The Greek philosopher, Heraclitus, is credited with saying, “The only constant in life is change.” For most of us, this reality is just a part of normal, everyday life. Some of us even thrive on change. But for individuals living with a form of dementia like Alzheimer’s disease, change is not something that is enjoyable – in fact, it can be downright earth-shattering.
“People who are living with dementia comprehend change in a different way than those of us with healthy brains,” says Chrissy Ross, Executive Director of Bridges® by EPOCH at Mashpee. “Changes that we may not even notice can cause them to exhibit disruptive behaviors like anxiety, aggression or stress.” Since these individuals are already dealing with so much change in their lives, says Chrissy, it can be almost like an allergic response – the smallest things will set them off.
The reason that change causes such a reaction to those with dementia are partly physical but mainly psychological. Experts at the Mayo Clinic and Alzheimer’s Association® state that disruptive behaviors due to changing environments are an individual’s way of trying to make sense of an increasingly terrifying and confusing world.
“In many ways, it’s very similar to a young child who is experiencing change for the first time,” says Chrissy. “When you don’t understand what’s happening around you, and you feel like you have no control over the situation, it can be very scary. Your loved one may be lashing out because it’s the only way he or she can gain some sense of control over what’s happening – no matter how illogical that may seem to you.”
Unfortunately, there’s no way to organize your or your loved one’s life in a way that doesn’t require them to change environments. You also can’t always know or anticipate when a changing environment will set your loved one off. It’s not always as straightforward as moving to a new place, or going to a hotel or being admitted into a hospital. Behavioral challenges could also be triggered by:
- Making changes to their current environment, such as getting new furniture, painting the walls or even rearranging the existing furniture
- Changing their daily routine, or changing caregiver arrangements
- Having guests over
- Changing their clothes or being given a bath
As you can see, “environmental changes” can really run the gamut, and there’s no way to avoid them. So how can caregivers be proactive and find ways to manage and reduce stress-related behaviors when a loved one’s environment needs to be changed? Here are some suggestions from the Alzheimer’s Association®that can help both individuals with dementia and their caregivers navigate change in a healthy and calm-as-possible way:
Do your best to create a relaxing and calm environment. Dementia makes it difficult for an individual to “filter” stimuli, which can result in an environment being completely overwhelming and chaotic. Make sure your loved one’s environment is as calm as possible. Remove clutter and get rid of any stressors (such as mirrors) that could cause trepidation or anxiety. Evaluate whether the situation is too chaotic or loud (is the television or radio on? Are multiple people having conversations?) and adjust accordingly. Finally, do your best to remain calm yourself. Don’t raise your voice or otherwise crowd your loved one. Try and move him or her to a quiet space to allow them to calm down.
Whenever possible, avoid triggers that can induce stress. Every individual can have different “triggers,” so it’s important for you to know what may cause issues for your loved one. Crowds, background distraction, glare and general noise can all be triggers, so be on alert.
Check your loved one’s personal comfort. It’s possible that your loved one may be acting up due to personal physical factors. Make sure they’re not too cold or too hot. Ask if they need to use the bathroom. Check to see if anything is causing them pain, or they’re hungry or thirsty, or if they’re simply tired. It’s also possible the behaviors could be due to an infection, illness or even a side effect of their medication.
Have a security object on hand to help reassure them. If your loved one is distressed, give them a favorite item like a security blanket, a stuffed animal or anything else that brings comfort to your loved one with dementia. At the same time, speak to them using reassuring language, saying things like, “You’re safe here,” “I’ll stay here until you feel better” or “I’m sorry you’re upset.”
Make sure your loved one gets enough exercise. Unwanted behaviors can sometimes be triggered if your loved one is bored or not getting enough physical exercise. Find some time to exercise every day, whether that’s taking a walk together, doing something physical like gardening or dancing or something else that your loved one enjoys. Exercise provides many perks besides helping minimize unwanted behaviors, too.
Use redirection techniques. Redirection is an oft-used tool that can help caregivers get their loved one’s mind out of their current situation and onto something that’s calming and reassuring. If your loved one is acting out, play some calming music, or bring out an old photo album or otherwise redirect their attention so they’re focusing on something constructive.
Make sure your loved one has enough social stimulation. Staying social is good for our health. Researchers have found that staying socially active can help reduce depression and stress and even improve cognitive function. Make sure your loved one is participating in activities that they enjoy. Another option to make sure they’re getting enough social interaction is to look into adult day care in your area, so that your loved one can be around others while still receiving the attention they require.
Remember that it’s not their fault. It’s easy to get frustrated with your loved one when he or she acts up due to environmental changes. Still, remember that he or she is not acting this way on purpose – it’s due to the nature of their disease. By recognizing the cause of the behavior and realizing it’s not “personal,” you may be better equipped to handle the situation with grace, compassion and efficiency.
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