aggression – My Alzheimer's Story

Challenges & Solutions, Resources, Toward better care

20 questions to ask yourself when someone who lives with dementia wants to “go home” or tries to escape wherever they are

February 16, 2020February 17, 2020 My Alzheimer's Story

Wanting to “go home” is a desire often expressed by people who live with Alzheimer disease and/or other types of dementia, even when they are in their own homes. Not being able to fulfill a loved one’s desire “go home” can be incredibly frustrating for care partners who would certainly take their family member living with dementia “home” if only they could.

In the early days of being a care partner to my mom, I didn’t know what to do when she said “I want to go home.” She would have her little bag packed with random stuff, and be ready to go out the door.

“But Mom, we are home,” I would say. “Look, Mom, this is your furniture, these are your carpets, those are your pictures on the wall. We are home!”

When she wasn’t convinced, the conversation would get more heated as we stood arguing in the kitchen, den, or living room of her big red brick house on the hill, until I sometimes heard myself yelling at her in exasperation “Where is home then, if it’s not here?”

I soon learned that arguing with her didn’t work. It was a waste of time and energy. It left both of us emotionally drained, and no further ahead. Eventually, I found different solutions to “I want to go home,” as well as other challenges. One solutions was to put myself in her shoes, to see her reality rather than my own.

What I discovered through self-reflection, observation and my own research is the behaviour we find challenging in people who live with dementia is behaviour we would likely exhibit ourselves in similar circumstances.

20 questions to ask yourself when someone who lives with dementia wants to “go home” or tries to escape wherever they are

When you find yourself in an environment that makes you anxious or uncomfortable, what do you do?
How would you feel if you were kidnapped? What would you do?
If you found yourself in a place that that was too hot, too cold, or too noisy, what would you do?
If were taken from your home by people you didn’t know, and put in a strange place full of crazy people, what would you do?
Where do you want to go or be when you feel tired, overwrought, out of sorts, out of place, lonely, scared or overwhelmed by everything?
How important is it to your well-being to feel like you belong somewhere? Where do you feel your greatest sense of belonging?
How long can you stay in one place without wanting to go somewhere else? Hours? Days? Weeks? Months? Years?
If someone locked you in your house and told you that you could never leave, how would you feel?
As a child, did you ever fall and hurt yourself while playing outside? Where did your instinct tell you to go for safety and security?
Have you ever run away from a problem, a place or a situation? When? Why?
Do you ever feel like you just have to leave when things get too much for you to bear?
Do you sometimes just want everything to be other than the way it is?
Do you take holidays and vacations away from home? How does it feel to be away? How does it feel to be away when everything seems to go wrong?
How do you feel when you return home after a holiday, vacation or long visit with friends or family?
In general, where do you prefer to be most of the time: in your own home or someone else’s home?
In general where do you feel most comfortable and in control: in your own home or someone else’s?
What feelings does the word “home” evoke for you?
Given the choice, when you feel tired or sick, would you rather be at home or somewhere else?
Do you sometimes long to be somewhere other than where you are?
When do you most appreciate being “at home” wherever that is or whatever it means to you?

It’s no wonder people living with dementia want to go home…

13 expert tips to help with “I want to go home.”

“wandering” is not a symptom of dementia

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Challenges & Solutions, Resources, Teepa Snow, Tips, tools & skills, Videos

teepa snow shows how to help someone living with dementia to put on a jacket or sweater without resistance

October 30, 2018October 31, 2018 My Alzheimer's Story

Image credit: Teepa Snow (screen shot from the video below)

“If only I had known,” is what I say to myself every time I see a Teepa Snow demo I haven’t seen before. This one was no exception when I first stumbled across it.

I had very few problems helping my mom get dressed. But how many times did I watch care workers struggle to do the same? Too many that’s how many! When I saw Teepa demo how easy it can be in the video below, I again wondered why EVERYONE who cares in some way for someone who lives with dementia isn’t trained in Teepa’s practical, positive approaches to care.

People who live with dementia “resist” receiving care for good reason: because, more often than not, we don’t know how to do things in ways that make them feel at ease.

Just watch the five-minute video below on how to help someone living with dementia put on a jacket or sweater in such a way that both care partners can feel good about what’s going on, and see if you don’t agree. I guarantee you will discover something you didn’t know or hadn’t thought of before.

