“A person with dementia sees the world differently, but their world is just as real to them,” said Dr. Andrew Duxbury, guest speaker at Dementia Q&A at Fair Haven in Birmingham on July 24, 2019. “Confrontation happens when we try to force them to live the same life that they were living before dementia, but that doesn’t work. The brain changes.”
Andrew Duxbury, MD, is a professor of clinical geriatrics on the faculty of the Division of Gerontology, Geriatrics and Palliative Care at the University of Alabama at Birmingham. His role there has been in community based geriatric care, including his lifelong affiliation with UAB Geriatrics Clinic.
In the Dementia Q&A seminar, Dr. Duxbury discussed four practical ways that caregivers can avoid confrontations that lead to frustration and anger in a person with dementia.
1 – Affirm Their Reality
Don’t try to force the truth of the real world into the false reality of their world. Instead, you can use language that affirms their version of reality to keep the peace. For example, suppose your loved one begins talking about the horses on the lawn. In truth, there are no horses on the lawn. You can avoid confrontation by simply acknowledging their version reality. “Those are nice horses. Let’s go down to the kitchen for breakfast.”
2 – Use Distraction
Most confrontations can be avoided by turning the attention of the person with dementia to something else that promotes peace and calm. One effective distraction is to play music that is beloved and familiar. Typically this is music that the person listened to in their teens and early 20s. Another effective distraction technique is eating. As we age our taste buds change, but the sweet tooth often remains.
3 – Avoid The Abstract
A person with dementia is not capable of abstract thought. For example, saying to someone with dementia, “What would you like to wear today?” involves too many steps in the thought process for the person with dementia to be successful. Instead, give a clear and visible choice between two things. For example, “Would you like to wear this blue shirt or this red one?” “Would you like a piece of toast or a muffin?”
4 – Ditch The Daily Bath
Dr. Duxbury explains that while it may be common practice in the United States to take a bath each day, it’s really not necessary. You can just as easily use wipes each day to clean up parts that might need it. But when you must take administer a bath, remember to get the person wet from the feet up, and not from the head down. Water falling down from a shower into the face of someone with dementia can be very frightening. Instead, find ways to associate water with fun, such simply adding a rubber ducky or bubbles to the bath water.
Dr. Duxbury emphasized that the decline of a person’s body, including the decline of brain function, is a natural process, and that for most people the decline begins in their 40s or 50s. Dementia speeds up the decline. So what does the doctor recommend that may help slow down dementia? “Remember what your mama taught you: eat right, get proper sleep, get some exercise, don’t drink to excess, and don’t smoke.”
For more information about Fair Haven’s Memory Care Assisted Living for persons with mild to moderate dementia, or Fair Haven’s dedicated household for persons with advanced dementia or Alzheimer’s, contact our admissions team at 205-880-1942, or send an email to Traci Kennedy at tkennedy@fairhavenbirmingham.org.