How To Best Manage Challenging Behaviors: Resources For Dementia Caregivers
Are you struggling with challenging behaviors in your loved one with dementia? You’re not alone. Many caregivers face the frustration of trying to understand and manage unpredictable behaviors.
In this episode, we tackle these common caregiving challenges with practical advice and biblical encouragement. Let’s break down some key questions about managing these difficult moments.
What is Normal Behavior in Dementia?
A common concern for caregivers is understanding what to expect as dementia progresses. The truth is, a person’s behavior during dementia is often a magnification of their pre-existing traits.
If your loved one was anxious before, their anxiety may increase. If they were calm, they may remain relatively peaceful until the later stages.
What many don’t realize is that dementia follows a backward progression, known as retrogenesis, where individuals slowly lose the abilities they gained in early life.
By seeing dementia as a reverse developmental process, caregivers can begin to anticipate changes and prepare for the future.
Handling Paranoia and Mood Swings
Paranoia and sudden mood swings are some of the most distressing behaviors caregivers face. These responses can stem from hallucinations or delusions. It’s important to remember that these are real experiences for your loved one, even if what they see or believe isn’t actually happening.
One key strategy? Don’t argue. Trying to reason with someone whose brain is changing will only cause frustration for both parties.
Instead, meet your loved one where they are emotionally. Focus on providing comfort and validation without trying to correct their reality.
Managing Sundowning: Practical Tips
Sundowning, or increased confusion and agitation in the late afternoon, can be one of the hardest behaviors to manage. Here are some real tips to make things easier:
1) Keep a routine – Consistency in daily activities and wake times is essential. Don’t let your loved one sleep too late in the day.
2) Get outside – Exposure to sunlight can help reset their body’s natural sleep-wake cycle.
3) Limit naps – Try to keep them engaged during the day so they aren’t napping too much, which can disrupt nighttime sleep.
Embrace Community for Support
Caregiving is tough, but you don’t have to do it alone. Lizette also emphasizes the importance of community.
Whether through a support group, church, or joining our online communities, surrounding yourself with others who understand your journey can make all the difference.
Are you ready to tackle caregiving challenges with confidence? Take these tips, and most importantly, remember that you are not alone on this journey.
By understanding your loved one’s behavior and making simple changes, you can create a more peaceful and manageable environment.
Ever Wonder How To Know What Is Causing Your Caregiver Stress?
Take Our FREE Caregiver Stress Assessment Today!
https://dignicarebydesign.com/quiz
Are You A Christian Dementia Caregiver Struggling To Cope With Caregiving?Join the FREE “Ask the Dementia Mentor” Monthly Meet Up! And be on the podcast, get support and your questions answered.
https://dementiacaregivingmadeeasy.com/ask
Read More:
Talking About Caregiver Burnout With Michelle Gordon
Check the other podcasts: https://dignicarebydesign.com/category/podcast/
Transcript
[0:00] Hey Christian caregiver, welcome to Christian Dementia Caregiving, the podcast where I teach Bible-believing Christians how to navigate dementia caregiving with practical help with a kingdom focus, as well as help you find hope for your caregiving future. This episode is brought to you by Think Different Dementia, where we create better futures for caregivers by building community around caregivers. And on that note, if you’re not yet a part of one of my communities, whether it’s subscribing to this podcast or subscribing to the YouTube channel, which is also Christian Dementia Caregiving, or joining my free Facebook group called Christian Dementia Caregiving, If you haven’t joined one of these ways of building a community around yourself in your dementia caregiving journey, then I invite you today to make sure by the end of today’s episode that you either subscribe to the podcast, hop onto YouTube and subscribe to the YouTube channel, or join my free Facebook group called Christian Dementia Caregiving. Because I really do notice the longer that I’m working with people in this capacity, and not as an occupational therapist anymore, but as the dementia coach, the longer I do this, the more I recognize that community is the key.
[1:25] Relationships are central to dementia and dementia caregiving. And doing a caregiving journey alone is where we set ourselves up for failure. So I invite you to join one of my communities so that you can start to get some real help, real practical community around you. And stay tuned for the future because coming up in October, I’m going to open up another free community that is off of Facebook because I, to be very honest, don’t like Facebook much at all. And I want to serve people.
