HHA HACKS: How to Care for Patients with Memory Challenges

Dementia is a disorder of the brain that causes memory and behavioral changes. 

Some examples include:

• Memory Loss
• Confusion
• Agitation
• Sadness and depression
• Anger
• Paranoia
• Delusions 

These memory and behavioral symptoms can be difficult for the caregiver. 

Here are some easy tips to help manage common symptoms of dementia.

First, remember that your client isn’t saying things on purpose to hurt you or jeopardize your job, it is out of their control and a symptom of their disease

Instead of getting angry or giving up, you should make a note of this to the nurse assigned to your client and your True Care coordinator so they can follow up with the client’s family or physician of offer you additional training and support. 

Second, stay calm and keep a smile on your face. Be mindful of your body language, don’t act defensive. 

Avoid reasoning and logical explanations

Trying to use reason to appeal to someone in the middle of a delusional episode is not effective. 

What will get you through this emotional storm is to validate their feelings. Show empathy, respect and positive regard. Don’t change the subject, but guide the conversation to more positive topics. 

Focus on validating the emotion behind their words

Let them know that you understand how they feel and that you want to help resolve the situation, maybe help them find what they are missing. 

If the problem cannot be solved, redirect them to another activity, or distract them with something they’re interested in.

Each situation and each person with dementia are different, so you’re the best judge of which responses are more likely to work.

It may take a little experimentation to get the hang of the validation and redirection technique, but it gets easier with practice.

Live in the client’s reality and live their truth

What is the client’s reality? What do they think is going on? Just go with it. Give answers that make sense to the client. Acknowledge and validate their feelings. Disagreeing with a client or trying to correct them is not likely to help the situation. You can agree with them, even if they are technically incorrect. This can help them feel reassured and safe. Ask them appropriate questions to engage them in a conversation instead of trying to get them to agree with you. 

What is the cause of the behavior? 

Is the client hungry, sad, bored, in pain? Do they need the bathroom? These are possible causes of behavioral challenges. 

Suggested responses to common challenging situations

1. “I can’t find my wallet/purse, someone took it!”

Having dementia means giving up control over so many aspects of their lives, including their finances, and this loss of control, combined with the effects of dementia, can cause them to think people are interfering with their money.

Suggested responses:

• “Oh no, is your money missing? I can see why you’re upset. Don’t worry, I’m going to help you look for it. Let’s start by checking this drawer…”
• “Oh no, is there money missing? That can be very upsetting. Do you want to check your purse to make sure it’s all there?”
• “It sounds like we need to look into this. Let’s go to the bank tomorrow when it’s open to get it straightened out. Since the bank is closed right now, let’s do (an activity they enjoy).”

2. “I can’t find my wallet / glasses / hearing aid / dentures, someone hid them!”

Someone with dementia may accuse someone of stealing or hiding an item when they can’t find it themselves.

It’s hard to admit that their brain has changed so much that they cannot find their things and they may  not even realize that they moved the item themselves.   

Suggested responses:

• “Is (item) missing? I can see why that would upset you. Let’s look over here, I thought I saw it earlier.”
• “Oh no, I must have put that in the wrong place when I was cleaning earlier. Let me get it for you.”
• “Oh no, your (item) is missing? I’m so sorry that that happened. Could I look around one more time? It may have just been put somewhere to keep it safe.”

3. “I’m not eating, what if there is poison in my food?”

Paranoia or delusions can cause someone with dementia to believe that someone is trying to harm them or that they are in danger, when they are perfectly safe in your care. Try to reassure them that they have nothing to fear.

Suggested responses:

• “I understand that you’re feeling afraid, but I want you to know that I would never let anything bad happen to you. Have you tried this chicken? It’s delicious. Let’s have some together and you can tell me more about (a topic or hobby they enjoy).”
• While using this or a similar calm response, eat the same meal together to show that it’s safe.
• Ask about the client’s favorite foods as an adult and a child. Suggest preparing a favorite meal or food. 

4. “I want to go home, let me leave!

For many people with dementia, it’s no longer safe for them to leave the house on their own.

Because they can’t go wherever they want anymore, they may lash out in anger. 

Suggested responses:

• “It sounds like you want to go out, where should we go?…Oh really, I love that place too? What do you like best about going there?”
• “We can go anywhere you like, what did you have in mind?…That’s a great idea! Let’s go after we have lunch. I made your favorite pasta dish, let’s go to the kitchen to eat.”
• “Remind me where you grew up, was it around here?”

While these tips are helpful, if the situation becomes too heated, please make sure to call your True Care coordinator and also make a note for the assigned registered nurse who can discuss the situation with your client’s physicians. It may be an indication of a worsening medical condition. 

You can practice these responses with your friends or in the mirror to get the hang of it and remember to make sure your body language is just as gentle as your words. 

The aim is to help your client to calm down and get back on track to compassionate senior care.

* Please note, this post is for advertisement purposes only and may not contain any licensed medical staff or actual medical procedures. Do not substitute the information in this post for medical or legal advice from a certified and licensed professional.*