More than 11 million adults in the United States care for people diagnosed with the disease Alzheimer’s and other forms of dementia. In addition to memory loss, most people with these types of disorders experience changes in mood and behavior, such as aggression, apathy, disorientation, depression, wandering, impulsiveness and delusions.
In this regard, many caregivers describe mood and personality changes as the most bothersome symptoms. Although antipsychotic and sedative drugs are often used to control dementia-related mood problems, their effectiveness is limited.
In a report for the New York Times, the expert Nathaniel Chingeriatrician and associate professor in the Department of Medicine at the University of Wisconsin-Madison, said that to manage mood swings and feel less overwhelmed by them, it is helpful for healthcare professionals to remember that these changes are due to brain changes.
“It’s no one’s fault, and recognizing that can help you feel less angry at your loved one,” the specialist said. Personality and mood changes are often due to deterioration of the parts of the brain that control attention, learning, feelings and other abilities.
“For example, a person who has lost cells in the frontal lobe, which control attention and behavior, may become more passive, decreasing the ability to plan,” according to the Center for Memory and Aging at the University of California, California campus. San Francisco. Francis; The person may also lash out at others, decreasing impulse control. It is true that the popular actor resists Bruce Willis.
“Additionally, people with dementia have less brain energy to process and adapt to environmental sensations and stimuli,” Chin said. Many experts also agree that people with dementia have lower stress thresholds than before and may feel overwhelmed more quickly. This is when a person with dementia may suddenly become agitated or combative, or start screaming.
“As the disease progresses, people lose language skills and communicate more through behavior,” he pointed out. Fayron Eppsprofessor of nursing at the University of Texas Health Science Center at San Antonio. “For example, a person might need to go to the bathroom, but can’t convey that verbally, and might hit something to express their frustration,” Epps explained, cautioning, “As a caregiver, you really have to investigate where that mood comes from. where it comes from.”
Caregivers of people with dementia have a system in place to address behavioral symptoms. They developed an educational program for healthcare professionals, known as the Approach DICEwhich means: describe, investigate, create and evaluate. The approach teaches caregivers to describe mood changes in detail (noting when, where, and even with whom they occur), investigate why they might occur, create informed reactions, and evaluate their success.
The teacher Elena Kales described a case in which DICE-trained health workers assisted and calmed a woman in a nursing home who wandered at a certain time every day. After investigating possible causes and learning that she was an avid gardener, caregivers began taking the woman to the residence’s patio once a day and helping her “get her hands in the dirt.”
“People with dementia may not understand exactly what you are communicating, but they will understand your tone and body language,” she explained. William Haleyprofessor of aging studies at the University of South Florida, who advised doing everything possible to speak calmly, with a relaxed face and posture. “Don’t get too fixated on the facts. Correctively telling a person with dementia that it’s Wednesday, not Thursday, could make them more nervous, and reminding someone of a serious misfortune they’ve forgotten can be devastating,” Haley said.
Martin Schreiber, author of “My two Elaines” a book about his experience caring for his wife, who has lived with Alzheimer’s for more than 15 years, advised: “It is not possible to successfully deal with this disease, but telling white lies and redirection are two useful strategies that many other caregivers health workers have used to provide care.” comfort and support.”
“Ensuring that people with dementia are regularly exposed to natural light and other forms of bright light can improve their sleep and mood,” they describe some of their research, adding that a good night’s sleep can reduce the so-called of sunset”, the crises that can occur with dementia at the end of the day, or at any time of the day, when enough stress and tiredness have accumulated.
“Taking a morning walk or doing another outdoor activity can benefit both of you,” Kales noted, adding, “But if going outdoors isn’t possible, a good alternative is to have your loved one sit up front to a window a phototherapy box (a device that imitates daylight) for about 30 minutes.
by RN
Interview between Time.news Editor and Nathaniel Chin, Geriatrician
Time.news Editor: Welcome, Dr. Chin! It’s a pleasure to have you with us today. Given the statistics indicating that over 11 million adults in the United States care for individuals with Alzheimer’s and other forms of dementia, let’s dive right in. What do you believe are the most significant challenges facing caregivers?
Nathaniel Chin: Thank you for having me! Caregivers face a multitude of challenges, but one of the biggest is managing the mood and personality changes that often accompany dementia. These changes can be profoundly frustrating and confusing for both the caregiver and the person with dementia. Mood swings—whether aggression, apathy, or disorientation—need special attention.
Time.news Editor: Absolutely, those symptoms can be very distressing. You mentioned that these are linked to brain changes. Can you elaborate on how this understanding can help caregivers?
Nathaniel Chin: Yes, recognizing that these behaviors are a direct result of brain deterioration can significantly relieve some of the emotional burden felt by caregivers. It’s important to understand that it’s not the person’s fault—it’s due to the damage in areas of the brain that control attention, emotions, and behavior. This realization can help caregivers feel less angry and more empathetic toward their loved ones.
Time.news Editor: That’s an insightful perspective. You also mentioned that the effectiveness of medications is limited. What are some alternative strategies caregivers can employ?
Nathaniel Chin: One effective approach is the DICE method, which stands for Describe, Investigate, Create, and Evaluate. This system encourages caregivers to carefully observe and document when and where mood changes occur and to investigate any potential triggers or underlying needs. By understanding the root causes, caregivers can create more tailored responses and evaluate their effectiveness over time.
Time.news Editor: DICE sounds like a comprehensive approach. Could you share an example of how this method has made a difference?
Nathaniel Chin: Certainly! For instance, a team of caregivers applied the DICE method with a woman in a nursing home who often wandered at a specific time of day. Upon investigation, they learned she was an avid gardener. By facilitating time in the garden, allowing her to engage with what she loved, they were able to reduce her wandering and improve her mood.
Time.news Editor: That’s a wonderful example of a personalized approach. It highlights the importance of understanding an individual’s past interests. How can caregivers effectively communicate with loved ones who may be losing language skills?
Nathaniel Chin: Communication becomes more non-verbal through the progression of dementia. Caregivers should focus on tone, body language, and presence. People with dementia might not grasp the words, but they often understand the feelings conveyed through these non-verbal cues. Key is to maintain a calm, reassuring presence even when verbal communication becomes challenging.
Time.news Editor: That’s a crucial takeaway for caregivers. Lastly, before we conclude, what advice would you give caregivers who might feel overwhelmed by the emotional and physical demands of providing care?
Nathaniel Chin: Caregiving can indeed be overwhelming. I encourage caregivers to seek support groups and resources in their communities. It’s important for them to prioritize self-care and find outlets to express their feelings. Connecting with others in similar situations can provide relief and valuable strategies that can help them navigate their journeys.
Time.news Editor: Thank you, Dr. Chin, for sharing your insights and expertise on such an important topic. It was a pleasure to speak with you, and I’m sure our readers will find this information invaluable.
Nathaniel Chin: Thank you for having me! I hope this discussion helps caregivers feel more empowered and supported in their vital roles.