Learn a few dead-easy techniques (including Teepa’s trademarked Hand Under Hand) that may help transform your life from misery to magic:

More here:

10+ Teepa Snow videos on dementia basics

Teepa Snow demos Hand Under Hand™ dementia care to connect, comfort and “control”

Teepa Snow demos 10 ways to calm a crisis with a person living with Alzheimer’s / dementia

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Challenges & Solutions, Toward better care, Videos

how my mom’s affection got mislabelled “aggression”

October 9, 2017May 19, 2018 My Alzheimer's Story

My mom had an unflaggingly positive attitude, as you will hear in the video at the end of this post. It features an audio clip I recorded on Mom’s 87th birthday in 2015; the last one we would have together. When I suggested to Mom that she needed a new sweater because the one she had on was moth eaten, she responded “It’s getting better.”

Everything was always “getting better” as far as Mom was concerned.

She was also outgoing, friendly, interested, engaging, and invariably the life of the party. She adored people, and was highly socially adept. So how did she come to be labelled “violent” and “aggressive” after she moved into a long-term care facility? There was a cluster of reasons, none of which were here fault, nor the fault of dementia. Ironically, one of the reasons was love.

Mom had a habit of giving people what she called “love taps,” light, rapid-fire pats on the hand, arm, cheek, bottom, or whatever recipient body part happened to be in close enough for her to reach. She had done this, as a sign of affection, for as long as I can remember. As her Alzheimer evolved, and her ability to verbally articulate her emotions declined, “love taps” and clapping often replaced words. She used them to express delight, happiness, frustration, and displeasure.

Unfortunately, her love taps and clapping were sometimes not well received, particularly (and understandably), by other residents who lived with dementia, and who didn’t “get” what these “slaps” were about.

But the staff should have known better. Sadly, instead of looking at the meaning of the behaviour, they labeled it “violent” and “aggressive,” and, as a result, Mom was medicated with dangerous and debilitating antipsychotic drugs.

I think that’s abuse. What do you think?

This video is part of a series extracted from a care conversation with my writer friend Lorrie B. “I’m keen for others to know the reality of my mother’s and my experience of long-term ‘care, and you’re the perfect one to help me do it,” I told Lorrie on Mom’s birthday in 2017.At this point, Lorrie had been the primary care partner to her own parents for three years, and they were still in their own home. She also had (and still has) her own blog called Unforgettable (I wish I were half the writer she is), which I highly recommend following (I do!). The other posts in the series are here.

20 questions that help explain why people with dementia get agitated and physically aggressive

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Challenges & Solutions, Toward better care

dementia not the cause in majority of harmful resident-on-resident interactions

June 19, 2017January 26, 2018 My Alzheimer's Story

“Senior with dementia guilty in death of nursing home resident,” the headline reads.

The incidence of these kinds of tragedies seems to be on the rise, and they will continue to occur with increasing frequency if we don’t address the causes and find solutions. Unfortunately, by blaming dementia for behaviour that could be averted if the real causes of the behaviour were identified and resolved, we are “barking up the wrong tree.”

The 2016 story headlined as above goes on to describe the sequence of events that led to the deadly incident. It says that a damning critical-incident report about the episode was not shown to the jury, and that the report found the nursing home failed “through a pattern of inaction and or inappropriate and insufficient action” to protect residents.

As is the case in most such incidents, there’s a lot more going on than dementia. These kind of headlines, and the labeling used by medical professionals as well as researchers, perpetuate and reinforce the stigma and misconceptions associated with people who live with dementia. The result is we’re no closer to addressing the issues that lie behind violent resident-on-resident interactions in long-term care facilities.

Dementia behaviour consultant Eilon Caspi explains on his archival blog documenting hundreds of such cases:

“It is important to emphasize that the vast majority of harmful resident-to-resident interactions that involve people who live with dementia in long-term care homes are the result of negative and distressing factors in the social (i.e. other people) and physical environment. In most situations, unmet human needs, situational frustrations, and perceived and real threats contribute or directly cause these behavioral expressions.

These social and physical environmental factors and unmet needs intersect with the person’s cognitive disability to generate the episodes. Most elders with dementia are not inherently aggressive. Like us, they react, respond, defend, and protect themselves when they experience distress, and when they sense that their dignity, privacy, identity, and personhood are threatened.

