For people living with Dementia, coping with stress is no simple matter. Feelings of fear or anxiety won’t always manifest themselves in clear and apparent ways. Making communicating these feelings even more difficult.
So, when they require hospital treatment for other conditions, it’s unsurprising that they may feel anxious or stressed, that’s natural. But understanding how they express these feelings is key to helping make their treatment more successful.
So what should you be looking for and how can you help?
This can be shown in many different ways, anything from being unable to settle or sleep to becoming irritable and aggressive.
The behaviours themselves are less important; it’s really what they signify that matters. If your patient is experiencing periods of restlessness, it’s probably an indication that they are anxious about something.
The key to managing this is identifying the cause of the anxiety and not the behaviours stemming from it; these are merely just a signpost to the problem.
By recognising these reactions, you are more able to quickly help offer the reassurance the patient requires under these unusual circumstances.
The actual solutions themselves can be anything from adjusting the temperature or their diet to finding activities that allow them to relax or feel more comfortable. So it might take some time to locate the root causes, but you can use these restless behaviours to help point you in the right direction.
When stressed, many people with Dementia can become restless and wander. Which on a hospital ward may not be ideal, as often it will mean they will need more attention than your other patients.
The problem is exercise and walking are a great aid for alleviating these feelings. However, if left unsupervised, some patients can wander off and not know where they are.
But this doesn’t mean they shouldn’t be allowed to walk or exercise. Instead, you could accommodate this by bringing in support, such as Dementia Support Workers, who can help support and supervise these patients during their treatment on your ward.
By offering this additional assistance, you reduce the patient’s stress and also their risk of injury or accident, which will all help aid their recovery.
For those who live with Dementia, a routine can often provide a great amount of comfort. So anything that affects this can have a great impact.
Attending hospital doesn’t fit into anyone’s routine, and for those with Dementia, this type of disruption to their routine can be particularly disturbing. It can, understandably, make them anxious, particularly towards the end of the day as they begin to tire.
This is known as Sundowning. No one’s entirely sure why this part of the day is most affected, but it is. So what can you do to help alleviate this?
Routine and familiarity are key. Try to retain as much of their normal routine as you can throughout the day. And for what you can’t accommodate, have a plan. Whether this is extended activities, changes in diet or whatever. It’s simply about creating an environment and conditions in which they feel as safe and secure as they can outside of their own homes. For more information regarding Sundowning read our blog HERE.
Activities, both mental and physical are great tools in helping those living with Dementia feel at ease. Often keeping busy can help distract them from the unfamiliarity of their surroundings.
The type of activities will depend on the person, but some simple ones that have proven effective are things like walking, reading and so on.
One way to judge is to speak to the person and their family about their usual routine, as the more familiar the activity, the better.
For those living with Dementia while receiving treatment, diet is extremely essential. Not only do they need to be eating the right foods, but they also need to eat. Some people can forget that they need to eat or drink.
So it’s important that food and drink become as much a part of their daily routine as everything else. It will them remain settled and focused, but will also contribute to their recovery.
This might mean speaking to their family about what foods they can or will eat, and when they usually eat. It’s not always as simple as serving them the usual meals found on the ward.
They also may need further assistance. This doesn’t necessarily mean feeding; instead, it could be company or consideration over how you serve the food. Helping them retain their independence is vital, so it’s about finding a balance between what assistance they need and what you can offer to help them remain calm and happy.
This can for some patients be a great cause of frustration and distress. The key is to offer as much assistance as the person requires. Don’t assume they need dressing, instead be on hand if needed and try to let them do it for themselves. Remembering to give them the space and time they require, and not being pushy or rushing them.
Paranoia is often an unexpected behaviour to experience when dealing with those living with Dementia. Situations you might believe are easily explainable can cause them to become suspicious of those around them.
As with other behaviours, the surface causes of these actions are not necessarily related to the root causes. So if a patient has concerns about those around them, it may just be an indication that they have genuine concerns, just ones that they can’t clearly grasp.
The key thing to remember is not the reality of the concerns they’re expressing, but just how real they are to the person. For those experiencing them, they are incredibly real.
So treat them as such. This doesn’t mean investigate them, but instead, deal with the person’s concerns sincerely, and offer them support and reassurance. You can find more about dealing with the causes of this kind of paranoia HERE.
This isn’t as common and usually, tends to affect people in the more advanced stages of Dementia. These visions can be anything from seeing things that are simply not there, to even believing they are in danger.
It’s a challenging behaviour to manage, and the only thing you can do is try and calm the person. Tell them calmly what is happening around them. DON’T get drawn into an argument and remain reassuring and calm throughout.
When appropriate, moving the discussion onto a different topic and other gentle distractions may help divert the patient’s attention and calm the situation.
Remember, at all times, your support and reassurance is so important.
For some people living with Dementia, stress can cause them to act out of character in seemingly inappropriate ways.
These could be anything from sexually inappropriate actions (lewd remarks, undressing and so on) to more aggressive reactions.
Always remain calm, and never take it personally. These behaviours are merely a reaction to the anxiety that they are feeling.
Speak to them directly, be reassuring and try to redirect their behaviour to something else; whether this is an activity or topic, etc. It’s key to remain calm and never make them feel embarrassed or threatened because of actions over which they have no control.
This is true for any of the above behaviours. They are not deliberate in any way, and cannot be helped. It’s down to those caring for those living with Dementia when in hospital to help support them through these moments.
By identifying these behaviours and providing the patients with the support they need to help with their anxieties about their treatment or surroundings, you are helping aid their recovery.