IF ONLY I CAN REMEMBER
By Regina Posvar
Q: DEAR Regina, sometimes I think my mom is refusing to listen to me. I know she can understand me but when I repeat or raise my voice, she gets so angry. I do not know what to do with her. I am sorry to say my patience is becoming thin. I know she has dementia but this does not help me with caring for her.
A: You are correct in your saying that knowing she has dementia does not help you with caring for her. Dealing with persons who live with brain changes is hard on both the carer and the person living with dementia. Patience is needed for sure but so are skills. I have met very few people with the natural ability to endure all of the challenges without good days and bad days of failing and the ups and downs of guilt and balancing their own health needs. Usually there is a good support system in the family or a combination of family and community. A family caregiver who is doing it alone may have all the patience to care but 9 out of 10 will compromise their own health and this too is unbalanced.
The symptoms you mentioned above are certainly part of brain failure. Another area to consider is that her hearing may be affected. Raising your voice or tone will only make things worse with someone who has hearing difficulties as well as a person with dementia.
Here are a few things that can be helpful with persons who have hearing loss with dementia and you can find this information from unfrorgetable.org.
1. Make sure they can see your face clearly before you speak and get on the same level – either sitting or standing – so they don’t have to look up or down at you.
2. Limit background noise – turn off a TV or radio and close doors so the room you’re in is as quiet as possible.
3. Listen out for other background sounds that might irritate a person who’s hard of hearing. For example, an extractor fan, telephone, a chair scraping on a hard wooden floor.
4. Try writing down simple messages if your loved one is comfortable with reading.
5. Use books and other visual cues that might help you both communicate more effectively.
6. Speak a little slower than usual, relax and smile!
The blog also talks about what not to do, which is not to shout or over exaggerate words. Also do not say things like “forget it” or “never mind it doesn’t matter.” The reason behind that is the person with dementia may feel it does matter.
If you are able to get your mom’s hearing checked and fitted for hearing aids she will need encouragement to wear them. However, some families will find it expensive if their loved one often hides things or accidentally puts them in the trash. Some families may or may not replace them. In any case making sure the person sees your face when you are speaking to them is very helpful.
Addressing your own patience:
The good thing is that you are able to recognize your feelings. Your frustrations are completely normal. Knowing your pressure points will help you control them. Here are a few common ones that caregivers experience.
1. “Stop shouting at me!” (you have engaged in arguing with the person with dementia)
2. “Stop asking me that!” (sometimes you do well with repetitive questions and other times it wears on you)
3. “Did you do that on purpose?” (This usually builds when you may be in a hurry and your loved one will pee on their selves right before you walk out the door!)
4. “I can’t take this on!” (you haven’t had much sleep and your loved one is having sundowning behaviours)
If you find yourself making these statements you are frustrated. When you recognize your frustration just take a step back for a moment to take a breath. Remove yourself from the immediate situation and take in 3 good deep breaths so oxygen is flowing to your brain particularly your frontal lobe. This will help you gain calmness, control and ability to think better. You will be able to look at the situation and see if you are missing a communication cue from your mom. Aggressive behaviour is usually related to anxiety that they are not comfortable about something. Could be pain or feeling your anxiety about something. If you conclude that you are the cause of the behaviour do not beat yourself up. Go for a walk, hit a pillow, write it down, go on the internet these are quick ways to calm yourself down.
Learn your points so when these times arise you know how to handle them.
Fact: 71% of people over the age of 70 are affected by hearing loss
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