Those who believe that most people with dementia are inherently “aggressive,” “violent,” and “abusive” are mistaken. These common misconceptions run the risk of further labeling and stigmatizing this already stigmatized vulnerable and frail population.

It is easy to forget that people living with dementia have a profound brain disease because their cognitive impairments may not be immediately and physically obvious. In most situations, when people with dementia engage in these episodes, they are actually fighting with each other to preserve their dignity. They “Fight for their Dignity.” The definition of dignity is the quality or state of being worthy, honored, and esteemed.

The widely-held misconception that most people with dementia engage in aggressive and dangerous behavior towards other residents reflects a “blame the victim approach.” This approach, in turn, often leads to a slippery slope in which psychotropic medications are used inappropriately and excessively. These medications are largely ineffective for most individuals with dementia, and frequently cause a series of side effects some of which are dangerous and can be deadly (some have a Black Box warning by the U.S. FDA).

Once the person with dementia is sedated, it becomes harder to identify the unmet human needs that caused the behavioral expressions to begin with, and there is little hope of then arriving at a humane, practical, and life-affirming solution for the person. Instead, other serious problems such as physical discomfort, disorientation, heightened anxiety, and falls ensue.”

All of that said, there must surely be cases in which the character of the person plays a significant role and may predispose her or him to aggressive and/or violent behaviour. Someone who has been difficult and aggressive their entire life may remain difficult and aggressive or get even more so when he or she lives with dementia. But again, this is not, in my opinion, a result of dementia; rather is is a function of the individual’s personality. Furthermore, assaults and other crimes are committed in our communities at large; it’s naive to expect that long-term care facilities will be crime free. The key is to do all we can to prevent crime and violence from occurring anywhere and everywhere, including in long-term care facilities.

Thanks to Eilon Caspi for the good work he does in this important area of dementia care. Read more about him below and get access to his 90-minute pay-to-play training seminar “Fighting for Dignity: Prevention of Distressing and Harmful Resident-to-Resident Interactions in Dementia in Long-Term Care Homes.”

Eilon Caspi is a Gerontologist and Dementia Behavior Specialist. He has worked his entire adult life in the aging field. He started his career as a nurse’s aide in 1994 in a nursing home where his grandfather resided. Both of his grandmothers had dementia in the final years of their lives.

During the last 15 years, Caspi has worked with, or on behalf of, people living with dementia and their family care partners, as well with care staff and other professionals who provide support and care to these individuals in the community and in long-term care facilities (such as nursing homes and assisted living residences). He can be reached here.

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Care Partnering, Love, Toward better care

painful care partner choices: love or loss (or sometimes both)?

January 3, 2017November 14, 2018 My Alzheimer's Story

UK dementia care pioneer David Sheard talks about two stark choices that each of us who loves someone who lives with dementia must make at some point in the journey – maybe even multiple times every day. Both choices, both paths, are painful. But one of the two creates the possibility for love, compassion, joy, and growth, while the other inevitably leads to regret, sorrow, despair and loss.

In the video below, Sheard speaks in reference to family and friends visiting loved ones who live with dementia in long-term care. But I think his wisdom applies equally to those who are primary care partners and living with their loved ones on a full or part-time basis in their homes or in the community.

Of the dozens of videos I’ve watched on dementia care, this is the one that I think is perhaps the most important of all in fundamentally changing the way we approach co-creating and maintaining loving and productive relationships with those whom we love one who live with dementia. It underlies everything else. I invite you to watch and share. Thank you.

https://myalzheimersstory.com/2018/06/24/what-if-everything-weve-been-taught-about-dementia-care-is-a-lie/

https://myalzheimersstory.com/2018/05/24/5-ways-to-make-toast-in-long-term-dementia-care/

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Information, Poetry, Resources, Tips, tools & skills

a play on words: christmas 2011

December 21, 2016December 21, 2016 My Alzheimer's Story

Mom and I had words on Christmas morning 2011, from about 03:30 a.m. to 05:30 a.m. I’d been in my role as care partner for less than eight weeks and hadn’t yet discovered there’s no point arguing with someone who is living with dementia in the mid to later stages. I didn’t know the best way forward was to step into her reality and go with her flow. I had a lot to learn. Three years later, I wrote a play on aspects of my journey with Mom; Scene 4 in Act 1 is based on Christmas morning 2011.

