Her dad is 92 and no longer working. But one day he talked nonstop about the trouble he was in at work, and how the lawyers were after him.
It was very real to him. He was so scared he started to cry.
That came from a message an Instagram follower sent me. Her family tried reassuring him, and it didn’t work. They tried redirecting him, and he kept going back to his story. “It was so sad,” she wrote. “It was such a helpless feeling.”
Loved One With Dementia in Distress?
People with dementia often become scared, upset, anxious or agitated. Here are four ways you can respond when that happens.
Each one can help bring calm, help them feel more at peace, and shorten the time it takes them to go from being really upset to feeling more comfortable. My goal is for you to have options to choose from, especially if the one you’re using right now isn’t working.
Why You Need More Than One Way to Calm Them
Before we get into them, know this. You’re going to need a combination of these approaches.
No one approach works for every single situation. We just can’t rely on one approach all of the time. That’s why having several in your toolbox is so important, and why it’s important for us as Careblazers to stay flexible and adjust when we realize it’s needed.
To make them easy to remember, I call them the 4 R’s: reassurance, redirection, reflection and retreat.
1. Reassurance: Let Them Know You’re on Their Side
The first R is simply reassurance. It’s simple, but it’s powerful.
You’re letting the person with dementia know you’re there to help them. You’re by their side, and you’re going to figure this out together.
With the dad from that message, reassurance might sound like:
- “I’m here for you, Dad.”
- “We’ll get through this together.”
- “I’m on your side. We’ll figure this out.”
This is a great place to start. See if it works before you move on to one of the other three.
But as we saw in her message, sometimes it doesn’t. So let’s talk about the other three.
2. Redirection: Reassure Them First
The next one you’ve probably heard about. It’s redirection.
Ideally, you only try to redirect after you’ve tried to connect with them and reassure them. When we redirect too quickly, it tells the person with dementia that you simply don’t care. You don’t believe them. You’re not interested. It comes off as you just trying to distract them, and they can often tell.
Once you’ve connected and reassured, redirection in this example might sound like, “Let’s go have a cup of tea,” and then moving over to the kitchen to have some tea.
Notice that without the reassurance first, this could come off as quite dismissive.
If redirecting hasn’t gone well for you before, I walk through the common mistakes in how to redirect difficult dementia behaviors.
3. Reflection: Respond to the Feeling, Not the Story
The third R is my favorite. It’s reflection. You reflect back to them what they’re communicating to you.
A lot of the time, when someone with dementia is upset, it isn’t really based in reality. Like this situation, where a 92-year-old man who’s no longer working feels like he’s in trouble at work. Trying to respond to their words can be difficult and tricky, and it doesn’t make sense.
Some caregivers feel very uncomfortable going along with a belief that isn’t real. It feels like a lie. It doesn’t feel right.
This is where reflection really comes into play. The best thing we can do is let them know we understand what they’re saying, and just let them talk.
Think about being upset about something in your own life and talking to a friend. That friend can’t solve the problem or make it go away for you. So they let you talk. They sit there with you, as uncomfortable as it might be, and let you share what’s going on for you.
We can do the same for people with dementia.
A simple way is to reflect back the emotion you think they’re communicating. For the dad in that message, reflection might sound like:
- “That sounds scary.”
- “You’re scared.”
Notice we’re not agreeing with what he’s saying. We’re showing that we understand. And it does sound scary. If we were in big trouble at work, it would be a scary situation.
You can also simply say, “Tell me more,” and let them talk. This helps them keep talking about what’s on their mind and share their experience. I think we’ve all been in situations where simply talking about something, even if it couldn’t be fixed, was helpful.
If you’re wondering why a belief like his can feel so real, I explain it in why people with dementia remember delusions but forget what really happened.
4. Retreat: When You’re the Trigger
The fourth R comes directly from a Careblazer on my Instagram page. It’s retreat.
This can be especially good when the person with dementia seems agitated or upset toward you, and you are the trigger. It might sound like:
- “Excuse me, I need to go to the restroom.”
- “Oh, I’m getting a phone call. Excuse me, I’ll be back.”
If they’re safe to leave on their own for a couple of moments, simply removing yourself from the situation can be enough to help them calm down.
You Can’t Prevent Every Upset
Here’s something we all need to hear. No matter how amazing a Careblazer you are, and no matter how many tools and tricks you know, there is absolutely nothing we can do to prevent our loved ones with dementia from getting upset from time to time.
And sometimes, them getting upset isn’t a sign that we have to jump in and fix it. Sometimes we just need to sit there and let them feel it and express it, even though it’s uncomfortable for us knowing they’re upset.
I wrote more about this in why you should not try to make your loved one with dementia happy all the time.
That’s why reflection is my favorite. Use it with your loved one. But also use it with yourself.
When the upset keeps coming back, it helps to have people to think it through with. Inside the Care Collective, we meet every week in support rooms and Q&A sessions with me and other dementia experts, brainstorming the common challenges and working out the difficult, unusual ones together. You can learn more here.
