questions – My Alzheimer's Story

Advocacy, Antipsychotic drugs, Toward better care

drugged & drooling

June 2, 2019June 2, 2019 My Alzheimer's Story

Many of the comments people make on my posts, and the stories they send me by email and snail mail break me heart. Some literally bring me to tears. This is one of them – a comment CL made when I posted “an open letter to the dementia community worldwide” on the MAS Facebook page:

“When my father was in the hospital for a stroke, a gentleman used to show up every day. He was an older patient, and he used to tell my dad great stories and jokes from his younger years. My dad thoroughly enjoyed these daily visits.

One day my dad asked me to check on “Robbie” because he hadn’t seen him in a couple of days. So I checked with the nursing staff and they said he was moved to a different ward. So I went to look for him. I found him restrained in a chair, in a zombie daze and drooling. It was heartbreaking!

When I questioned the nurses, they said someone complained about him walking around talking to other patients, so they did this horrifying drugging and restraining!. I cried. Then I told my dad he had died. I couldn’t tell him the truth. It was awful!.

P.S. Robbie never hurt or touched anyone. He just stood at the bottom of the bed and talked. Still haunts me to this day. Five years now.”

The very same thing happened to my gregarious and fun-loving mom: she was physically and chemically restrained for being friendly and sociable. Just the thought of it still makes me cry. Imagine the state of poor “Robbie,” who had brought others joy with his “wandering,” if his friend’s daughter felt it was better to tell her father Robbie was dead rather than tell him the truth of what had happened. Better to say he was dead. Think about that.

I believe it’s a crime to do this to vulnerable people, and in particular to vulnerable elderly. We must stop it. And we must #BanBPSD.

drugs, not dementia, robbed me of my mom and her of her mind

four years later is too late for my mom. but it’s not for others.

safety pins & call bells

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Challenges & Solutions, Life & Living, Toward better care

20 actions to foster and maintain dignity in dementia care homes

May 30, 2019May 30, 2019 My Alzheimer's Story

I was thrilled to learn that Australian dementia care advocate, author and activist Kate Swaffer included an excerpt from my “open letter to the dementia care community worldwide” in her statement to the Australian Royal Commission on Aged Care Quality and Safety (read the full statement here).

Kate’s comprehensive and thought-provoking statement comprises a wealth of information including a list of 10 Dignity in Care Principles, which Kate originally published on her blog in 2014.

Inspired by her list, I added ten more items to create twenty actions that long-term care providers and their staff could implement to foster and maintain the dignity of people living with dementia (PLWD) who reside in their facilities.

Maintain zero tolerance of all forms of neglect and abuse
Support people PLWD with the same respect you would want for yourself and/or members of your own family
Treat each person living with dementia as an individual by offering a personalised service
Address PLWD using their preferred name, title or other form of address
Enable PLWD to maintain the maximum possible level of independence, choice, and control
Encourage PLWD to do what they enjoy, whatever it may be, and give them the means to do it
Listen when people express their needs and wants, especially when they uses actions to communicate rather than words
Respect people’s privacy
Provide appropriate, well-designed living environments that are comfortable, easy to navigate and welcoming
Ensure people are able to complain without fear of retribution
Engage with family members and carers as care partners
Assist PLWD to maintain confidence and positive self esteem
Act to alleviate loneliness and isolation
Avoid the use of physical and chemical restraints
Provide interesting, stimulating and appropriate things for PLWD to do
Give PLWD opportunities to contribute and lead meaningful lives
Treat PLWD like people, not like objects, or as if they are “lesser than”
Connect with PLWD as fellow human beings
Focus on what PLWD can do, not on what they can’t
Avoid blaming, shaming and taming!

Preserving dignity is part of respecting human rights. We need to ensure it happens across the board.

20 paths to dementia care homes away from home

7 ways to improve dementia care in less than three minutes

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Care Partnering, Resources, Toward better care

20 dementia “what ifs?”

May 15, 2019May 16, 2019 My Alzheimer's Story

The ways we see dementia and the people who live with it are changing, but not fast enough! Many of our perceptions remain distorted and damaging. These distorted and damaging perceptions result in poor care, stress and unacceptable outcomes.