Act 1 Scene 4

Christmas morning; Susan’s bedroom 03:30 a.m. Susan is in bed with the light off. We hear sounds of walking around, opening and closing cupboard doors and dresser drawers in bedroom across the hall. Mom comes into the doorway to Susan’s bedroom, she is silhouetted by the light from her room across the hall.

MOM (Angry, aggressive): Sue? Are you coming with me or not?

SUSAN (Soft voice, rasping cough): Well, I don’t know where we’re gonna go, Mom, because–

MOM (Impatient): I’m going home to Mummy’s, to where I live, on the Georgeville Road.

SUSAN: I know, but we’re already there, Mom.

MOM: (Loud; exasperated): What do you mean we’re already there Sue?

SUSAN: I mean that’s where we are, we’re on the Georgeville Road. At your place.

MOM: Don’t be ridiculous Sue. This is not our home. I wanna get home, so I’m gonna go. If you don’t wanna come, don’t come, but I’m going home. I’m not gonna stay here all night in a place that’s not mine with nobody in it.

SUSAN: I’m here Mom. And the cat’s here. We’re safe here Mom.

MOM: Don’t be so stupid Sue. (She leaves the doorway and goes back to her room. As she does so, her room becomes lit and we can see what she’s doing. She continues yelling from her own room across the hall.) I’m gonna get out of here and I’ll do it quickly. The only trouble is I don’t have any clothes to wear. That’s the only problem. Unless I put them in the cupboard here or put them up here somewhere, but I’ve gotta find something to wear. My pants. Where are those? I’m gonna wear a sweater, if I can find my sweater. I thought I had taken it out, and put it on. I don’t know where it is now.

(Mom continues rummaging, looking underneath the bed, etc. Susan switches her light on. Reaches over the side of the bed, picks up her iPhone, checks the time as she hangs over the bedside, rolls back into the bed exhausted, coughs, checks the iPhone again, puts the back of her hand on her forehead. After a few seconds she reaches over onto the floor, picks up an old galabiya, sits up, puts it on and, gets up and walks out the door and over to Mom’s room; she goes in and sits on the bed.)

MOM (Still rummaging in drawers): OK. There’s my sweater. I’m heading out. I’m not gonna stay here all night and listen to them. They don’t know anything. Now, the only trouble is I don’t have a bra. Must be here somewhere. If not, I’ll just wear–I won’t bother. But I know I did have the bra when I left there. Maybe it’s…no, it’s not there. I’ll find one maybe in here…I don’t know. Here’s one. That’s it. Got that done. But I’m not gonna stay here and just rot, you know? I wanna get home.

SUSAN: Well, maybe it would be a better idea to wait till the morning, Mom, and just take it step–

MOM: NO! I’m going now. What’s your problem Sue? Is there something wrong with you or something? Are you going a little funny?

SUSAN: Mom, it’s dark outside. It’s Christmas Eve. I just checked on my phone. It’s 3:30 in the morning, and it’s minus 16 degree Centigrade. We can’t–

MOM: No it’s not. Don’t be ridiculous Sue. It’s 3:30 in the afternoon, and I’m going, and that’s it. For the last time, are you coming or not?

SUSAN: No Mom. I’m going back to bed. (Susan walks back into her room. Gets in bed with her galabiya on, and switches off the light. Mom comes back into the doorway of Susan’s bedroom in silhouette.)

Mom: So you’re gonna stay here and sleep Sue?

SUSAN: Yep.

Mom: You’re just gonna stay here?

Mom: Yes.

Mom: Well, Sue, I think it’s a bit ridiculous. I think you should come home.

SUSAN: I think we are home, Mom.

MOM (shouting): What do you mean, Sue? We’re not home. This isn’t our home. You’ve lived at our home. It’s a big house. You had your own bedroom, I had my own bedroom. This is not our home. I can’t understand why you would say a thing like that, you know? I’ve been downstairs. There’s nobody at the desk. There’s no one here. If you wanna stay here and live like that, fine. But I’m not. I’m gonna get in my car and I’m gonna go. Sue, you’ve got a bad cough, and you should be home. I don’t really want to leave you here like this. You should come home with me. But if you insist on staying, well, there’s nothing I can do about it. (Mom picks up a 10-inch long flashlight that’s sitting on the corner of the dresser beside the door.) I’ll take this with me so I can see when I get outside.

