Sometimes dementia-related delusions involve unhappy events, memories or fictional narratives of the present. Unlike dementia-related hallucinations, there is a plot or story line when delusions of the present occur.
De-escalating violent outbursts in dementia caregiving
When a person living with dementia hits, kicks, spits, shoves, or shows other aggression towards a caregiver it may be motivated by pain, strong dislike, or fear. I recently coached a professional caregiver, Lila, who had a troubling encounter with a resident at the assisted living community where she worked.
Reality orientation: it’s still necessary, sometimes.
Reality orientation is usually not recommended, unless danger threatens the person with dementia or those around him or her. And, whenever possible, scapegoats can help dementia caregivers remain trusted by their family members or clients living with dementia. A few examples...
The Dementia Field Guide – a new approach for caregivers
This dementia caregiver manual is a vital resource for family members and medical professionals to better understand the dementia and how to anticipate and address the needs of those living with Alzheimer’s or other dementia.
New Street Compass, which provides mentoring to caregivers, announces the release of The Dementia Field Guide, a resource for those caring for people with dementia. Author and New Street Compass founder Cloud Conrad developed The Dementia Field Guide to address aspects of caregiving for dementia patients that other resources don’t cover. The book outlines the intricacies of how Alzheimer’s and other dementia affect the brain and equips caregivers to handle the practical, relational and emotional changes over time.
“Most caregiver education is extremely generic and doesn’t provide guidance to the specifics of a caregiver’s situation because so many variables are in play with dementia. No textbook can best address specific situations because each person’s progression of dementia is as unique as the individual themselves. Dementia affects the brain as well as an individual’s personality, experiences and relationships. What caregivers need is actionable, useful guidance to help them feel more confident and competent in their own situation,” Conrad said.
The Dementia Field Guide is a handy, self-paced reference, geared toward family members who become caregivers, along with medical professionals/independent caregivers. Conrad has discovered that these groups feel ill-equipped to handle practical, relational and emotional changes in those with dementia. They may face fear, frustration and anxiety about how to handle uncertainty and unexpected situations. The book is also a helpful resource for assisted-living facilities, where the demand for service exceeds capacity and staff turnover is high. The Dementia Field Guide offers long term care trainers a well-thought-out and organized approach to teach professional caregivers how to provide the most beneficial dementia care. This training material can support employee and resident recruitment.
Unique Disease Requires Unique Approach
According to the Alzheimer’s Association, over 6 million Americans have dementia. Mathematically, therefore, one in every five families is affected by the disease. By 2035, sources project that one in every two households will be affected, which is why it’s important to become more educated on the disease.
The Dementia Field Guide helps “unlock the brain of dementia,” providing caregivers with the knowledge and understanding to feel confident and competent when they assume the caregiving role. Conrad outlines the role of eight key brain functions in everyday living, how dementia changes them and what can happen as the decline progresses.
Unlike cancer or heart disease, dementia requires a different set of bearings for caregivers, as it’s the only disease that affects a person’s memory, thought processes and actions. The Dementia Field Guide outlines foundational principles to help to set the direction of caregivers’ approach to dementia – the Dementia Caregiver Compass. Conrad based the principles on the idea that the universal human needs we all share remain constant for people living with dementia. In addition to physiological and safety needs, they still feel the need to belong, to be valued and to have purpose. These needs motivate action but cognitive impairment from dementia distorts their attempt to address them.
“Just as we use points on the compass to find our way to a new destination, the Dementia Caregiver Compass is needed to navigate dementia successfully, charting a course out and away from challenging situations and maintaining your bearings to reach a more serene place, as easily as possible. Instead of directional points, the Dementia Caregiver Compass has points of intention,” Conrad said.
Other caregiving training programs frame many of the scenarios caregivers encounter as challenging behaviors or dementia-related behaviors, but Conrad takes a different approach in the Guide.
“Thinking of these scenarios as ‘behaviors’ silently encodes them with judgement and implies a need for correction or consequences. When we view the actions of a person living with dementia as ‘behaviors,’ we are operating from the false position that the person has chosen such actions and reactions,” Conrad said. “When we view the changes in memory, thoughts and actions as symptoms of dementia rather than a logical, conscious attempt to fulfill a need, we are better positioned for success in caregiving. This is an important differentiator of my approach.”
Caring for the Caregiver
The Dementia Field Guide also addresses how caregivers can protect their own well-being. Having been a primary caregiver for two family members, Conrad understands that emotional support is as necessary for caregivers of dementia patients as knowledge and skill. This support can help them pilot the obstacles between the present state they’re facing and a desired state free of stress and anxiety. Conrad knows this from research as well as her personal experience mentoring caregivers and as a caregiver herself.
During the three years her father lived in an assisted care facility, Conrad made several observations, which helped shape the book. Family members seemed afraid of being able to cope with their loved one’s changes in behavior, words and actions – worried they may do something wrong and make things worse.
“I learned that no matter how wrong I did something my father and I were both better when going through his dementia together. I realized if I did something wrong today, I would have another chance to figure it out tomorrow,” Conrad reflected. “Eventually, I did. But it would have been so much easier to have had a guide book like this back then. “What I know from my experience, training and practice is that the information in this Guide is key to providing caregivers the knowledge, tools and confidence to problem solve their own situations.”
The Dementia Field Guide is available for purchase online. The retail price is $32.50.
New Street Compass also announces enrollment for two online courses starting in January 2022 for anyone wanting to learn more about dementia. Conrad will present the content, which is relevant for family members, professional home health aides, and health care personnel in an assisted living or memory care home. Registration is required and space is limited. Learn more.