[2:01] And I don’t feel like I can do that on Facebook. So stay tuned for that.
Community Support for Caregivers
[2:06] That’ll be coming up sometime in October, hopefully. But anyway, I decided to do a series of three question and answer style episodes
Understanding Challenging Behaviors
[2:15] to see how I can truly give you some practical solutions to some of your caregiving challenges. Today’s episode, I’m going to answer three questions on how to best manage challenging behaviors as a resource for dementia caregivers. So challenging behaviors. Now the new word for challenging behaviors is really called responsive behaviors, which to be perfectly honest, I hate the word challenging behaviors, but that’s the one that’s out in the world. That’s the one that insurance, you know, when you’re a therapist and you’re writing notes, you use the words, challenging behaviors. We’re starting to use the words responsive behaviors now. However, the reality is language takes a time to catch up. So because most people understand it in terms of challenging behaviors, I am going to interchangeably use challenging behaviors and responsive behaviors. So here was a question. What is normal behavior for someone with dementia and what should I expect as their condition progresses?
[3:27] That was a question that was asked by a person who was joining my free Facebook group. So that’s another avenue for you to get questions to me is through the free Facebook group.
[3:39] So we’re going to do three today. What is normal behavior for someone with dementia and what should I expect as their condition progresses? How can I handle paranoia and sporadic mood swings in a loved one with dementia? And what are the best strategies for managing sundowning? So those are the three questions we’re going to look at today. So what is normal behavior for someone with dementia? What should I expect as their condition progress?
[4:03] So here’s the question. What is normal behavior? Because I contend that our normal way of being our whole entire life, to a large extent, impacts and facilitates how we navigate our dementia care giving journey, our dementia journey, if we’re somebody living with dementia. What is normal behavior to start with, right? We are all sinners. We all transgressed God’s law every single day. We all have our own normal struggles and challenges and besetting sins from before.
[4:36] The difference is that when we are honest with ourselves as a Christian, we are able to a large extent to put a veneer over some of our deep thoughts, our normal, normal knee-jerk responses of anger or pride or stealing or any type of sin, cussing, whatever it is, when we are in our right mind, when we are not dealing with a broken brain, we have the ability to hide our sins from other people. We have an ability to put a veneer on it and kind of suppress press it somewhat, but those behaviors, those thoughts, those actions are always there. We’re redeemed by God and saved by him, but that doesn’t mean that we don’t struggle with sin. So what is normal behavior for a person living with dementia? It is whatever we would have been contending with, right? One of my biggest challenges or one of my biggest frustrations is that I do not subscribe to the philosophy that, uh.
[5:41] Dementia is unpredictable because we serve a God of order. And because we serve a God of order, there is order even to a dementia caregiving journey. There is order to the progression of dementia if you know what you’re looking for. None of us who have seen children growing up have any, you know, if it’s a normal child growing up, we know what normal person behavior is in a kid growing up. We kind of know there are little bits of differences. We have different abilities. we have different strengths, we have different weaknesses, we have different personalities, we have all these differences. But yet, a baby born with two arms, two legs, two eyes, two ears, and nothing particularly wrong with them, will eventually predictably turn into an adult person. And we know what that progress looks like, right? And we know what normal behavior for a child developing is. Well, normal behavior for a person living with dementia is normal human behavior. And so another way I describe challenging behaviors is normal human behavior magnified. So if the person was always an angry person beforehand, it’s likely that they’re going to be an angry person magnified when living with dementia. If the person was perhaps an anxious person beforehand, they may continue to be a even more anxious person as they’re living with dementia because that particular behavior is magnified. And so that’s the one part of the question. And then the second part of the question was, what should I expect as their condition progresses?
[7:10] The reality of the matter is, like I said, I believe dementia is very predictable because it follows the normal human progression from baby through to adulthood, developmental progression, but going backwards. That is called retrogenesis. Retro means back. Genesis means to the beginning. in it. So there is a philosophy out there. There is a framework out there that really talks about the progression of dementia following normal human developmental milestones, but going backwards, retrogenesis, back to the beginning. And I find that to be the most accurate description of what you can expect as a person’s condition progresses. So the way I teach people is I want you to consider.