SUSAN (calm, monotone): Mom, it’s minus 16 outside. You can’t go outside Mom.

MOM: Sue, I’m going and I mean it. I don’t care if it’s minus a hundred outside. I’m going home and that’s it. (Mom switches on the flashlight and shines it on Susan in the bed.) Well, at least this works, thank goodness. I’ll take it with me. Are you sure you’re not gonna change your mind and come home, Sue? I don’t want to leave you here, but I want to go home and I’m going.

SUSAN: I’m staying here Mom.

MOM: Suit yourself Sue. (Mom turns and leaves. She marches off stage left, we hear her going down unseen stairs. After a few seconds she calls up the stairs.) Sue, the door’s locked. Where is the key to the door, Sue?

SUSAN (coughing): I don’t know Mom.

MOM: Sue, if you don’t tell me where the key to the door is, I’m gonna’ break the window. (Sound of the flashlight hitting the window.)

SUSAN (sits bolt upright in bed, shouts): No Mom! Please don’t break the window!

As Susan says “break the window,” we hear the sound of breaking glass and the stage goes black.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Mom didn’t actually break the window, that’s a dramatic device. But she did strike it with a wooden Christmas statue. And the rest of the conversation is real. It went back and forth for two hours until I finally bundled us both up (with Pia Roma, Mom’s cat, stuffed down the front of Mom’s winter coat because we couldn’t “leave the cat behind”), and drove three miles down the road and back. Here’s a 90-second clip of the tone before and after:

How did we eventually get to the calm in the last bit of the audio? By using the concepts I later used to develop the BANGS model outlined at these links:

Watch the full one-hour BANGS webinar here (it’s free)..

What I learned is that people who live with dementia often respond in predicable ways, and we can calm situations by 1) understanding their responses are normal and 2) de-escalating situations rather than fuelling the fire. Awareness is the first step. Here’s a tool to help develop it.

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Care Partnering, Resources, Tips, tools & skills

20 questions to change the direction of dementia anxiety and aggression

October 14, 2016December 1, 2017 My Alzheimer's Story

I discovered through personal experience, research and observation that people living with dementia (PLWD) behave in logical, natural and understandable ways to stressful situations, just like most of the rest of us do. Although they react as any “normal” person would, their behaviour is more often than not mistakenly attributed to the disease rather than to whatever catalyst actually sparked it.

People living with dementia are people; they respond normally when they are threatened, demeaned and made to feel powerless: they resist, lash out, become agitated or try to flee. Blaming the disease leads us in the wrong direction. What we should be doing is asking ourselves questions to reset the compass ; questions such as:

What might I and/or others have done to precipitate this situation, and how can I rectify it as quickly as possible with as little disruption as possible?
Would I behave the same way in similar circumstances? How would I feel? What would I want?
How can I defuse the situation? (Hint: do not tell people who are upset or agitated to “calm down!”)
What is threatening the person? How can I remove the threat?
How can I help this person feel more at ease?
What unmet need might this person be expressing? Is s/he in pain or experiencing some other kind of physical discomfort? Is s/he hot, cold, wet, thirsty, hungry, etc.?
What environmental factors might be contributing to his/her anxiety, and how can I neutralize them?
Is my tone of voice conciliatory and respectful?
Is my body language relaxed and open?
Can the person see and hear me properly?
Have I surprised him/her in some way?
What action can I take right now to restore calm?
How can I meet her/his immediate need?
How can I meet her/his deeper need?
Have I said I’m sorry?
What more can I do to empathize?
Could I ask for the support of someone else who might be more effective in dealing with this situation?
What could I do differently next time?
What can I learn from this?
How can I share that learning with others? How can apply my knowledge to engage more effectively with this person and others who live with dementia in the future?

Too many people with dementia end up needlessly medicated for behavioural expressions that are provoked by the environment and the people around them, including paid care workers and family members such as myself who are drafted into caregiving roles with little or no experience or training.

By questioning and reframing, I believe we can transform the way we see dementia and the people who live with it; we can also find ways to deliver better care. Specifically with respect to the issue of aggression, putting ourselves in the place of PLWD will help us discover what might underly behaviour we find challenging or problematic. We can then address the underlying causes instead of inappropriately prescribing antipsychotic medications.