What if we learned to ask better questions? What if we opened our minds to possibility and out-of-the-box solutions? What if we created a new world in which people who lived with dementia were not stigmatized, shunned, and isolated? What would that world look like? What would dementia care look like?

These 20 questions are meant to get people thinking about what the world might look like if we saw dementia and the people who live with it with new eyes:

What if we weren’t afraid of dementia and the people who live with it?
What if we viewed dementia as just another life challenge some of us have to face?
What if we understood that people who live with dementia are people until they die?
What if we knew with certainty that people who live with dementia have needs, feelings and emotions just like the rest of us?
What if we knew how to communicate effectively with people who live with dementia?
What if we knew that it’s really not that important if people with dementia recognize us or not?
What if we understood that behaviours we may find “challenging,” “difficult,” or “disruptive” are actually ways for people living with dementia to tell us what they want and need?
What if, instead of excluding, we included people with dementia in our lives?
What if we learned how to step into the individual realities of people who live with dementia instead of trying to fit them into our reality?
What if we created communities that brought together all kinds of people with diverse cognitive abilities instead of segregating them?
What if we loved people for who they are right now instead of who they were yesterday or the day before?
What if we were able to see the potential in people who live with dementia?
What if we could see what people can do instead of what they can’t?
What if we knew that people recognize love even if they don’t recognize our faces or know our names?
What if we could learn to find healing and joy instead of pain and sorrow in our relationships with people living with dementia?
What if we could see dementia differently?
What if we could see people who live with dementia differently?
What if we could connect instead of disconnecting with people who live with dementia?
What if we learned to appreciate the time we have together now, instead of mourning (in advance) the time we won’t have in the future?
What if we could see possibility and opportunity instead of obstacles and barriers?

What if all of the above?

It’s time to reimagine, recreate and revolutionize the way we see dementia as well as the way we provide care to the people who live with it.

More posts in the “20 questions”series here as well as below.

20 great questions to ask when a loved one with dementia doesn’t recognize you anymore

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

20 questions to ask yourself about dementia-related incontinence

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Care Partnering, Resources, Toward better care

10 great reasons to ask 20 questions and how to create them

May 15, 2019 My Alzheimer's Story

Isn’t it funny how we often walk through life without pausing to ask ourselves why we’re doing what we’re doing, or even if it’s important to do it? We march through our days robotically, repeating our routines and possibly making the same mindless mistakes without a second thought.

I’ve learned it’s useful to stop and ask myself if there might be a better way. Asking questions is one of the basic techniques used in most “helping” professions. Life coaches, business coaches, doctors, psychiatrists, psychologists, social workers, nurses, doctors, and others constantly ask questions. Why? Because questions are useful tools; they help us to:

Discover new information
Diagnose problems
Think more clearly
Generate ideas
Explore possibilities
See new perspectives
Reveal patterns
Provoke reflection
Encourage conversation
Stimulate participation

As a dementia care coach and care partner, I use a technique I call “20 questions” to help others better understand themselves, the people they care for, and the process they’re in. Anyone can use 20 questions to gain insight into any challenge or issue. All you need is a pencil and paper, or your favourite word processing package, your imagination and a topic. The rest is simple:

Put your topic at the top of the page
Brainstorm questions related to it
Write or type the questions on the page
Do not edit yourself; write whatever comes to mind
Don’t worry if some questions are similar or if you repeat
Keep going until you run out of questions
Do not try to answer the questions
Leave the questions to percolate for an hour, a day, a week or a month
When you feel ready, review the questions
Be open to the answers, ideas and solutions that emerge

Here are a couple of examples of dementia care issues I’ve delved into more deeply using 20 questions.

Blow ups

It happens to everyone at one time or another: we lose our temper with someone we love, we say things we don’t mean in the heat of the moment, and we’re wracked by guilt afterward. Here are my the first three questions (the other 17 are here):

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.)

Dementia anxiety and aggression

I have learned through personal experience, reading and research that people with dementia (PWD) behave in logical, natural and understandable ways to stressful situations – just like most of the rest of us do. But there’s still a whole world of misunderstanding among family caregivers and professional care workers about behavioural expressions in people with dementia. I built this list: 20 questions that help explain why people with dementia get agitated and physically aggressive; here are three of the questions:

What would you do if you wanted to escape, but all the doors were locked and you didn’t have a key? What would you do if you weren’t allowed out – ever?

