that regulation, you don't even really need to say anything. It's just our nonverbal behaviors coming from a more calm place.

7:48Another thing you can try doing is to use proximity instead of words, meaning in the more advanced stages, a lot of times language is more difficult to land. The person with dementia might have a harder time understanding your words and what you are saying. However, they still understand proximity and closeness. So if you need to help somebody else in the room, you could try and see if it helps if you stay within eyesight. If you maintain light touch briefly. So if you're on the phone and you're talking to somebody, does it help if you just have your hand on their lap or rubbing their back? Is it possible that them being able to visually track you sometimes helps reduce that anxiety?

8:33Number three, this is my favorite, reduce idle time, which means many times behaviors happen during the waiting gaps. Basically, when they have nothing else to do, they are literally just waiting, wondering what to do, where to put their attention. But if you can give them something to do ahead of time, something that they literally would be interested in doing that takes their attention, that is going to reduce the chances of them escalating and getting anxious when your attention shifts to something else. So maybe it's as simple as them holding an object, flipping through a magazine, watching some of their favorite videos on TV, having something to hold in their hands.

9:22sorting something to go through, right? So engagement can often reduce anxiety better than explanation. So this is what I like to call get ahead of the behavior. If you know separating yourself or focusing your attention somewhere else increases anxiety and you need to go do something, what can we give them to do instead? And finally, this is probably the hardest one to hear, but just accept this as part of the disease. Sometimes you can do everything right. You can give them something to do ahead of time. You can rub their back while you're on the phone. You can stay within their eyesight. You can do all of these tips, but the brain's tolerance for your divided attention is simply gone and they are going to show their distress and anxiety regardless.

10:09That does not mean you failed. It doesn't mean you're not doing something right. It just means their capacity changed. their brain has changed in this way and it makes it really difficult for you and for them. That's why one of the most important things to work on, which I talk about and we work through together every single week inside the Care Collective, is what are we doing for ourselves to regulate our own emotions, our own resentment, our own frustration? Because it does not matter even if we have all of the behavior tips in the world, it still doesn't address the loss, the grief, the pain, the frustration, the resentment that we feel as human beings underneath.

10:50Now, I want to talk to you because this kind of behavior, if you are going through it, it feels suffocating. You might be feeling like, I can't even talk to somebody else. I can't even take care of anybody else. I can't even get a break or do the things they say I should do for self-care because my loved one needs me constantly. That absolutely, understandably, leads to feelings like resentment, feelings then like guilt for having the resentment. It's like this spiral and it's exhausting. And so this is why a response strategy is important. If this is something you are going through or you have gone through, chances are high you're going to go through it again.

11:33So think ahead of time a little bit, like what will be your response strategy? And one response strategy that is just as important as anything you say and do is what you're going to tell yourself and hear when you face it. So Careblazer, if you're a loved one, acts worse the moment your attention shifts to something else or someone else. It's not jealousy. It's not manipulation. It's not cruelty. It's not their personality. It is literally attachment distress of a brain that can no longer regulate uncertainty and handle timelines. and even though it's not easy, sometimes understanding the brain changes can lead us to have more understanding and compassion and hopefully lead to a different way to respond.

12:18So Care Blazer, if this is something regularly happening in your home and you wish you could get real life feedback, this is exactly the kind of thing that we work on together inside the Care Collective. We learn not only what's going on in the brain, but how do we respond in a way that doesn't escalate their behavior, but also doesn't continue to add to our caregiver strain? How do we prevent the burnout from happening? We practice together. We talk about these situations. We talk about what's helped. And you can check out the Care Collective by looking at the description below this video. There's a link you can check out to learn more.

12:57Careblazer, I'll be back next week with a brand new video. As always, I'm sending you love. Bye.