Download the 20 questions pdf here.

Note: I developed a process called “BANGS” to help myself and others avert “shoot outs” with people who live with dementia. It’s easy and it works. You can learn the steps and use it too. The BANGS model is outlined at these links:

“B” is for breathe.

“A” is for assess, accept, and agree.

“N” is for never, never argue

“G” is for go with their flow, let go of your ego, get over it, get on with it, get down to it

“S” if for say you’re sorry

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Care Partnering, Challenges & Solutions, Tips, tools & skills

6 reasons care partners fight with their loved ones

July 19, 2016April 22, 2018 My Alzheimer's Story

“I wonder why we feel such a strong need to make them see reality?” Jenny mused during our coaching session. “I used to tell myself every morning: ‘today I will NOT argue with Dad or try to make him see reality, and yet every day I’d eventually crack.’”

Jenny had just finished reading “never, never argue is the ‘N’ in BANGS,” and was doing some self-examination. We were exploring ways she might behave differently to reduce the stress she was experiencing as a care partner to her mother.

“Like your post said, who the hell cares if his hair was brown or black!!? Yet I waged such an internal battle with myself. ‘Don’t argue!’ I would say to myself and twenty minutes later I would lose my patience and try to get him to see reality – not HIS reality, MY reality!”

Jenny had lost her father to dementia and was caring for her Mom, who also had the disease.

“Now that Dad is gone,” she said. “I’m pretty good with Mom. I don’t want to repeat the mistakes I made with Dad. But I still ‘crack’ and insist she’s mistaken from time to time, even though I know it doesn’t work.”

Jenny’s words caused me to do some reflection of my own after our Skype call. Sometimes it seems we can’t help arguing, even when we know it’s ineffective and can escalate situations that we could easily defuse if we had our wits about us. When things get “pear shaped,” we sometimes blow up and then feel guilty afterward about losing control.

Here are some of the factors that may be at play when normally calm care partners lose their cool and forget the “never never argue” dementia golden rule:

1) ego

Ego is how we see ourselves. It’s the part of us that knows we are important and able, that we matter, that we count. Ego wants us to be right, maybe even more so when we know the other person is clearly and unequivocally wrong! Letting go of our own ego to bolster someone else’s isn’t easy, but it can work wonders in helping a loved one who lives with dementia reaffirm their own selfhood.

2) exhaustion

Being a caregiver, particularly to someone who lives with dementia, is often physically, emotionally and psychologically draining. Many care partners lack proper support, have little respite and become so worn out they are unable to function properly at even a basic level. It’s virtually impossible to behave rationally when one’s energetic reserves are completely drained. Put the oxygen on yourself first; get some rest.

3) frustration

Never-ending and seemingly insurmountable challenges of all shapes and sizes, unfixable situations, insoluble problems, constant repetition, being on the receiving end of abuse from various quarters – all of these result in levels of frustration that are hard to imagine unless you’ve lived them. Sometimes that frustration gets the best of us and we snap.

4) getting stuck in unproductive patterns

We all know the cliché “it’s hard to teach an old dog new tricks.” Although an increasing number of young people are being drafted into caregiving roles, a far greater number of us are longer in the tooth and have likely engaged with our care partners in certain ways for a lifetime. We’ve got “baggage.” It’s hard to break old patterns, and to employ new tricks that deliver better results.

5) lack of knowledge

Alzheimer’s and other dementias are relatively new diseases. Until recently, behavioural expressions such as aggression were believed to be caused exclusively by the disease. Now we know behavioural expressions are more often than not responses to environmental factors and the way we interact with people who live with dementia. With that understanding, we have begun to develop new tools and techniques that enable us to engage more effectively with people who live with dementia. But not everyone is aware of those techniques, and you can’t use tools you don’t know about.

6) lack of practice

Once we’ve been introduced to more effective behavioural tools, techniques and skills, it takes time to master them. Practice makes perfect as they say. But it’s hard to practice when we’re exhausted, frustrated, stuck in old patterns and not able to let go of our ego!

The next time you find yourself arguing with someone who lives with dementia, it may be helpful to take a step back and ask yourself what’s going on. Identifying what lies behind your behaviour is a first step toward changing it and creating a calmer and more peaceful environment for everyone. Awareness may also help you to stop feeling guilty and/or beating yourself up for falling into the arguing trap. We’re only human; we need to give ourselves a break!

