Monday, February 20, 2012

Improv - Making the Best of Dementia Behaviors

What I have learned in dealing with unusual behaviors is to just roll with them. I see it like improv, where I react to whatever’s happening with the openness to work through it cheerfully. Fortunately the behaviors my grandmother exhibits are rather mild, so it's not difficult to work through. If my grandmother doesn’t remember something, I say “that’s okay” and move on to something else. Positivity is key.

I also use other methods of communication like showing her imagery and photographs, making eye contact, smiling, patting her hand or arm, and including her whenever possible. It has made the entire difference for my own visits lasting a pleasant 4 to 5 hours, while my mother, who doesn’t utilize these methods, having less tolerable, even frustrating, shorter 30-minute visits.

While visiting my grandparents at their care facility, I noticed several behaviors of my grandmother’s that were unsettling, but possible to work though.

1) Slapping the table repeatedly
My grandmother often slaps her hand, palm flat, against the table. She does this several times in succession. My mother finds it annoying and usually tells her to stop doing that, but of course that does not help.

While I was there, visiting with my husband and mother-in-law in tow, my grandmother did this slapping the table behavior mostly during our conversations. It seemed to me at the time, and now confirmed after this week’s readings, that she must have felt left out of the conversation with the 4 of us (my husband, mother-in-law, grandfather and I) carrying on a normal conversation, and my grandmother unable to jump in, must have used this noisy action to break in to the conversation.

My method to comfort her was to make eye contact with her and smile. If I was sitting close enough to her, I would also pat her hand. This seemed to calm her behavior for a bit, but the slapping would return as soon as our conversation lingered too long without her.

2) Interjecting “Bye Bye!” while waving (in the middle of conversations)
Another behavior during others’ conversations is that my grandmother will interject loudly, “Bye bye” while waving us away. I see this also as another way to break into the conversation.

My method for this behavior is to smile, make eye contact, and let her know we were staying a while longer. My grandfather usually shakes his head in frustration, but he doesn’t correct her as much as he used to thankfully.

3) Half sentences

While I was describing the delicious pancakes my grandmother used to make from scratch, she shook her head and waved her hand interjecting “Too much! Too much!” I tried to help her answer this thought more fully by offering, “Too much food?” or “Too much work?” She said, “work”, so we settled on that.

4) Unable to Communicate Food Preferences/Needs

While eating with my grandparents at their care home, my grandmother said she wasn’t hungry, then proceeded to pull French fries, pickles and strawberries off the nearest plates. Since the whole table was family, it wasn’t a problem. Still, I wanted to make sure she got enough to eat, so I cut my sandwich in half and give it to her (she took one bite and didn’t want it). So then I offered her more of the same items she was preferentially picking (finger foods like fries, grapes, strawberries, and pickles) off husband’s plate, then my mother-in-law’s plate, and finally sending my husband to bring her a whole plate of food.

5) Difficult Phone Calls
On her last birthday in November, she relayed to me that was not her birthday that day, but that her birthday was not until next September. I knew better than to correct her; I just said “Oh okay.” However, when she then asked, “Now who are you? Mom or dad?” I have to admit, I was thrown by this question. I wasn’t sure how to respond. As much as I read up on Alzheimer's and dementia, there still so much more to learn. The disease fascinates and amuses as much as it discourages and disappoints. It continues to grant me opportunities to learn something new.

1 comment:

  1. Hey there! . . . when she says Mom or Dad, how about saying "Who would you prefer?". . . there is such a fine and special line ethicists draw between the negativity supporting a so-called delusion and the creativity of dreaming together with someone. With my father, I just imagined we were dreaming together, after all, i am my mother, my father, my grandparents and just about anyone my dreaming life sends me, why not bring that into daily life too?? So, alone, i would go with whatever she is dreaming. It's generous, detached, creative. Let me know what you think . . Susan

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