Best early advice for carer givers, especially dealing with aggression?

[JulieOpenUni]

What is considered the most valuable early advice for new Dementia care givers, especially any useful advice in coping with aggression? I am interested in advice carers pick up from both informal and formal sources or even just trial and error. I have a short time frame for understanding this area more (by end of April) so would really appreciate relevant insights/ quick shares where possible.

 

[Cat27]

@JulieOpenUni has permission to post.

 

[canary]

Get paperwork sorted out - POA (both finances and Health) as soon as possible

Apply for Attendance Allowance ans see if there is anything else that you can benefit from esp Council Tax Exemption.

Dont assume that you will always be able to cope on your own. Get help in as soon as you need it.

Not every person with dementia will become aggressive, some do and some dont - everyone is individual so blanket advice will not work. If aggression becomes a problem try and find out the trigger - is it pain, sundowning, fear? Is personal care the trigger, or trying to explain things? In OHs case it was saying the word "no" which made him feel that I was trying to control him.

Dont be guilt tripped by people who have no experience of dementia.

 

[TNJJ]

If you are in a situation where someone is getting aggressive and confrontational.Walk away. Gives them and you a chance to calm down.
I was a paid carer in community and homes. Now unpaid carer for my parents.

If they are in a dangerous situation try and make it less so but not always possible. Sometimes distraction works,sometimes doesn’t.
Sending a different person in can sometimes work. Sometimes PWD take a dislike to someone and no matter what they just dislike them.

 

[lemonbalm]

As @canary mentions, look for triggers. Aggression, shouting and screaming can often be caused by something as simple as a need to go to the toilet, or being too late and being wet/soiled, or just being tired. It can be caused by sheer frustration at not being able to express that they are in discomfort or in pain, or that they are unable to do something they want to do/say what they want to say. Do not confront them, try to speak calmly and softly in short, easy to understand language, never shout. If you ask a question, make it one that can be answered yes or no. Sometimes distraction such as soothing music, tea and something sweet can help. Dementia can be very frightening, both for the person with the dementia and the carer/s. Show compassion, never argue, step back if the person is very angry or trying to scratch/punch (I have sometimes actually put my hands up slightly in a conciliatory gesture). Remember that it is not their fault.

 

[JulieOpenUni]

Get paperwork sorted out - POA (both finances and Health) as soon as possible

Apply for Attendance Allowance ans see if there is anything else that you can benefit from esp Council Tax Exemption.

Dont assume that you will always be able to cope on your own. Get help in as soon as you need it.

Not every person with dementia will become aggressive, some do and some dont - everyone is individual so blanket advice will not work. If aggression becomes a problem try and find out the trigger - is it pain, sundowning, fear? Is personal care the trigger, or trying to explain things? In OHs case it was saying the word "no" which made him feel that I was trying to control him.

Dont be guilt tripped by people who have no experience of dementia.

Thank you so much for these useful comments. I have heard a few others talk on the value of playing close attention to triggers. A real strength came across in your comments and I really wish you well. Thank you.

 

[JulieOpenUni]

As @canary mentions, look for triggers. Aggression, shouting and screaming can often be caused by something as simple as a need to go to the toilet, or being too late and being wet/soiled, or just being tired. It can be caused by sheer frustration at not being able to express that they are in discomfort or in pain, or that they are unable to do something they want to do/say what they want to say. Do not confront them, try to speak calmly and softly in short, easy to understand language, never shout. If you ask a question, make it one that can be answered yes or no. Sometimes distraction such as soothing music, tea and something sweet can help. Dementia can be very frightening, both for the person with the dementia and the carer/s. Show compassion, never argue, step back if the person is very angry or trying to scratch/punch (I have sometimes actually put my hands up slightly in a conciliatory gesture). Remember that it is not their fault.

Thank you for your quick and helpful feedback. Did you learn this approach (don't confront...speak softly, yes/no questions) through working things out yourself, from others or from set guidance might I ask? Maybe a blend of all 3 could be realistic?

 

[JulieOpenUni]

If you are in a situation where someone is getting aggressive and confrontational.Walk away. Gives them and you a chance to calm down.
I was a paid carer in community and homes. Now unpaid carer for my parents.

If they are in a dangerous situation try and make it less so but not always possible. Sometimes distraction works,sometimes doesn’t.
Sending a different person in can sometimes work. Sometimes PWD take a dislike to someone and no matter what they just dislike them.

Thank you so much for your feedback, it sounds like you have experience in all angles through paid work and now your family. All useful points. Thank you so much.

 

[lemonbalm]

Thank you for your quick and helpful feedback. Did you learn this approach (don't confront...speak softly, yes/no questions) through working things out yourself, from others or from set guidance might I ask? Maybe a blend of all 3 could be realistic?

Learned mainly from experience, partly instinct and from online research.

 

[canary]

A tip that i learned from someone else to avoid my OHs trigger of me saying "no", was to never say that word, but instead to start the sentence with "yes" and then say what I needed to say, even if I was actually saying no.
eg - OH says - Im going down to the cafe now for coffee
Me - Yes, that would be nice, but they are shut today. Perhaps we can go again when they are open.

 

[Weasell]

The difference with dementia is it sounds like one condition. In reality the individual can be an assortment of different people throughout the day, and this requires
the person interacting with them able to deal with that.

The person can go from someone unable to work any kitchen appliances, to lecturing you like the ex head teacher they once were, and in a very short space of time.

The carer also needs to work out a way to receive the aggression aimed at them and not take it personally, this is an art in itself. If they don’t sort this out it will show in their body language when they next deal with the person.

It is important the carer doesn’t think they can ‘ educate’ or train the person. The motivational speech ( not to leave the ham out of the fridge overnight ) they gave yesterday was wasted. It’s today now, the person has forgotten it !

The main triggers I find are poor communication, making demands on the person and trying to do anything faster than a snails pace.
On this site there is a link for ‘ compassionate communication’ that is simply wonderful at preventing aggression.

It may be useful to cover some basic points from the mental capacity act. Also ABC’s can be used to build up a picture of why challenging behaviour is occurring.
But my best advice is if aggression turns to violence then run!

Compassionate Communication with the Memory Impaired

The following piece was posted a while ago on DSF and made a big impression on me. It is something I have referred to time after time and tried hard to follow. We have many new members who may not have seen it before. Yesterday I posted it on another Thread but thought it might be helpful if...

forum.alzheimers.org.uk

 

[TNJJ]

I have yes. I have been pinned up against a wall and then with another client had a knife pointed at me. In those cases distraction worked as I couldn’t run. The lady who pinned me up against the wall was often looking for her cat(it had died)I told her it had just walked into the kitchen. She let me go and then went looking..I got out of there as fast as lightening and refused to go back. Very often you have to think on your feet and can never be complacent. (She should have had 2 carers but the company refused to send two. In the end nobody went in. Another care company took over...