Suggestions When Dealing With An Alzheimer's Person
General Over-view of problems associated with the handling of Alz. Victims
Part 2
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1. Anything can
be misconstrued as threatening.
Due to brain damage the ability to evaluate situations is greatly diminished
in a person who suffers from Alz. or some form of dementia. Because of
this, their reality takes on a different view and anything that is frightening
to them can be misconstrued as dangerous. Some Alz. people will respond
with aggression if they think their life and well-being is being threatened
and even the most placid person can become combative. Combine with that
the anxiety from not knowing where they are, being surrounded by strangers
and in an environment they are not familiar with, can result in an emotional
eruption. ALWAYS approach an Alz. victim with caution. Keep the situation
as unhurried as possible. Key in on their behaviors. Do they appear anxious,
are they pacing...are they shouting or acting defensive? If so, they are
viewing the situation as dangerous and are quite capable of reacting violently.
(how to handle this will be discussed further down).
2. Never assume everyone's reactions will be the same just because they
all suffer from Alzheimer's Disease.
Each person who suffers from Alz. disease behaves and responds differently.
Just because one Alz. person reacts one way, there is no guarantee the
next one will behave in the same way. Although each suffer from the same
symptoms of Alz. not everyone suffers the same severity. Some victims may
simply withdraw into themselves if the situation becomes to much for them
to handle, while others may react the exact opposite. Always view each
person as an individual with Alz. and never assume they will act or react
the same way.
3. Evaluate the situation constantly. Moods, reactions and responses can
change in the blink of an eye.
Even to experts, Alzheimer's can be the master of manipulations. One moment
it can lull a person into thinking everything is fine, and the next they
find themselves confronting a person whose perception has changed completely.
In one instant the Alz. person appears docile and placid, the next they
can be suspicious, aggressive and paranoid. Some of this can be due to
several things. One, is something commonly referred to as "sundowning"
which is a strange occurrence that happens frequently in many Alz. people.
As it sounds, sundowning occurs from late afternoon into the evening hours
(although it can last much longer than that).
Things to look for:
The person may appear delusional, restless and agitated. The symptoms can
range from being weepy to combative. They may see things, (i.e. hallucinations)
and their suspiciousness, paranoia, confusion, and disorientation increases
immensely. Many people wander away from home during sundowning because
the restless is uncontrollable. The more agitated they become, the higher
the anxiety level goes. If an Alz. person is known to be an active sundowner,
the chances increase that the person will be more volatile during that
time.
WHY? First off, fatigue. The person who is sundowning may be exhausted
which heightens the level of emotional response. Secondly, the Alz. persons
perception is greatly diminished and since they have no true grasp on reality,
reactions may be spontaneous and eruptive. ALWAYS assess the situation
(if you approach an Alz. who is showing the above symptoms) with caution.
Stay out of the "strike zone" (i.e. close enough to be struck).
Instead, stand back and extend your hand. If it is batted or hit, remain
at a safe distance and speak to the AD person is a quiet friendly tone
until they have calmed down.
4. Keep in mind the Alzheimer's persons mentality is greatly diminished.
Unfortunately those who do not deal with an Alz. person on a regular basis,
does not realize what the disease does to the persons mentality. That is
why I have taken the liberty of including a chart. (i.e. Correspondence
of Functional Assessment Stages in Alzheimer's to Normal Development) which
will give an in-depth look at the digression. Most commonly Alz. people
are only judged by what they LOOK like, and no one takes into consideration
that the persons mentality may be well below their ability to respond "correctly"
to societies way of thinking. If you will notice on the chart, by stage
5, an Alz. persons mentality is only that of a 5 to 7 year old child. And
by stage 6 it digresses from 5 years to around 30 months. THAT is the reason
why people have a hard time "grasping" the responses they get
from an Alz. victim. Little does anyone know that while the person may
LOOK 75, beneath the silver hair, the person can only comprehend on an
age level of a child.
5. Maintain eye contact with an Alz. person at all times when talking to
them.
When you speak with an Alz. person, ALWAYS maintain eye contact. In doing
this it will give you an accurate idea of how 'aware' the person is, and
also how much the person is understanding / relating to what is being told
to them.
6. Always begin each 'discussion' with this person by using their name
(if you know it).
By late stage 5, the Alz. person can no longer process or retain information
for longer than 5 minutes. In otherwords, whatever you say to the person,
will be forgotten in a matter of minutes. That is why it is always important
to start any conversation with the person by using his name as well as
your own. Not only will this assure him/her that you know them, it will
decrease the anxiety they may be feeling.
7. Use short simple sentences to convey your questions.
As I said above, you will be dealing with a person whose mental capabilities
are greatly diminished. By remembering that their level of understanding
is now child like as well as their inability to retain information, it's
important to keep your questions as short and simple as possible. Keep
in mind that lengthy explanations will be forgotten so try to utilize questions
that can be termed in only 5 to 7 words.
8. Ask only one question at a time and allow plenty of time for them to
respond.
The normal response time to answering questions is usually very short,
unless it is being answered by a person with Alz. You see the process of
answering a question is extremely difficult for an Alz. victim. The system
in the brain mechanism does not work like ours. Many times, a person may
not answer the question for several minutes...possibly even longer, depending
on the brain damage. However as I mentioned above, this is another reason
eye contact is so vital. It will tell you if the person has 'received'
the question. If not be prepared to ask it over and over again, repeating
it in the same voice, using the same words, and allowing a lot of time
to let them absorb what you are saying.
9. Never assume the person understands the situation that is going on.
Most people would not think to include this hint, but in actuality it is
one of the most important. You see people who have Alz. disease are great
impostors. They don't look sick nor in the early stages do they even act
that sick, but behind the scenes it is a different story. A very astute
Alz. victim is very good at giving general innoxious answers. They can
easily fool a person into believing they are very much aware of what is
going on. But if the truth be told, the brain damage prevents them from
really grasping the severity of situations. All to often, to the casual
observer, and Alz. person can easily slip into a pattern of giving clichés
answers and every indication of awareness. So listen closely to what the
person is saying. You will realize that over time, the person is replying
to you in very broad, general answers. If you have doubts wait a while
and re-ask the question again.
By Marsha Penington
Click HERE for Help Sheet # 11
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