What would you do if a stranger tried to take something that belonged to you? What if they managed to get it and they wouldn’t give it back?
What if you said you didn’t want to have a bath but people took your clothes off anyway and then they forced you into the bath and told you to calm down and be quiet?

What 20 questions can you come up with the help address your life and/or caregiving challenges?

More posts in the “20 questions”series.

20 questions to ask yourself about “wandering”

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

20 questions to ask yourself about dementia-related incontinence

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Care Partnering, Resources, Toward better care

20 questions to ask when someone living with dementia “resists” or “refuses” care

March 25, 2019 My Alzheimer's Story

I have learned through personal experience, reading and research 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. They react as any “normal” person would, but their behaviour is attributed to the disease rather than to whatever catalyst actually sparked it.

When you think about it, it’s not rocket science, or at least it’s not if you haven’t bought into the biomedical model that labels normal behaviour as aberrant because people have a diagnosis of Alzheimer or a related dementia.

I hope these questions will get you thinking about how “resisting” and “refusing” care might be understood and treated differently. I also hope it will prompt solutions other than a prescription pad and antipsychotic drugs.

20 questions to ask when someone living with dementia “resists” or “refuses” care

Is the person able to do this herself? Would she prefer to do it herself?
Is the care necessary? Could it be deferred or stopped altogether?
If a stranger were doing to me what I’m doing to her, how would I feel? What would I do? How would I react?
Have I asked his permission to do what I’m doing?
Is it the right time for this? Would another time be better?
Am I the right person to be providing this kind of care to her? Would someone else be better equipped?
Have I been properly trained in this kind of care?
How did I approach her? What was her initial reaction? Did I change my approach based on her reaction? Am I going with her flow?
Did I start with and continue to use Hand Under Hand?
What was going on with him in the previous hour or two? What was he doing? Could whatever it was have caused him to feel upset or uncomfortable?
Is this the right environment to be providing this kind of care? Is more privacy needed? Is it too noisy?
Do I normally have a good relationship with her? Does she like me? Do I like her?
Am I treating him with respect? Am I treating him like a child, or a patient rather than like a person?
Am I taking steps to preserver her dignity? Am I being compassionate and understanding? Have I put myself in her shoes?
If I were on the receiving this kind of care, how would I feel? What would I do? How would I react?
How do I feel about providing this kind of care to him? Am I comfortable? Embarrassed? Matter of fact? Clinical? Angry? Disgusted?
Might I have hurt him in any way? Physically or emotionally? Could he be in pain? Is the care process painful?
Is she hot, cold, hungry or physically uncomfortable in some way?
What tone of voice am I using? What kinds of words am I using? If someone were to speak to me like I’m speaking to him, how would I feel? How might I react? What would I do?
Do I have enough time to provide this care properly? Am I hurried and rushed? If I am hurried and rushed, might this be causing her to feel anxious or uncomfortable?

More posts in the “20 questions”series.

20 questions to ask yourself about “wandering”

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

20 questions to ask yourself about dementia-related incontinence

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Take my short survey on behaviour here.

Care Partnering, Resources, Toward better care

20 questions to ask when a care partner or resident walks around at night

February 2, 2018June 21, 2018 My Alzheimer's Story

My first few months as the full-time care partner to my mom while she was still living in her own home were difficult, mostly because I didn’t have a clue what I was doing. I learned as I went, but it was a slow process, and some knowledge came too late to be of much use to us. But it may be of use to you.

When I became tired because Mom was up and ”wandering” in the night, I turned to her family physician and then to her geriatrician for help. Both of them prescribed antipsychotics (Risperdal and Seroquel respectively), about which I knew little at the time. Neither doctor could offer any other suggestions or options, even though I specifically asked for non-drug alternatives as I knew Mom didn’t like taking medication.

I’m certain things would have gone differently if I’d had a better understanding of the reasons Mom got up in the night. When you think about it, it’s not rocket science, or at least it’s not if you haven’t bought into the biomedical model that labels normal behaviour as aberrant because people have a diagnosis of Alzheimer or a related dementia.

I hope these questions will get you and others thinking about how this particular “behaviour” might be understood and treated differently. I also hope it will prompt solutions other than a prescription pad.

