When a person has dementia, sudden and unexpected mood swings can occur from time to time. However, there are things you can do to improve the relationship between you and the person with dementia and prevent situations from escalating. Here are some ways to keep the peace:
1. Accept that you have to change – the person with dementia will not be able to change their behaviour. Dementia is a disease of the brain, so it’s natural that it will affect their behaviour on occasions. As a carer, you have the power to change your own behaviour and how you react to their moods. Accept that anger is inevitable on some occasions. While it’s not acceptable for them to try to hit out (be ready to move away) you need to make sure you don’t react to their anger. This may be easier said than done if you’re tired, but it’s important not to let situations escalate. A few examples of when anger can occur are when a person with dementia is being asked to take tablets or being moved from a chair to a bed. They may not want to take their medication at that point in time and they may not be ready to go to bed. Don’t push it. What harm can it do if they take their tablets an hour later, or if they stay up for a bit longer? Leave it and try again a bit later on when their mood has improved. Sometimes a small break is all that is needed.
2. Don’t contradict what they say – none of us like to admit when we are wrong. But if you were contradicted and someone was able to correct you in a calm manner without being rude, you would accept they were in the right if you believed them. A person with dementia can’t do this. Don’t correct them by saying things like: ‘You said we were with Joe, but actually Joe wasn’t there that day’. Let them share their perceived memories in their own way, as pointing out their mistakes may make them angry or affect their confidence.
3. Be aware of your body language and tone of voice – a person with dementia may not remember or understand what you say to them all the time but they will always pick up on your body language and how you say things. Try to speak slowly and calmly and use open body language. Avoid folded arms and if they are seated, don’t lean over them, kneel down to their height. It’s not always about what you say. If your tone of voice is abrupt or impatient, they will pick up on it, even if you are trying to say nice things.
4. Don’t criticise how they are coping – at some stage, a person with dementia will begin to struggle with daily tasks like washing, dressing and using modern devices. If you notice a deterioration in their coping skills, don’t point this out – even if you want to use it as justification for persuading them to agree to a carer coming in. Rather than saying: ‘You need more help because you’re not coping’, which is likely to make them defensive and also has the potential to upset them, say something like: ‘Sue is going to pop in and do the dishes. It will free you up to do something else.’ This makes it sound like you are empowering them to perform other tasks, rather than rendering them incapable of doing anything.
5. Ease up on things that aren’t too important – when caring for a person with dementia, you may have noticed that their basic hygiene like washing and dressing isn’t as good as it used to be. Conflict can occur when you insist that they have a bath or shower every day if they don’t feel like it. Most of us like to bathe or shower daily and that’s certainly what we’re brought up to believe we should do. However, is it really important for them to do this every single day if it causes them distress? It may be more appropriate for them to have a wash on some days. This may be more manageable for them and less stressful. If it avoids the stress of an argument, then it could be a better idea.
6. Identify triggers that may cause sundowning – a person with dementia may become restless and agitated late afternoon or early evening and this is called sundowning. They may become angry, upset, demanding or disorientated. Experts aren’t quite sure what causes sundowning – it seems to result from changes in the brain but it could be due to the fact that the person is restless if they haven’t done very much during the day. They may be bored. If you think they are restless, then get into the habit of suggesting that you both go out for a walk earlier in the day to break up the monotony of being indoors. Or if you think they are tired, then maybe a brief nap early afternoon might be a good idea. Generally though, being more active during the day to avoid restlessness later on is a good option.