Q: Dear Regina, I have recently started caring for an elderly man with dementia. His behaviour is not kind. About three or four times a week he gives me a mean look then he spits his food out at me. I don’t like when he does that and it makes me very upset. I know that he needs help but I feel he is doing it on purpose. He knows what he is doing. I told him if he does it one more time I will pinch him. He has not done it today. Just in case he starts back up, how can I stop that behaviour?
A: First of all, threatening to inflict pain to a person who depends on your help with communication challenges is ethically inappropriate. He is not a child who needs discipline. Your reaction to his behaviour will not help him. However, I understand not wanting food spat at you. That does not feel right and it is frustrating. You are reaching out for other ways to handle this and it is encouraged with all caregivers and families who are caring for their loved one. I appreciate the question.
Let’s back up and look at the whole scene that you described to me. 1) it happens frequently at mealtimes. Is it with certain foods? Many times certain foods take longer to chew and if it has a consistency that does not dissolve while chewing, the brain will not be triggering them to swallow. So foods like rice or harder things to chew like some meats and some vegetables they will spit out. So with this question start noticing what you are feeding him.
2) Evaluate your approach to him during mealtimes. Are you demanding and telling him to eat; telling him he hasn’t eaten enough, he needs to eat more..? These can feel childlike and may strike resentment. Try giving him a choice of what to eat. Show him two so that it is not overwhelming. Ask him if he likes it? (Pleasant short questions).
3) Are you sitting next to him? Or, are you standing over him? – Again this feels childlike if you are standing over him during his mealtime. He may have dementia but his dignity is still there and needs to be considered and respected. If you are feeding him you will have to develop skills on a friendly approach to help him. You can develop those skills with support from dementia trainings. Contact your local Alzheimer’s Association and they can guide you.
The main approach to this question is to check and evaluate your own approach and look for things that might be triggering the behaviour. It is not easy and it gets tiring. You are doing great and remember to take a break for your own care.
Q: Dear Regina, my brother has Alzheimer’s and his family takes good care of him. I visit as much as I can. I notice he is grinding his teeth a lot. His daughter took him to the dentist and told us he needs dental care and the cavities may be hurting him. The family had agreed to not put him under to get the treatment. We are afraid he will not make it through the procedure. The dentist doesn’t have much advice without the procedure. Can you give us a recommendation for this situation?
Dental care needed for elderly is common and it is perfectly okay to choose not to put an elderly person under to have a surgical procedure done. However, you are correct to want to find an alternative treatment. I have recommended Thieves toothpaste to people living with dementia. You can get it on AmazonThe toothpaste promotes healthy gums and teeth and surprisingly has taken away discomfort in persons living with dementia. The ingredients are safe and globally approved. It is costly but think of it as medicine. It promotes oral care without a struggle. You may even take some of the paste and just rub on the gums. Follow the instructions.
Taking care of his pain will help decrease anxiety. Opting out of medical procedure is a choice that we all have a right to make. When we make decisions for another person we really should consider the current discomfort the person is in and address that pain as much as possible. Allowing them to suffer in pain without finding other ways to help is negligence. It is okay for you and I to say I will suffer with pain but it is not your right to inflict that choice on someone else by choosing to do nothing. Continue to advocate for those who can’t.
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Answer to the person who asked the first question.
Take a better job where you do not have to deal with dementia patients. Life has many nicer, better and more rewarding options to make a living.
As for Regina’s answers, they are all suspect. She seems to be the reincarnation of Mother Teresa, isn’t she?