Like many dementia care partners, I spent years arguing with my mother and exacerbating no-win situations before I became aware that debate only created more anger and angst. By arguing, I became the cause of her “bad behaviour.” It wasn’t the disease, it was me; it wasn’t her fault, it was mine. Had I put myself in her shoes, I would have saved us both a lot of aggravation.
BANGS is an acronym for five ways anyone can use to avert and defuse conflict with people who live with Alzheimer’s dementia and other kinds of dementias.
“A” is for assess, accept, and agree.
“G” is for go with their flow, let go of your ego, get over it, get on with it, get down to it
This post is about never, never arguing. Arguing with someone with dementia gets you nowhere. It just adds to everyone’s frustration and creates an environment where more conflict is likely to occur. Imagine this conversation at a family dinner:
“His hair was jet black when he was little,” the person with dementia (PWD) says about his grandson.
“No, it’s always been brown,” the boy’s mother counters.
“No it wasn’t. It was black,” the grandfather with dementia shoots back.
“I’m his mother, I should know,” the boy’s mother’s voice rises an octave or two.
A heated row ensues over the colour of the boy’s hair, which has always definitely been brown, not black. But who cares? The argument could have been averted had the daughter simply agreed with her father about the colour of her son’s hair.
This tendency to argue is not confined to “natural” care partners. Many paid care workers in institutions such as long-term care facilities, nursing homes, and hospitals are unaware they create problems by the way they talk to and treat people with dementia. Imagine this scenario:
“That’s not yours honey,” the caregiver says as she tried to pull a small object from an old woman’s grasp.
“It is so. It’s mine!”
“No it’s not!”
“Yes, it is!”
“Give it to me. NOW.”
“NO.”
The old woman with dementia slaps the caregiver on the arm as the caregiver yanks the object away.
If you think it sounds like kindergarten gone bad, you’re right! That’s just what it’s like, and situations like these are why many people with dementia get branded “aggressive” and “violent,” and why far too many are given harmful and largely ineffective anti-psychotic drugs.
We have the power and the responsibility to change these responsive behaviours by changing how we behave ourselves.
The minute care partners stop arguing with their loved ones and others they interact with who have dementia, things greatly improve. I know it from personal experience and there’s stacks of research to prove it.
Dementia communication is perhaps the only place where that old cliché about “never say never” never applies!
Don’t want to end up in a “shoot-out” with a PWD? Use BANGS. The full 50-minute webinar is here:
See also: Teepa Snow demos 10 ways to calm a crisis with a person with dementia
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Hello Susan,
can you tell me what the G and S stands for in BANGS. If its ok I would like to put this up in my activity corner where I work, to remind people and help them to remember to breathe and keep calm when a patient is frustrated or angry about something.
Thankyou Jo
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Hang tight Jo, you gave me an idea. How many people in your workplace?
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Hello,
I work in a hospital and im the only activities coordinator. Besides me there are nurses, health care assistants, physios, occupational therapists,house keeper, ward clerks, sister, matrons and doctors.
Kind regards Jo
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Okay Jo,
I’m working on the G & S posts which I will release over the next couple of weeks. I will also do a small “poster” for you to pin up if you can be a little patient with me 🙂
How many employees does the hospital have in total? Is it for the elderly only? Is it a memory care / dementia care hospital?
Regards, Susan
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On my ward which is caring for long term conditions 50% of my patients have alzeimers/dementia. I have 18 patients that I look after. A poster sounds great. I will say goodnight now as I have a early start tomorrow. Thankyou for replying and I look forward to your posts.
Kind regards Jo
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18 patients on my ward. Long term elderly conditions. 50% of my patients have alzeimers/dementia plus other conditions such as copd, parkinsons, learning disabilities, cellulitus,
Uti’s.
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Excellent advice Susan. It’s so easy for us to forget this simple technique but I can see how it can really have an effect on the situation. We’ll keep working to get the anti-psychotic drugs out of dementia care 🙂
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Thanks and damn right we will!
They may help for a small percentage of people with dementia as our friend Michael has experienced with his partner Gregory, but for many including Mom they are unnecessary and harmful.
Thanks for helping me achieve what would appear to be the purpose of the last chapter of my life ❤
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My mom and I argued for decades, but we stopped when she was diagnosed. We no longer sweat the small stuff. It no longer bothers me when she gets details wrong or different from what I remember. I’m just so glad to finally have a loving relationship with her these days. Thanks for putting this all out in the works!
