Author:
Kim Warchol, President and Founder of DCS at CPI
Help! Help! Have you seen my mom? I want to get out of here. How do I get out of here? My address is 3730. How do I get home?
No! Leave me alone!
Help!!!
Have you ever heard any of those words said in a heart wrenching tone in your dementia care experience? I've heard all those things throughout my career, and they really hurt my heart. When words are said this way, it is most likely anxiety.
This anxious feeling occurs when a person living with dementia feels violated, threatened, lonely, scared, and they send us those overt signals through what they say and how they say it. The truth is, they aren’t looking for the bricks and mortar of their home or for their mom as much as they are looking for the familiarity, safety, security and comfort these represent.
When this happens, do we stop and respond and help that person who's experiencing such stress and anxiety, to feel better? That's where great, quality dementia care training begins. We stop. We listen. We learn. Because we care.
I remember one time I was working in a senior living facility and I heard those kinds of screams coming from behind the closed door of the shower room. Sadly, I was the only one who stopped and asked, “What's happening? Is she okay?” One of the staff members said, “Ah, that's just Millie. That’s just what she does when she gets a shower.”
It’s that sort of dismissive attitude that is exactly what's wrong in dementia care. We must see that person as a person first. If we heard that type of blood curdling scream or anxiety coming from any other human being, in any other situation, we would stop and act. Why then don’t we respond the same way when it involves a person with dementia and/or we are in a nursing home?
So, in this dementia care insight, we're asking, what should we do when anxiety happens in dementia care? The answer is simple. SEE THE PERSON AS A PERSON FIRST. This will compel you to stop and try to help address their needs, their wants, and their fears. Always help them to feel safe in your care. Don’t think of this as an option. Consider it our humane obligation.
To accomplish this important priority, we must do three things:
1. STOP and offer your help.
Never ignore or push through to get the “task” done. This is a vulnerable, precious human being in distress. Help them.
2. Calmly approach and use strategies to deescalate the situation.
This person may be in a flight or fight condition so knowing how to calm is key. For example:
- Approach in a calm manner. This may mean you need to take a moment to check in on your own anxiety level. Do it. Starting the interaction without stress is vital because “behavior influences behavior”.
- Be supportive, demonstrating support in your body language and tone of voice. Show you care.
- Validate their feelings to help them feel your concern. Say something such as, “I can tell taking a shower is upsetting and you are scared. I can understand how being in this cold room with someone you don’t know could be frightening. I want to help you to feel better.”
3. Investigate to discover the root cause then address it and put plans in place to avoid triggering this reaction in the future.
- Think about something in the person’s history and preferences that could create a stress reaction. In the case of taking a shower, is there any history of trauma or abuse that’s creating fear? Are they a very private person who feels embarrassed or uncomfortable? Did they always prefer baths to showers?
- Also look at the care approach? Did the care partner gain trust and agreement? Did the care partner move slowly, assuring understanding before moving on to the next step?
- Examine the environment. Is there anything frightening or uncomfortable such as is it too cold or is it difficult for the person to get in/out of the shower or bath?
Sometimes a person’s history can help us during our investigation to find the specific stress triggers. Other times we use our common sense and then trial and error elimination to find and address what’s causing the distress and fear reaction.
Summary
With the holidays upon us there are going to be many opportunities to use these skills in care situations, or gatherings that are meant to simply be filled with fun and joy. Holidays often bring change of routine or location and overstimulation, and this may inadvertently push the person beyond their stress limits.
Now more than ever it is time to prepare yourself and your staff to be able to keep everyone safe and to help the person living with dementia to thrive. As an example, our Dementia Capable Care training will:
- Assure your team is prepared to know how to reduce the likelihood of inducing a stress reaction that can put all at risk of harm or injury. An ounce of prevention is worth a pound of cure.
- Assure your team knows what to do when a stress reaction happens which will effectively douse the anxiety without extinguishing the beautiful soul that burns brightly within.
Take a little time to improve or refresh dementia care and nonpharmacologic “behavior” management skills today through quality dementia care training and reap the plethora of benefits tomorrow.
Gain the knowledge and skills to optimize function, safety, and quality of life for those you serve and certifications to distinguish yourself or your organization as a leader
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