20 questions to ask when people living with dementia walk around at night

What do you do when your bladder is full? Do you ever wake up in the night with a full bladder or with the feeling that you need to pee? Does it sometimes happen more than once in one night?
What would you do if you got up in the night because you had to pee and you couldn’t find the bathroom? Would you go back to bed? Would you keep looking for the bathroom until you found it?
What would you do if you woke up in the middle of the night with an overwhelming thirst and you had forgotten to put a glass of water on the bedside table like you normally did?
What would you do if you got up in the night because you were desperately thirsty and you couldn’t find the bathroom or the kitchen to get yourself a drink of water? What if you couldn’t find the light switches either?
When you were a child, did you ever crawl into your parents’ bed because you felt afraid in the night?
Do you, have you or did you ever let your children crawl into bed with you because they are or were afraid of the dark or of something else in the night?
Do you ever have nightmares or bad dreams? Have the nightmares or bad dreams ever shaken you so badly that you wanted to get up, even though it was nighttime?
How would you feel and what would you do if you woke up from a deep sleep and you were in a strange place you had never been before and nothing was recognizable and it seemed like you were alone?
How would you feel and what would you do if you woke up in the night and you weren’t in your own bed? What if there were a stranger lying asleep beside you?
Have you ever gotten up in the night to have something to eat because you felt hungry?
What if you got up in the night to have cookies and milk because you felt hungry and you couldn’t find the kitchen? What if the place you were in was like a maze?
What would you say to someone who told you it was the middle of the night when it was actually the middle of the day? What if they told you needed to go to bed in the middle of the day?
How would you feel and what would you do if you lived alone and you found strangers in your house at night when you got up out of bed to get a drink of water?
What would you do and how would you feel if you went to the bathroom in the night, and when you were finished you didn’t know how to get way back to your bedroom? Would you stay in the bathroom? Would you try to find your bedroom?
If you were in a strange place where you were being held prisoner, and a chance arose to escape, would you take it even if it were nighttime?
How would you feel if you lay down on the sofa for a nap on a sunny afternoon and the next thing you knew you woke up in someone else’s bed in the dark with pyjamas on?
Have you ever gone into a room to get or do something and then forgotten what you went to get or do? What if that happened to you in the night? What if it were in a hotel?
Have you or do you know anyone who has sleep walked? Do you ever get up in the night and have only a vague memory of having done so the next day? Do you sometimes feel groggy and disoriented when you wake up? Do you ever get out of bed and function like you’re on “autopilot?”
Is it harder or easier to navigate in the dark than in the light? Would it be harder or easier if you forgot to put your glasses on?
Is it normal for healthy adults to go to bed at 7 p.m and sleep straight through to 7 a.m the next morning? Do you sleep 12 hours a night without waking on a regular basis?

Download the PDF here.

More posts and PDFs in the “20 questions”series.

https://myalzheimersstory.com/2017/05/02/wandering-is-not-a-symptom-of-dementia/

https://myalzheimersstory.com/2015/04/19/20-questions-that-help-explain-why-people-with-dementia-get-agitated-and-physically-aggressive/

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Care Partnering, Inspiration, Life & Living

20 opportunities being an alzheimer’s or related dementia care partner might offer you

January 14, 2018June 3, 2018 My Alzheimer's Story

I believe the way we approach life has everything to do with the way we experience it. I believe the same thing about being a care partner to someone who lives with Alzheimer disease or a related dementia.

Like me, most dementia care partners are drafted into the role with little if any training or knowledge of the diseases that cause dementia. We are bombarded with an overwhelmingly negative narrative that comprises nothing but suffering, pain, loss, grief, and tragedy. If we let that narrative define our experience of being a care partner, we, and the person or people we care for and with will indeed suffer. The negative narrative becomes a self-fulfilling prophecy.

What if we could turn that around? What if, instead of focussing on loss, we concentrated on what we stand to gain? What if we homed in on potential?

