5 Strategies Effective Dementia Caregivers Use During Challenging Situations

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By Valerie FeurichMay 5th, 2021

5 Strategies Effective Dementia Caregivers Use During Challenging Situations

How to calm and diffuse the situation when you’re caught off guard
Original article by Teepa Snow, adapted by Valerie Feurich
Caring for a person living with Alzheimers disease or another form of dementia can be full of surprises. When dementia sets in, the brain undergoes chemical as well as physical change. As a result, the way a person perceives their environment is altered.  

A person’s visual field, for example, will change dramatically as the disease progresses, causing changes in behavior and possibly surprising reactions to your efforts to help. In addition, the person’s ability to comprehend spoken language or to correctly identify and express unmet needs may also decrease, which can result in a lack of understanding or agitated behaviors.

So, what can you do as a caregiver, or care partner as we prefer to call you here at Positive Approach to Care®, when you’re surprised and caught off guard by the person living with dementia? Below are five tips used by effective care partners to help you overcome challenging situations:
1. Take a step back
When an interaction isn’t going well, you have a choice – you can push your agenda and watch things get worse, or you can step back and take a moment to think. The person may have an unmet need that they are unable to express. Or, in your effort to be helpful, you may have unknowingly upset them.

As an example, did you make sure you were in the person’s visual field when you approached them? Did you use the Positive Physical ApproachTM to get permission to come near them? Many times, when we’re trying to help, we don’t take into account how we may be perceived by a person with a changing bran. Yet, not taking into account the person’s changed perception can backfire. Keep in mind that the person living with dementia is doing the best they can.

Instead of being a judge, try to be a detective. Remember that your brain likely works better than theirs, so try to take a step back and assess the abilities of the person in your care. See if you can figure out what may be driving their reaction. What are you seeing? What are you hearing? Could they have an emotional or unmet physical need? Try to see the situation from their point of view, and see if you can figure out what may have upset them in the first place.
2. Respond, don’t react
What you thought would happen, didn’t happen. The person living with dementia did not react the way you expected or wanted them to. It can be tough to stay calm when you’re surprised or caught off guard. You may be feeling frustrated, maybe even angry. What can you do?

First, stop reacting. Stop trying to correct, stop pointing out errors, stop trying to fix things. Stop raising your voice, stop pushing, stop saying Remember? I already told you. Don’t argue with them; it will not help the situation.

Instead, do use the words they have given you. How? Repeat back to them what they have said to you. Why? This technique, reflective, narrative language, helps the person living with dementia feel like you got their message. It helps you both acknowledge and validate what the person is feeling.

Remember that it isn’t about being right or wrong. The sooner you can let go of that idea, the better off you’ll be. Instead, take a deep breath, and say I’m sorry, you’re right, or maybe I’m sorry, I was just trying to help. That way, you increase your chance of calming the situation while safeguarding your relationship.
“Apologizing does not always mean you're wrong and the other person is right. It just means you value your relationship more than your ego.”  - Mark Matthews
3. Make plans, but expect them to change
Having plans in place can help you manage your daily care activities. So, create a plan, think it through, and get organized.

However, make sure you also stay flexible. If your plan isn’t working, don’t try to force it. Your plan is part of your agenda, and not theirs. Instead, be willing to let that plan go, and try to have some alternatives ready (your plan B, plan C, and plan D). Stay flexible, and figure out where to go from here.
4. Figure out what you can and can’t control
It can be hard to let go of how things once were, or to see the person you may have known for a very long time change before your eyes. As hard as it may be, try to acknowledge these changes, and realize that you can’t control them. You can’t control their dementia or the person’s past (who they’ve been and what they like). You can’t control, fix, or change the way they may react to certain situations.

However, what you can control is the person’s physical and sensory environment, such as the objects they use and how they spend their time. Try to pay attention and see if you can figure out what makes them feel valued and important. When do they relax and build energy?  How do they spend their day?

The other thing you can change is your approach. You can try to remember that a person living with dementia may perceive their environment differently and that it is you, the one with a healthy brain, that needs to change. You can build your skills and knowledge to be able to respond better in the future.

Change what you can change. Let go of the rest.
5. Take care of yourself
When something you tried to do didn’t work, when you’re getting frustrated or angry, consider taking a timeout for yourself. Why? Not only does anger, frustration, or despair negatively impact you, but the person you are caring for is likely to pick up on it and react to your stress level.

Instead, step out of the situation. Take at least three deep breaths - breathe in and out, deeply! Breathing deeply will help you get back to neutral, lower your emotional level, and help you regain perspective.