[7:56] Most of us have seen young people grow up, babies grow up into adults, and we kind of know intuitively when a kid is safe to live alone, you know, to be alone throughout the day, when they can make a sandwich for themselves, when they’re ready to drive a car, when they are, you know, safe to decide the coursework that they’re going to take in college. We intuitively know these things. Now I want you to start to look at that whole process and use the spidey senses you’ve gut feeling and pay attention to the person who you love and who’s around you, because as they change, it is going to follow that same progression, just moving backwards. And so I really hope to help allay your fears somewhat if you’re afraid of what to expect.
[8:41] Because each person, yes, is different, but so is each child growing up. We all have different likes. We all have different dislikes. And those are the things that are the nuances.
[8:51] But that’s just because we’re human and we’re each person different to another person. We speak different languages. We have different cultures. We have different memories. We have different ways of doing things. It doesn’t make the one person right, the other person wrong. it just means that the way we are going to sometimes respond is because of some of these other things. But the progression of dementia is very, very predictable. So I hope that allays anybody who is listening, who is afraid because they don’t know what to expect. I hope that allays your fears. I know a few things about life in general. Number one is unless the Lord comes again, none of us are going to make it out of here alive. So we know that if it’s your husband, if it’s your spouse, if it’s your child, none of us are going to make it out of here. At some point or another, we are all going to, like I said, unless the Lord comes again, pass away. So we know that. The second thing I know to be true about dementia is that if we live long enough with dementia, we will need 24 hours supervision.
Managing Paranoia and Mood Swings
[9:50] I’ll say it again. If we live long enough with dementia, we will need 24 hours supervision. So we need to plan for that ahead of time. All right, so off my little soapbox, here’s the second question. How can I handle paranoia and and sporadic mood swings in a loved one with dementia. So paranoia is one of those things that oftentimes comes with a couple of things. It can be hallucinations or it can be a delusion. So what is a hallucination? A hallucination is a person actually seeing, smelling, hearing.
[10:20] Feeling, tasting something that isn’t really there. So they really see a person who is walking outside that isn’t there, right? That is a hallucination.
[10:32] A delusion is believing something that isn’t true, a delusion. Oftentimes, delusions are paranoid. A person has paranoid delusions. And the most common delusions in dementia, specifically Alzheimer’s, is my husband or wife is having an affair or somebody is stealing my stuff. Those are the two most common paranoid delusions people tend to have. So when a person is experiencing and living with dementia, one of the biggest, most basic rules that you need to start to follow almost immediately upon recognizing or realizing that the person is living with brain changes is not to argue with them. Not to try to reason through the fact that there isn’t something there or that nobody stole their stuff. Because guess what? You cannot reason with a broken. So when a person’s brain is changing, when their brain is changing, it means I have to change. I have to do things differently. Are you feeling stressed as a Christian dementia caregiver? Let me help. I offer a monthly dementia care audit to one listener of this program to provide you with personalized but evidence-based strategies from a biblical perspective. We only have one session available each month. Don’t miss this opportunity to make your dementia caregiving journey easier. Schedule your own dementia care audit today.
[11:57] So the first strategy I want to teach you today is not to argue with them, not to try to reason through and say, but no, that isn’t true, because they truly believe that it is true. They’re not lying. This is what they believe. It’s just like somebody who really believes that the green grass outside is blue. You can talk until you’re blue in the face. They are going to believe the green grass outside is blue because maybe they are colorblind, right? So do not argue with a person who has hallucinations or actually any kind of brain change. Just don’t try to reason with them. We have to find other strategies. And then related to the sporadic mood swings, what might be helpful for you to consider is exactly what the situation is, because it may look sporadic to you, but there might be something going on that is causing those behaviors. Typically, these responsive behaviors occur in five, one of five different ways.
[12:55] The first one is something is occurring with the person. So they’re tired or they’re overwhelmed or they’re hungry or they’re hurting or something is going on with that human that we can see and pay attention to to know that that is a specific trigger or a cause of the behavior or the responsive stuff that we are observing. The second thing is what is going on in the environment? Is it super, super loud? Is it super cold? Is it super hot? Is there a bunch of rugrats running around that aren’t there usually every single day that are causing these types of disturbances in the environment? So the person, the environment, the activity participation. So either is the person super overwhelmed because they’re bored out of their skull or there’s too much going on in the environment. So what’s going on related to activity? Activity or task participation. And then the third one is how am I as the caregiver.
