Decreasing distress in dementia patients

Dementia

Patients can become distressed for any number of reasons. It could be the fear of losing their identity after a life-changing injury or their loss of ability to reason and understand what’s happening around them.

The latter is particularly prevalent in patients with dementia. Dementia patients’ behavior is more likely to escalate as the disease progresses. They are unable to comprehend things happening to them and begin to lose their identity of self. At some point they will lose the ability to communicate verbally and possibly even non-verbally. Any of those changes understandably could cause agitation.

What causes agitation?

While it may not be obvious at first, there is likely a trigger to their distressed behavior; it’s important to figure that trigger out to reduce or eliminate the distressed behavior.

Some of those triggers could include but are not limited to:
• Pain
• Fatigue
• Boredom
• Overwhelmed/overstimulated
• Misinterpretation
• Bowel and bladder issues
• Unfamiliar surroundings or people

How to reduce distressed behavior

Once those triggers are identified, there are several ways to help reduce and hopefully eliminate the distressed behavior. The following are a few examples of therapeutic interventions that can reduce distressed behavior brought on by triggers.

Play soothing music

Loud noises can be stressful to just about anyone, but they are even more so to patients with dementia. They can cause overstimulation or fear in dementia patients.

In working with dementia patients, I’ve found music can be very soothing to them and can drown out some of the more stressful noises, especially if it is the patient’s favorite type of music. Listening to the patient’s favorite type of music can provide emotional and behavioral benefits to people with dementia. Musical memories are often preserved in Alzheimer’s disease because areas of the brain associated with musical memory are relatively undamaged by it.

Create a calming space

Whether in the home or hospital setting, make sure the patient’s environment is calm and soothing.

Everyday items can become scary to dementia patients, especially as the condition progresses. For example, they may not recognize themselves in the mirror, instead thinking a stranger is staring at them. Either remove or cover mirrors to avoid this.

Bold and busy patterns can also cause confusion, and bright colors can be distracting.

Instead, recommend more neutral color pallets, and introduce the patients to aromatherapy. This can be very calming for patients with dementia, as it decreases agitation and even improves their quality of sleep.

Ensure there is proper lighting, as well. Most dementia patients are older and have poor eyesight; combining that with dim lighting can lead to distressed behavior. Warm, glowing, not glaring light can assist in making it easier for dementia patients to locate their belongings and make them feel safe, which also reduces stress.

You can also avoid the stress of not being able to locate personal items by making sure their belongings are easy to find. Store items in see-through containers or on shelves and counters rather than drawers and boxes.

Treat with dignity and respect

Always treat dementia patients with dignity and respect. Even though their mental capabilities have declined, they have feelings. Constant corrections or voicing frustration can trigger distressed behavior.

Allow patients to remember events however they want to remember them. They may recall events differently or even recall things that never happened. Provide support and encourage them to tell their story.

No one benefits by correcting them; in fact, it can be detrimental to their emotional well-being.

Dementia patients are very perceptive of other people’s emotions. If they sense that you are stressed or frustrated, they will also become stressed. Allow them time to answer questions. Keep questions simple with “yes” or “no” answers.