Jean looked out her kitchen window to see her mother striding down the sidewalk. Although her mom had dementia, she remained physically strong and she was making tracks. She dropped her dish towel and raced out the door.
“Mom!” she called. “Where are you going?”
“To New Brunswick.”
Her mother had grown up in that province, but hadn’t returned since childhood. Jean caught up with her, keeping stride while she scrambled for a good response.
“That’s nice. You haven’t been there in years.”
“That’s right. I want to see it again.”
“Can I go with you?”
This slowed her a little. “I guess so.”
“I’ve never been there. You could introduce me to everyone.”
“Okay, I’d like that.”
Jean gently touched her mother’s arm. “Would it be okay if I got a few things to take?”
“I guess. If you hurry.”
Jean knew her mother loved to help. “Can you come with me and help me get what I need?”
“Alright, let’s go.”
They turned back to the house. Once inside, Jean rubbed her arms. “It’s a bit chilly out there. Would you like a cup of tea? And maybe one of those chocolate chip cookies I baked?”
These were her mother’s weaknesses, and when the tea and cookies were finished, all thoughts of New Brunswick were gone, too. For now.
Agitation, pacing, wandering
With any intervention, it’s important to remember that nothing works all the time. Jean could try that same tactic in a few days and have a different (and not as happy) result. But it’s always worth a try.
The unmet need could be any number of things: the need to go to the bathroom, restlessness from lack of exercise, hunger, loneliness…the list goes on. For chronic agitation or pacing, it’s often helpful to ensure they can walk or get some form of exercise daily. Being outdoors (when possible) alleviates boredom, another unmet need.
I’ve told you about Fred, who came down the hall to our neighbourhood in his wheelchair several times a day. He created havoc in our empty dining room, but I discovered if I approached him with my biggest smile and started talking to him like an old friend, we could “walk” together back to where he lived. His (almost insatiable) unmet need was to feel a connection. As I held his hand, smiled and we talked, he enjoyed our time as I took him home. Often he would turn around and come back immediately. 🙄
Anger, aggression, lack of filter
Especially in a community situation, this is difficult. Trying to find the balance between safety and quality of life for others close by and respectful care that meets the needs of the elder, can be nearly impossible. Here are some suggestions:
- Sometimes an immediate intervention helps. Georgina used to flare up immediately before a meal, so we made sure her food arrived when she did. Lucy would get agitated before a bowel movement, so her care partner removed her to the bathroom at the first signs.
- If foul language, hitting or other aggression is present, remove the person to a quiet space immediately. Becoming overstimulated or overtired can lead to an outburst of this kind of behaviour.
- Talk in a soft, quiet voice. Smile, but hold their eyes so they know you are listening. Make affirmative sounds. (“Yes? Okay. Is that right?”)
Medication may be necessary. Talk with your doctor, ensuring you are on the same page. You want to control the behaviour, but not turn them into a zombie. Ask him or her to explain both the side effects and the time expected for the drug to begin to work.
Keep your sense of humour. Under the “lack of filter” category, I remember Margaret. A quiet, repressed minister’s wife all her life, I’m sure she thought many things but said none of them. When she was diagnosed with dementia, that filter slipped away. She used to sit in the hallway, making comments about all who passed by. When a member of the board, a large gentleman, walked by, she turned and said to the lady beside her in a loud voice, “That’s a fat man!”
🤣
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