Remember all that ❤

https://myalzheimersstory.com/2016/06/07/10-tips-to-help-you-tango-not-tangle/

https://myalzheimersstory.com/2016/01/10/10-things-to-remember-when-you-interact-with-people-who-forget/

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Care Partnering, Challenges & Solutions, Life & Living, Tips, tools & skills

20 questions to ask yourself when you blow up

June 5, 2016June 5, 2016 My Alzheimer's Story

It happens to everyone at one time or another: we lose our temper with someone we love, we say things we didn’t mean in the heat of the moment, and we’re wracked by guilt afterward.

Care partners to people who live with dementia are no different from anyone else. We too lose our temper and say things we don’t mean. We are only human. We’re often drafted into the role of care partner without training, without knowledge and without the proper skills. Guess what? That takes its toll.

When we “lose it” the impact on the people we love who live with dementia can appear devastating. We feel doubly guilty because the behaviour that drives us crazy is not intentional on their part. They don’t do what they do maliciously, Alzheimer’s disease or another form of dementia reduces their ability to behave in ways to which we are accustomed. We worry for their safety, we want to protect them. We are stressed beyond reason and we snap. We lash out, just as they sometimes do, because we feel angry, frustrated and powerless.

It’s often hard to let go of what we’ve done and to forgive ourselves when this happens.

Here are 20 questions to ask yourself when you blow up:

Are you doing your best? If you are truly not doing your best, how could you do better? Are you trying to do too much? Are you stretched too thin? Do you have enough support?
Do you expect other people never to lose their patience and/or get angry? If you do, is that a realistic expectation and are others always able to achieve it?
Are you sorry? Is there an opportunity to say you’re sorry? Have you taken it? (Hint: if you haven’t, try it now. Find seven specific ways to phrase it here.)
Do you love the person you care for? Did you intentionally want to hurt them, or make they feel bad, sad or upset?
Did you intentionally yell at them, berate them or blame them? Or were you simply at the end of your proverbial rope?
Has anyone ever been angry with you for any reason? Has anyone ever yelled or spoken to you in a harsh way when you didn’t deserve it? While it might have been unpleasant at the time, did you get over it?
If you answered “yes” to #6, were you able to forgive the person who was angry or berated you? What helped you to forgive them? If you couldn’t forgive them, why not?
At your core, are you more “good” than “evil?” As a rule, do you tend to be abusive or compassionate?
Has your care partner who lives with dementia ever behaved in ways that were hurtful to you? Were you able to forgive him or her? What helped you to be forgiving? What stopped you from forgiving?
Is it helpful to feel guilty and/or beat yourself up over something you have done? Instead of feeling guilty and/or beating yourself up, what actions might you take to heal what has happened? Be specific.
Have you given some thought to the circumstances that led to the blow up? What happened exactly? Can you step back and analyze what went down in a cool and non-judgmental way? How good a detective are you? Can you turn this into a learning opportunity?
Did you blow up after a long string of small incidents (i.e. was this the straw that broke the camel’s back)? Or was it one BIG incident “out of the blue?”
Do the answers to #11 and #12 suggest what you might do differently the next time to avoid a similar result? (For example: Perhaps deep breathing would have helped calm you and diffused the situation. Might the triple “A” in BANGS have been useful?)
Are you mentally and/or physically exhausted? Are people who are mentally and/or physically exhausted able to perform at peak levels?
Do you pat yourself on the back every time you do something good, kind, compassionate, and loving for your care partner who lives with dementia? If not, why not?
Do you do more “good” things than “bad?” How often do you praise yourself and tell yourself what a great person you are for the good things you do? Is it more or less often than you feel guilty about the “bad” stuff?
What rewards do you give yourself for the amazing work you’re doing?
Can you let it go? Are you able to forgive yourself? If yes, what would be the result? If not, what would be the result?
Overall, do your actions and care make your care partner’s life better or worse? More livable or more miserable? Easier or harder?
Are you a superhuman superhero?

Let me know if these questions help by commenting below. Find more “20 questions” posts here.

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Tag: aggression

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20 questions to ask yourself when you blow up

Here are 20 questions to ask yourself when you blow up: