How to Respond More Positively During Surprising Events in Dementia Care

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By Valerie FeurichSeptember 23rd, 2021

How to Respond More Positively During Surprising Events in Dementia Care

3 Strategies for Creating Better Outcomes When Unexpected Situations Arise
By Valerie Feurich
Have you ever been surprised by a person living with dementia? Chances are, if you are a care partner, you answered yes. And even more likely, you thought something like Once? I get surprised all the time.

Truth is, if you’re caring for a person living with dementia, like Alzheimers disease or other forms, you’ll likely encounter surprising situations frequently. As the brain’s cells begin to shrivel and shrink, transmission of data from one cell to the other no longer works as it once used to. This will change a person’s abilities and reactions, leading to situations you may not have seen coming.

So what can you do to better prepare yourself for these unpredictable events? Here are three things you can try:
1. Respond with curiosity
A cork board with letters on it spelling the word curiositySo, a situation did not turn out as you expected? The person living with dementia did something you did not see coming? As hard as it may be, if it’s not a dangerous situation they’re in, try going with the flow.

We know it can be really difficult to get out of the habit of immediately saying the first thing that comes to mind. Yet, realize that the first thing that often innately gushes out can sound judgmental or annoyed. Neither will help the situation. Instead, see if you can take a deep breath, and respond with wonder, rather than panic, anger, frustration, or judgment.

As an example, if you found your person living with dementia standing naked on the porch, instead of exclaiming Oh my god, dad! Why did you take your clothes off?, try saying Oh wow! You took your clothes off. Were you hot, or something else? You know what, it’s nice and cool inside. Let’s go (adding a hand gesture to follow you).  

By responding with curiosity instead of judgment, you’re not only less likely to make the person in your care feel bad, but you’re increasing your chances of figuring out what might have triggered their actions in the first place.
2. Use interjections
An image of the word "wow" on a paper cutoutWhat is an interjection? It’s a word or phrase used in exclamation, which can be used to interrupt or redirect a conversation. Now you may be wondering: How does that help me in dementia care?

In its simplest form, using an interjection like Oh, wow!, Wooooow…!, or Whoa!, gives you both a moment of pause. For the person in your care, your exclamation of Oh, wow! is likely to create curiosity, and can even get them to pause what they’re doing. By showing wonderment instead of panic, you’re less likely to make the situation worse. In fact, saying Oh, wow! is an open gesture to start a conversation that may help resolve the situation.

Using an interjection gives you a pause and an opportunity to collect your thoughts. It increases your chances of responding in a more thoughtful manner, and not just impulsively reacting to the situation at hand in a way that could harm your relationship going forward.

Additionally, holding your breath in a moment of surprise creates carbon dioxide, which triggers your brain to think there’s danger. So, by saying Oh wow! you’re actively exhaling carbon dioxide, reducing the chance of triggering your brain’s protective mechanism. Next, you’ll then need to take another breath, thereby supplying your brain with fresh oxygen. And by not allowing your brain to go into danger mode, you’ll be much more likely to respond to the situation, instead of merely reacting on impulse.
3. Use reflections
Reflecting, or mirroring, is a communication technique that can help calm an anxious or upset person living with dementia.

To try this method, reflect back or rephrase the last few words that the other person has just told you.

In addition, try to match their tone of voice. It might feel more natural to try to use a calm soothing voice, but do you like being told to calm down when you are upset? Reflecting their words and their tone of voice (though just under their level) allows your person to feel heard and that you understand their feelings.

As an example, your conversation could go something like this:

  • Valerie: “This isn’t fair, none of this is fair.”
  •  Teepa: (in a similar but slightly calmer tone) “You’re thinking this isn’t fair?”
  • Valerie: “Yeah! None of this is fair. I didn’t do anything.”
  • Teepa: (in a similar but even calmer tone) “It doesn’t feel fair, and you don’t like that.”
By reflecting the last few words the person told you, you’re signaling that you’re hearing what they said. And by reassuring that you heard them, they’ll be more likely to feel like you are there for them.
An image of a happy looking senior in a wheelchair with his familySimply said, Dementia = Surprises. Unexpected situations are likely to arise frequently on your journey of dementia, and how you respond (and not react) to the situation can make a big difference. By responding with curiosity instead of judgment, by using interjections to give you both a little pause, and by reflecting your person’s words to help bring calm to the situation, you can choose the path with a greater likelihood for a positive interaction and outcome.

Yes, habits can be hard to break, but realize that you just successfully crossed the first hurdle. You took the time to read through this entire post, hopefully leaving you with greater awareness than when you first arrived on this page.

As author Jim Kwik explains, first you create your habits, then they create you. You may struggle with implementing these tips at first, but the more you try and practice, the greater the likelihood that you’ll succeed. Better responses increase your chances for a more harmonious interaction, protecting the relationship that you two share. That’s worth the effort, isn’t it?
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Interested in learning more about this topic?
Listen to Teepa Snow's Dementia Care Talk Show podcast episode #111 below:
Wish you had a tool to help you
resolve awkward public situations?
Teepa Snow's Companion Cards Can Help!
How do they work?
If you’re experiencing an unexpected or awkward situation, discreetly hand one of these cards to the person near you to help them understand the situation.
Learn More >>

One Comment on “How to Respond More Positively During Surprising Events in Dementia Care”

  1. These are such good tips.
    My husband was diagnosed with Alzheimer’s in 2017 and died in 2019.
    I had accidentally come across one of Teepa’s videos while trying to find help.
    It really helped me and my family to deal with this awful disease.
    We had been married 53 years, and there were times he did not know me.
    He would look at me and say, “Where is my wife?”
    And because of Teepa, “ I would say, “ Let me go find her.”
    I would go outside, come back in, and he would say, “Where have you been.?”
    Difficult situation was diffused.
    Thank you so much.♥️♥️

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