Don’t hesitate to ask for help. This is hard work.
Caring for a person living with dementia can be challenging. As the person’s brain changes, not only is their perception altered, but their ability to comprehend spoken language and to correctly identify and express unmet needs also decreases.

If you do not consider these changes, you may find yourself at the receiving end of a surprising reaction to your attempt to help. If that happens, try to take a step back so you can collect yourself and respond instead of reacting.

Realize that your plans may need to change and that you’ll want to try to stay flexible. Stop trying to control what you can’t, control things you can change, and let go of the rest. And most importantly, remember that you can’t pour from an empty cup; take care of yourself.
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20 Comments on “5 Strategies Effective Dementia Caregivers Use During Challenging Situations”

  1. Thank you for this post. I need to read it at least once a day! So hard not to be in control or able to “fix” my dear husband. So hard to watch him slowly leave…

  2. Appreciated this article today. It has given me the tools to deal with the unpredictable days with my Dementia clients. I had day like no other recently and caught me off gaurd. Good to know I’m not alone and emotions can run high. I will stop, take notice, positive and reflective reinforcement and breath.
    Hope to be a better companion, care giver…

  3. I’m so grateful for my sister, Donelle Clarke, for sharing Teepa Snow with me. I always go to my sister with any medical needs my husband and I go through. Reading through Teepa Snow’s information has helped me to help my husband.

    So now you both are my go to people!

    Thank you so much for your wonderful words of wisdom!

  4. Thanks this is very helpful. I just ran into a different response last night. Good to stop back to prevent reacting.

  5. so you’re hollered at to come NOW, when your hands are full of batter, and you have to drop everything and go run. the partner yells loud when you’re far away [thank G], but when you’re right next to them, they do not even open their mouth as they think they’re telling you what they want. you hear a low hum, and you see the lips compressing …but not opening, and definitely no words are coming out. so you try to guess: did you say X? Y? so your ‘partner’ suddenly can talk loud enough to tell you he’s gonna BASH you if you don’t mmmmmm. so you guess again, and he flails at you, and you have to back off…finally you make a wild stab, and apparently t was right, and you do what you suggested. and looking at his face you can see him thinking ‘see! she did too hear me!’ which then reinforces his belief that slugging you [or offering to ] is the answer. this does not sound like a win win situation.

    1. Hi,
      My name is Alejandro and I work for Positive Approach to Care as a mentor. Thanks for taking an interest in the content. This seems like a situation that would be tricky to deal with at the very least. If you are looking for some support with your situation we have free half hour consultations with out consulting team members. You can sign up for a consultation by using this link. https://teepasnow.com/services/consulting/phone-consultations/

  6. This has been very helpful.
    I would love to have some suggestions about how to encourage my husband to shower, shave and change his underwater more often. He is now in a memory unit and the staff at this point isn’t skilled to know how to deal with these issues. He has oily skin and needs to shower more that twice in 7 days. Also not shaving or washing his face is beginning to cause skin problems. Any suggestions would be greatly appreciated.

    1. Hi Bonnie,

      Thanks for leaving the comment, we appreciate you taking an interest in the content. We would love to offer suggestions for your situation. We have a couple of different ways that we can try and help.

      We offer free half hour consultations with a person from our consulting team, you can sign up here. https://teepasnow.com/services/consulting/phone-consultations/

      If you are interested in interacting with Teepa about the situation we also offer “Ask Teepa Anything” or “Dementia Problem Solving” as an option for you to interact live. https://teepasnow.com/services/online-learning__trashed/webinars/

      We also have recorded webinars that are available for purchase if you are interested in watching something related to the topic. https://teepasnow.com/product-category/online-video/webinar/

  7. I have a patient very hard to take care of her, strong caracter and personality, very aggressive and apathetic. It’s very important to me always getting your advice. Thank you very much. I learned a lot and continuing learning.

  8. I wish you could buy “patience”. I would need a full time job to pay for the deposits I would make. This article is very timely and gratefully appreciated.

  9. I was able to get a better understanding of what people with dementia need as well as how to deal with them in difficult situations. I know that I need to remain calm and respectful of their decisions and my plans can always change at any time or moment.

  10. Hi my name is Lamija and I m currently working in assisted living so this artical will be really helpful for me so thank you so much I will try to read this each day.

  11. Hi my name is Lamija and I m currently working in Assisted living this will be really helpful for my work,theese are really good information and I will try to read this each day.

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