Dementia distress makes it hard to help with essential care tasks
You might be helping with something like moving positions in bed, changing clothes, or other tasks that involve closeness and movement.
When your older adult gets 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 4 key steps that calms 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 dementia
1. Recognize when someone is very tense and afraid
10 seconds in video
Trying to move or help someone when they’re already very tense causes 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 trying to continue with the care task, stop and use the next steps to help them to calm down.
2. Get to the safe and reassuring hand position
1 min 25 sec in video
Using the hand over hand method is the safest position to use 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 try backing off from the task and offering 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 (1 min 48 sec in video). 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
3 min 20 sec in video
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, do some exaggerated breathing to encourage your older adult to breathe deeply. 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 with 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
3 min 55 sec in video
Now that they’re feeling calmer and safer, you can get back to 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” in a rhythmic tone – twice. 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’s going to happen.
As she begins the movement, she repeats “roll to me…roll to me” in that same calm, rhythmic tone.
Next Step Learn how to calm someone and continue a care task from expert Teepa Snow (5 minutes)
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By DailyCaring Editorial Team
Image: Family Caregivers of BC
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