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Posts Tagged ‘alzheimers’

Managing Hoarding Behaviors in Patients with Dementia

HoardingHoarding is its own psychological disorder, characterized by an excessive accumulation of objects to the point where it begins to interfere with the person’s life, often by covering just about every available surface in their living area and/or including keeping food and medicine that has gone bad. The person feels distress at the thought of throwing anything away, and while the disorder can be isolated, it can also be paired with other disorders, such as severe anxiety and/or depression. It may make them feel safe to know they have everything they could ever possibly need.

Hoarding can also be found in conjunction with Alzheimer’s or dementia, in which case it may be due more to confusion than out of any fear of throwing something away. Food may have been left to rot because they can’t remember when they bought it and their sense of smell has deteriorated to the point where they can’t tell it’s gone bad. Medications may likewise be left to go bad if the person can’t remember what it is, why they’re taking it, how much they’re supposed to take, when they’re supposed to take it, or when they took their last dose.

Likewise, mail may be left to pile up if they’ve lost the mental capacity for sequential tasking. If that’s the case, then someone will need to sit down and go through the mail with them to make sure no important documents are lost and bills don’t go unpaid.

Patience is A Virtue

As tempting as it is to get frustrated with hoarders and dementia patients (and doubly tempting when the two disorders are combined), it is of the utmost importance to remain calm and speak kindly and gently to your loved one. Remember that they’re not doing any of this on purpose, and if you lash out or yell at them, you’ll make them more confused and anxious, which will make everything worse.

Choose your time to talk about the hoarded objects wisely – specifically when your loved one is in a good mood. Talk them through the process of selecting items to be thrown away – if they haven’t yet lost the ability to appreciate logical reasoning, you might be able to convince them to discard much of what they’ve collected without too much trouble.

Memory Box Technique

The memory box technique is one strategy that has proven to be successful when dealing with hoarders. Choose a box to be their designated place to keep “special things.” You can even decorate it together to make the box both more special and more memorable – this has the added benefit of creating a fun activity you and your loved one can share together. Anything your loved one likes to collect can be put in the memory box, which makes it easy for you to keep track of the accumulation of those items. If their rubber band collection is getting out of control, for example, you can remove some of them and your loved one probably won’t even notice. You can also label and keep items that really are valuable, such as keys and wallets, in the box. That way, when your loved one comes to you looking for something, you can simply suggest they check their box.

How to Handle Someone Who Has Behavioral Problems Due to Dementia

Behavioral Problems Due to DementiaDementia can be scary and confusing for everyone involved. Those with dementia often feel lost, confused, and out of control of their own lives – all of which are terrifying. That fear can sometimes prompt them to lash out violently (either verbally and/or physically) against those around them, which is both painful and frustrating for the targets of their aggression.

So what should you do in such a situation? How can you calm them down and avoid hurting them?

The first step is to educate yourself. Know the signs of dementia and some of the behaviors that might come along with it.

Aggression

This can often start with the patient insisting they want something they can’t have (such as to go “home”) or that they don’t want something they can’t avoid (such as something in the environment, something in their schedule, or even the caregiver themselves). A simple statement can sometimes turn to yelling and may escalate into violence.

As tempting as it can be to argue with them, that’s not helpful. Don’t try to force the issue and don’t restrain them if it’s not absolutely necessary. Instead, try to divert their attention to something else while speaking to them in a calm, measured voice.

Confusion

Statements like “I want to go home” are often the most painful to hear out of someone with dementia who is already home. It means they’ve forgotten where they live, and they want to return to a place where they lived during another part of their lives.

The most important thing to remember is not to argue with someone with Alzheimer’s or dementia because that is an argument you will never win. You cannot reason with someone who is suffering from dementia and trying to do so often only makes things worse.

Depending on the person, explaining the change in their situation, especially through the use of photos and tangible objects, might work, but more often than not it’s best to try to distract them. Suggest going for a walk with them or getting a snack and get them to talk about other things. If they ask things like “When are we leaving?” or “When are we going home?” try putting them off by telling them you can’t leave until traffic clears up or the whether is better. Sometimes a small lie is better than trying to explain to them what they can’t (or don’t want to) understand.

Poor Judgment

This can take a variety of forms – from trouble with finances, to hoarding, to paranoid behaviors, such as accusing a loved one of stealing from them. While some of these strange behaviors are obvious, others take more subtle forms, making them difficult to diagnose. The person with dementia may not even know they’re struggling with something, and even if they do, people are rarely willing to admit they need help.

If you suspect a loved one may be suffering from poor judgment, try to find out quietly. See if you can get a look at one of their bills to make sure they haven’t missed any payments. If that’s not possible, try to have them figure out the tip at a restaurant and see if they struggle any more than they usually do.

The most important thing is to remain encouraging and reassuring. Offer to help in small ways that minimize the other person’s embarrassment. Again, don’t ever try to argue with them, and don’t ask them outright if they’re unable to handle certain situations because that won’t end well.

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