[13:55] The care partner contributing to this? Am I super stressed and they’re picking up on my stress levels? Am I tired and I was snippy and I caused these things? So it spells out peace and the E is evaluate and educate, evaluate and educate. So what I would love for you to do is to start to pay attention to this peace frame, person, environment, activities, care partner, and then evaluate and educate, evaluate and educate. So real boots on the ground solution for you in order to be able to manage some
Strategies for Sundowning Issues
[14:29] of these responsive or challenging behaviors.
[14:32] Then the last question, and this one will be a little bit briefer because I really am trying to keep the episodes a little shorter for everybody, but what are the best strategies for managing sundowning issues?
[14:44] Now, sundowning is is one of those ones that really can be pretty challenging to try to work through. But nuts and bolts on the ground strategies related to sundowning is number one, routine is your friend. Do not allow the person who you are living with or taking care of, do not allow them to sleep until two o’clock in the afternoon. One of the biggest differences between facility-based care and And home-based care is that facility-based care has a very structured routine. And a very structured routine related to time of day when things happen help to keep the person living with dementia on track. So get out at the same time every single day, even if you had a bad night. Do not let the person sleep until 10 o’clock, 11 o’clock in the morning. The reality is sometimes we do this because that block of time is when we actually have time to get our stuff done. When we can do the laundry or the groceries or whatever, make them eat. But I really want you to not allow the person to sleep as late in the day, get them up every day at the same time, meals at the same time. The fabric of the life to be very structured and routine every single day, it will significantly help. The second thing related to sundowning is getting them in the sunlight, getting them outside. Sunlight in the morning on your eyes resets your circadian rhythm, resets your brain to know it’s daytime and it’s time to be awake.
[16:09] The third thing is do not allow the person to take numerous constant naps throughout the day, which means because they have lost the ability sometimes to initiate doing things by themselves, it means I need to come alongside them and help keep them engaged in their environment so that they’re not just sleeping. Yes, there’s a point in time when, as the person is transitioning into the later stages, that this is going to change. But typically when somebody is sundowning, they’re still pretty mobile. There’s still a lot going on related to being able to engage them in their environment.
[16:43] So that’s the third thing I would recommend that you do is really do not let a person nap. And then the last thing is is try to, a couple of other things that you can try. There’s a couple of lights that you can get, like blue light therapy that you can try in the house. What happens is it will help suppress melatonin, which means by a little later on in the day, you take the light away and then the melatonin, normal body’s melatonin production will increase and then it’ll help to have the person sleep a little bit later in the day. So sundowning is really, you know, lights, put in as much light as you can. There are a lot of reasons for sundowning, but those are just some nuts and bolts, boots on the ground strategies that you can try and see if they help some of
Conclusion and Listener Engagement
[17:28] these quote unquote challenging or responsive behaviors or normal human behavior magnified. I really hope you’re enjoying these more practical question and answer type episodes.
[17:40] I’m super excited about them. They give me a lot of fun to do because, you know, whatever questions you have, somebody else for sure has. Something I’m working on is going to be to get a way for you to send me a voice message with your own particular question on, and that we can try to get some more of the listeners’ actual questions on the podcast. And yet again, if you haven’t yet signed up for a one-on-one free 20 to 30-minute opportunity to ask your questions and be on this podcast, Send me the word audit, A-U-D-I-T, on Messenger or Facebook and sign up for an opportunity to have a conversation with me. I really am here to serve you, so that’s a way you can serve me. Another way you can serve me is share this podcast with other people that you know who are struggling as family caregivers, particularly if they’re Christians. And you don’t need to be Christian to listen, but my heart is to serve the Christian community. And I really do want this podcast to grow so I can serve more people in the world. And as I try, when I remember to end all of my podcast episodes, remember I pray for you every single day and that I pray that the Lord will bless you and keep you. And I look forward to seeing you in our next episode.