Being a care partner to someone who is living with Alzheimer or a related dementia may provide you, your family members and your friends opportunities to:

take living and loving to greater depths and heights
heal past wounds and protect against future hurt
learn more about the person you care for and with
learn more about yourself
grow your capacity for compassion
discover what is most important in life
better understand what it means to be human
practice patience
embrace empathy
find ways to manage adversity
learn how to live in the moment – right now!
get into the habit of letting go
find joy in simple things
create a more meaningful life
see the world from a different perspective
spend more time with someone you love
know your own strengths
ask for and receive help from others
be a source of inspiration
share your human experience

I experienced all of these things and more, so I know for a fact that turning the tables on Alzheimer disease and other dementias is possible. Was my life as a care partner a bowl of cherries? Certainly not! Nor was it a long slow train through hell and into oblivion. It contained as much joy as it did heartbreak. I guess some of that is sheer luck. But a lot of it also had to do with being open to opportunity.

https://myalzheimersstory.com/2016/05/14/top-15-things-dementia-care-partners-say-theyve-learned/

https://myalzheimersstory.com/2014/02/27/5-uplifting-emotions-felt-by-alzheimers-dementia-caregivers/

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Care Partnering, Resources, Tips, tools & skills

20 questions to ask yourself if you’re wondering whether or not you should visit someone who lives with dementia

September 17, 2017February 17, 2020 My Alzheimer's Story

This week a new subscriber sent me an email, which said in part:

“My mother has dementia, and I went to see her a year ago. She got violent with me and verbally abusive. I took it personally and I haven’t seen her since. However, I have been sending cards and items of clothing in hopes to cheer her up. I was just told that she has 6 months to live, so I’m flying back down there the beginning of October.

Until I saw your [BANGS video] today I have been sitting here petrified and in total dread. Now I’m starting to feel empowered and not so scared. I feel so guilty for not seeing her this whole time. I hope our upcoming time together goes well, and we create some memorable last memories. With your advice I think I can make this work.”

I don’t know if this person’s mother lives in a LTCF or not, but the email made me think of all the people with dementia who live in LTCFs, and who don’t have visitors for whatever reason. Many who remain in their own homes or in the homes of their care partners also do not get visits from family members and friends. This tragedy made me think of 20 questions people may want to ask themselves when they wonder whether they should make the time and space to visit family members and friends who live with dementia.

Here are the 20 questions:

How does it feel to feel lonely? When do I feel most lonely? What do I want when I feel lonely?
How does it feel to feel loved? When do I feel loved? What makes me feel loved?
How would it feel to never see my family again? How would it feel to never see my friends again? What is it like/would it be like to feel abandoned?
How important is touch to human health? How important is touch to me? How important is touch to the person I know/love who lives with dementia?
What does it mean to be connected?
How important is connection to human health? How important is connection for me? How important is connection to the person I know/love who lives with dementia?
How does it feel to be bored? What are some ways to alleviate boredom?
How important is it to human health to be active and engaged? How important is it for me to be active and engaged with life? How important is it for people who live with dementia to be active and engaged with life?
What are the benefits of visiting people in hospital for the people who are being visited? What are the risks?
What are the benefits of visiting people in hospital to the visitor? What are the risks?
How do I feel when I see someone I like/love who I haven’t seen in a long time?
What might stop me from visiting someone I know/love who lives with dementia? (Make a list of as many things as you can think of.)
What lies behind the list of answers to question 12? What emotions might play a role in my answers?
What would happen to me if I became isolated, bored, disconnected, lonely, and unloved? What might happen to others in similar circumstances?
What am I grateful for? What am I angry about?
What is important to me? What is my purpose? What constitutes living?
How has the person I know/love who lives with dementia impacted my life? Has my life or well-being ever depended on them? In what way?
What do I want the person I know/love who lives with dementia to know about the way I feel about them? Have I told them? When and how? Have I shown them? When and how? What did that feel like for me? If I haven’t told them, why not?
Is it important that the person I know/love who lives with dementia recognizes me? If yes, who is it important to?
If the person I know/love were to die tomorrow, would I have any regrets?

Sometimes questions are more powerful than answers; I hope these are helpful. I think it’s also important to remember that we can’t control others’ behaviour and some people will choose to distance themselves no matter how much we might wish them to be involved (more on that here).

Links to other sets of 20 questions here.

https://myalzheimersstory.com/2020/02/16/20-questions-to-ask-yourself-when-someone-who-lives-with-dementia-wants-to-go-home-or-tries-to-escape-wherever-they-are/

https://myalzheimersstory.com/2016/10/14/20-questions-to-change-the-direction-of-dementia-aggression/

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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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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