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I think and feel you are so much more at ease with your mom now than when you first started following and commenting here Heidi.
I’m so glad you have found more peace and healing ❤
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Little thing, so you are in charge ? it may be me but I thought we were looking beyond dementia and actually at the person,their thoughts and the moment they are in, so what are you arguing about and why?
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Well, I’m not sure I understand your comment/question, because the whole idea is NOT to argue and I think it’s quite well explained in the post and there are two examples to illustrate…
But here’s another one: the other day I happened to overhear a conversation between a nurse and a person with dementia (PWD). The PWD said: “It’s getting late, it’s dark out, I need to go to bed.” The nurse responded: “No you don’t, it’s the middle of the afternoon.”
Small incidents like this may happen many times a day.
The care partner who does NOT have dementia has more control over his or her own behavior in the situation than the person with dementia does. The idea is to go with their (i.e. the PWD’s) flow rather than to lock horns.
Does that make it any more clear, or is it worse? Or somewhere in between LOL?
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I find all these posts very helpful. My husband is experiencing most of these things as his Parkinsons.It has helped me understand and interact much better,Thank you SO much Susan/ You are amazing.
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Thank you so much Beulah.
I’m glad the posts are helpful and that you are able to use them to make things easier on yourself and your husband.
Thanks for everything you are doing for him, and for commenting on the blog – you are also amazing!
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I am a hospice chaplain. Many of our patients have dementia and are in group homes. Would love to get posters to hand out as an in-service or put up! Need the info in my own home too! LOVE BANGS, especially the N. Hard to believe he is not all there….
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Nancy, I have thought about doing posters at some point, but haven’t gotten around to it. I wonder if I sent you the artwork in PDF if you might print it off and post it…? Would that work for you?
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I would be glad to try! Thanks for the offer!
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I hope I will make it happen @Nancy – fingers crossed and don’t hold your breath LOL 🙂
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I can’t find the original article I read about BANGS. I can only remember the “N”. Would you guide me to the article or repeat the meaning of the letters? Thanks! I AM holding my breath! SO many people need this information! 🙂
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Hey Nancy,
Here are the individual posts:
B B is for breathe
A A is a triple starting with assess
N N is for never, never argue
G Go with the flow and more
S Sorry may be the most powerful part of BANGS
You can watch the full one-hour webinar here:
Tips for reducing anger and aggression in dementia care
I would be grateful if you cited my blog as the source and encouraged people to visit and subscribe.
Thanks, Susan
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Couldn’t agree more. What’s more, BANGS works. I’ve cared for my dad with Alzheimers and my mum with Vascular Dementia. When mum died, members of my carers’ FB group commented how ‘lucky’ I’d been that I hadn’t had the problems some people have. It wasn’t luck.
I wish I’d found your site when I was still a carer – you’re doing a great job.
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Pam, thank you so much for the validation. And yes you’re right, attitude and behaviour have a lot more to do with it than luck, although, to be fair, some people do face more challenges than others.
I’m reminded of the sporstman who responded to a quip from a journalist about how lucky he was with: “Funny, the more I practice, the luckier I get.”
I wish also wish I’d found a site like this one when I was at the start of my journey, because my life would’ve been a whole hell of a lot easier than it was at the time 🙂
On the plus side, I’m glad I can share what I’ve learned so others have an easier time of it.
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I have my mom in a caring home for people with dementia and Alzheimer’s, Susan. Mom has been extremely difficult to deal with lately, lots of angry outbursts. The transition from the dimension she knew into the dimension that’s entirely new has been a huge challenge for her and me. Your advice is timely, not to mention easy for me to remember when my mind goes blank from the stress of it all. “BANGS.” Yes! I can do this. I’ll spread the word of help to mom’s home caregivers, too. Thank you! I hope you and your care partner are doing well.
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Hi Sandra, I’m sorry about the way your Mom’s situation has evolved. I’ve had a lot of good feedback regarding the BANGS model which many people seem to find helpful. Many care facilities are ill-equipped to properly care for people with dementia – be aware that they may tell you your mother needs to be medicated when she might in fact need better care. Just a heads up.
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While I agree in general, what if the issue is that they have seriously soiled their underwear and they are denying it and refuse an invitation to change into something else?
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I still think there’s no point arguing. A different way needs to found…
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