When the Skies of Dementia Stir Anger and Fear
Alzheimer’s cafes are indoors picnics with singalongs, chatter around tables and educational interviews/discussions. Our motto is; “All in the same boat.” These reflections came from cafe discussions. Please add any of your own thoughts.
We’ll explore the topics of anger and fear; why we experience them, why they are unsettling and how we can prevent and resolve them once they arise.
Why do we have emotions? What purpose do they serve?
Strong emotions such as anger and fear have long helped us respond to threats. Similar to senses such as vision and hearing, anger and fear alert us to situations that may require action. Our nervous system has fine tuned “fight or flight or freeze” responses to danger. This hardwiring is shared with most other creatures. Fear and anger can be experienced throughout the entire body as panic, a pounding heart, dry mouth, sweaty palms etc. Not all situations that trigger emotions require a full reaction. Modulating and quieting emotions as they arise is a skill that can be affected by having dementia. Aristotle said there is a right time to be angry with the right person for the right reason for the right duration. Regulating the type and intensity of emotions can be a challenge when living with dementia. On the upside this uninhibited emotional freedom can allow unbridled joy, laughter and wonder.
What about Dementia and Anger?
Handling anger can be one of the biggest challenges when living with dementia or caring for a person with dementia when their filter is not functioning. Fists may come down hard on the table. Regrettable outbursts occur with no brakes.
What are the triggers?
Anger can be related to:
Physical triggers – discomfort, hunger, temperature, exhaustion, frustration from the inability to do simple tasks, medical dental issues (pain)
Emotional triggers – over stimulation, being overwhelmed, helpless in the distress of others, lonely or bored
Mental triggers – confusion, mixed up memories, embarrassment, being confronted with inaccuracy, a sudden change in environment or surrounding, feeling lost, uncertain.
Dementia and Fear
People with dementia can often feel afraid and anxious. The physical experience of agitation and worry can be described as being restless, tremulous, breathless, sense of foreboding, sweaty, heart pounding, ringing in ears.
How can those living with dementia and their caregivers help prevent and deal with fear and anger?
- Create a calming environment – safe and quiet spaces. Draw on gratitude for the familiar things to reorient, soft music or sound of running water
- Avoid environmental triggers - noise, glare/bright lights, background distraction, distressed others (residents).
3) Monitor personal comfort – pain, hunger, thirst, temperature, fatigue, sleep. Dental/medical issues
4)Simplify tasks and routines. Use memory aids. Ask closed ended questions which can be more easily answered by yes or no. Break up conversations into smaller parts. Try to stay in the present and distant past.
5) How can caregivers respond? Listen to the frustration and try to understand
6)Provide reassurance and let them know you are there
7)Modify the environment e.g decrease noise or use distraction
8)Involve the person in activities, e.g go for a walk, listen to music. “Music washes away the dust of everyday life.” -Art Blakely
9)Check yourself, do not raise your voice, criticize or argue. WALK AWAY BRIEFLY and bring back water, try deep breathing.
You may have heard it says “A diagnosis of dementia is worse than cancer.” A possible reply is “Many people find this time in their lives they are being lovingly cared for as never before” There is much you can be reassuring about; especially non-abandonment.
BE KIND TO YOURSELF. It may seem as if you have caused their anger but it will likely be disproportionate compared to how they would have handled the situation before they had dementia. Try not to take it to heart but understand that they are doing the best they can.
Some people become softer and gentler and others become more feisty.
If you are feeling burned out, exhausted, detached you are in good company. Please read my post; BURNED OUT? RESOURCES IF YOUR JOB LEAVES YOU IN ASHES. Do good care of yourself too.
