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A Defensive Game Plan for Dementia Outbursts

It’s not just about forgetting or being confused.  If you have a loved one with dementia, it is also about the “three E’s” that can derail an already difficult day:

  • Emotional discomfort from medical or physical issues
  • Environmental factors from anything new or unexpected
  • Excessive responses to too much input.

Emotional Discomfort.  What may have been just the usual pat on the back or touch of another can become a stimulus that creates an agitated or angry response.  Think about everything a newborn experiences…all the experiences are, well, new.  In fact, most can get a negative response.  New clothing is too uncomfortable, being hungry or thirsty cause babies to cry, anything new can cause a baby to cry, lack of sleep makes us all cranky or anything new that is introduced can be uncomfortable.  Remember that every experience is going to feel new all over again, and it’s important to ease into everything.

Environmental Exposure. Remember, everything is new when a person does not remember the first experience any longer.  Loud noises don’t just get their attention…the doorbell, clutter, human interactions, room temperature or even mirrors that reflect them to themselves can alarm them.  Once you get to experience all of these stimuli then you’ll be better able to prepare your loved one as well as yourself.  What would we do in an alien environment where we had to learn what everything is all over again with each encounter.

Excessive Input.  Think of your loved one’s experience with conversation as the equivalent of a press conference after a natural disaster, and they haven’t been prepped by an assistant.  What would it feel like to answer questions about a flash flood or forest fire when it seems like everyone is blaming you?  Recognize also that your loved one with Alzheimer’s may sense that they are being blamed for something, that they sense anger from a stranger (and everyone is a stranger) or they simply don’t understand…as if it were aliens trying to abduct them from this planet.

Some basic operating rules to help you and your loved one navigate the world together:

  1. Don’t challenge the misinformation or delusion; just let it go and change the subject.
  2. Don’t make it complication by explaining…just encourage them to have a seat.
  3. Employ distraction like a favorite piece of music or maybe a TV show from MeTV.
  4. Get help to keep yourself grounded…a counselor for you, daycare for your loved one.

And remember that for all of these experiences that may not quite end they way you would like, you get a chance to get it better tomorrow.  And you can learn from what works and what doesn’t in order to make the next issue for your loved one … a non-issue.

Charlotte Bishop is an Aging Life Care Advisor, Geriatric Care Manager and founder of, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families in metropolitan Chicago.  She also is the co-author of How Do I Know You? A Caregiver’s Lifesaver for Dealing with Dementia.


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