When you’re helping someone with Alzheimer’s or dementia with a care task, they might suddenly become afraid, distressed, or panicked.
You might be helping with tasks like moving in bed, changing clothes, or other activities that involve closeness and movement.
Dementia Distress Makes It Hard to Help With Essential Care Tasks
When your loved one becomes fearful and upset, they’re likely to scream or fight and won’t cooperate or let you help. That makes completing the necessary care task nearly impossible.
To calm the situation and get the task done, we found a helpful, free 5-minute video clip from dementia expert Teepa Snow. In this excerpt from one of her workshops, she demonstrates four key steps that calm stress and distress in dementia.
Here, we explain the 4 steps that Teepa uses to calm the situation so you can get back on track and accomplish the care task.
4 Steps to Calming Stress and Distress in Those with Dementia
1. Recognize when someone is very tense and afraid
Trying to move or help someone who's already very tense can cause them to panic and resist even more. They might even start screaming in fear and shouting for help.
Because their muscles are so tense with fear, they can’t compensate for any unexpected movement and might feel like they’re falling. That could cause them to instinctively grab onto something for stability and hold on as tight as they can.
If they accidentally grab your hand or arm, you could unintentionally get hurt while they’re panicking.
Instead of continuing with the care task, stop and use the next steps to help them calm down.
2. Get to the safe and reassuring hand position
Using the hand-over-hand method is the safest approach when someone is panicking. From this position, they won’t be able to grab you easily, and you’ll be able to pump their palm to add pressure in the hand to help calm them – it’s a natural human response.
You may want to back off from the task and offer your hand so they’ll have a chance to take it.
If you know that they tend to grip with their fingertips or nails, use Teepa’s tip to wear a glove and/or hold a washcloth to cushion your hand. You’ll still be able to do the hand pump, won’t get hurt, and can keep calm more easily.
3. Gradually lower your voice and slow down to calm the situation
In Teepa’s example, she says “Ow, ow, ow” repeatedly. At first, she’s speaking at a louder volume. Gradually, she speaks more and more softly and slowly.
At the same time you’re doing that, make soft, kind eye contact and continue to pump into the palm of their hand.
When things have calmed down, have your loved one practice exaggerated breathing to encourage deep breathing. It may also be a good time to say a few brief words to empathize with how they’re feeling and apologize for startling them.
If “ow” doesn’t seem to fit your situation, you may want to use a short sound that mimics or matches your older adult’s panic reaction. That can help them feel like you’re hearing them, understanding them, and are on their side.
4. Speak slowly and repeat simple, brief instructions twice before starting to move
Now that they’re feeling calmer and safer, you can resume the original care task.
To make this go more smoothly, speak slowly, clearly, and rhythmically, and keep instructions very simple and brief.
In Teepa’s example, the task has two steps: 1) hand on the rail, 2) roll to me. She begins by slowly saying “one, two” twice in a rhythmic tone. Then, she states the two steps in the same slow, rhythmic tone, “hand on the rail…roll to me,” and repeats that twice as well.
Only after repeating these instructions slowly does she begin any movement. This gives time to process the instructions and understand what will happen.
As she begins the movement, she repeats “roll to me…roll to me” in that same calm, rhythmic tone.
Recommended for you:
- How to Approach Someone with Dementia: 6 Tips for a Positive Care Experience [Video]
- How to Help Someone with Alzheimer's: 5 Essential Tips from Expert Teepa Snow [Video]
- Dementia and Eyesight: An Expert Explains 3 Common Changes and Behaviors [Video]
About the Author
Connie is the founder of DailyCaring.com and was a hands-on caregiver for her grandmother for 20 years. (Grandma made it to 101 years old!) She knows how challenging, overwhelming, and all-consuming caring for an older adult can be. She also understands the importance of support, especially in the form of practical solutions, valuable resources, and self-care tips.
Would like to get advise for my 90 year old father that is yelling all day long ‘
Medications are not helping. Just making him very tired can not even open his eyes but still is yelling.
It may take a combination of solutions to improve your father’s mood and behavior.
It can help to understand if something is causing his yelling, like physical pain or discomfort. He may not be able to communicate his needs. This article has more info – Understanding and Managing Dementia Behaviors: A Comprehensive Guide https://dailycaring.com/understanding-and-managing-dementia-behaviors-a-comprehensive-guide/
Another factor could be that behavioral medications don’t always work as expected in people with dementia so it’s possible that a change in medication should be considered. Don’t make any changes to his medication routine without clear instructions from the doctor (it can be dangerous to suddenly stop some medications). The first thing to do is to contact his doctor to let them know that his symptoms are not improving and to see if he should change his dosage (sometimes, too high a dose can be counterproductive), try different medications, or safely discontinue certain medications.
You might also want to try some non-drug interventions. More info here – 6 Things to Try Before Using Antipsychotics for Dementia Behaviors https://dailycaring.com/how-to-handle-dementia-behaviors-without-antipsychotic-drugs/
Having a regular routine can also be helpful in providing some calm and stability that could help his mood. More info here – 3 Top Benefits of a Daily Routine for Seniors https://dailycaring.com/why-routine-is-important-for-seniors/
These articles may also be helpful in understanding what’s causing the yelling and finding ways to reduce this behavior:
– 5 Types of Medications for Alzheimer’s Behavior: Effectiveness, Benefits, and Risks https://dailycaring.com/5-types-of-medications-for-alzheimers-behavior-effectiveness-benefits-and-risks/
– Keeping a Dementia Journal Makes Caregiving Easier: 7 Things to Track https://dailycaring.com/keeping-a-dementia-journal-makes-caregiving-easier-7-things-to-track/
– Solve Challenging Alzheimer’s Behaviors with Expert Communication Tips https://dailycaring.com/video-difficult-alzheimers-behaviors-solved-with-expert-communication-tips/
Great advice .. I worked with individuals with Alzheimer’s for many years. Can be a challenge but also comes with great rewards.
That’s wonderful! It’s so true that it’s a challenging role, but can be very rewarding as well.