Why Identifying the Feelings Behind Actions is Crucial in Dementia Care
As dementia progresses, verbal communication often becomes difficult, which can lead to actions that may seem puzzling or disruptive. These actions—such as agitation, aggression, wandering, or repeated questioning—are usually signals of unmet emotional needs, like fear, frustration, or a desire for comfort and familiarity.
Identifying the feelings behind these actions is key to responding effectively and reducing distress. The person-centered care approach, widely used in dementia care, emphasizes understanding each individual’s emotions, personality, and life history. It encourages caregivers to view actions as a form of communication, especially when verbal abilities decline.
Common Dementia Actions and Their Emotional Triggers
Let’s look at some common actions seen in dementia care and examples of how identifying underlying feelings can lead to more appropriate responses:
1. Agitation and Aggression
Agitation and aggression are common reactions, especially when an individual feels overwhelmed. These responses are often rooted in fear or frustration.
For example, during a bathing routine, a person may react aggressively because they feel vulnerable or frightened, not because they are angry. Understanding that the underlying feeling is fear allows caregivers to approach the situation with calm explanations and reassurance, making the experience less distressing.
2. Wandering
Wandering can pose safety risks, but it's often driven by a need for familiarity or security. A person may wander because they are searching for a place they remember or a sense of purpose, such as "going to work."
Creating a familiar environment with personal items or engaging the person in purposeful activities, like folding laundry, can help satisfy their emotional needs and reduce wandering.
3. Repetitive Questioning
Repeated questioning is a common source of frustration for caregivers, but it's often a sign of anxiety or uncertainty. When a person continually asks, “When are we going home?” they may not be talking about a literal place but are instead expressing a desire for comfort and security.
Responding with patience and reassurance can address their need for stability rather than correcting or becoming frustrated by the repetition.
4. Refusal to Eat or Bathe
Refusing food or personal care is often linked to feelings of discomfort or loss of control. As dementia progresses, individuals may no longer recognize the need for basic care or may become distressed by unfamiliar sensations.
Offering familiar foods or allowing them to choose between two meal options or bath times can help restore a sense of control and reduce resistance.
Steps to Identify and Name the Feelings Behind Actions
To effectively manage these actions, caregivers must first practice empathy and observation. Here are a few steps that can help identify and name the emotions driving the response:
Observe the Situation: Look for patterns. When does the action occur? After a particular event? At a specific time of day?
Consider the Person’s Life Story: Understanding the person’s background can provide valuable insights. Did they thrive in routines, or were they more spontaneous? This history can help identify unmet emotional needs.
Check for Physical Discomfort: Sometimes, actions are rooted in physical discomfort, like pain or hunger. Always rule out physical causes before focusing on emotional triggers.
Empathize and Reflect: Ask yourself how you might feel in their situation. Naming the emotion (e.g., fear, frustration, or loneliness) can help guide your response.
Respond with Compassion: Once you’ve identified the emotion, respond in a way that addresses that need—whether it’s offering comfort, reassurance, or adjusting the environment to ease their distress.
Real-Life Example
Consider Mrs. Johnson, a woman in the moderate stages of dementia who frequently tries to leave her memory care facility, insisting that she "needs to go home." Initially, the care staff would tell her, "This is your home now," which only increased her agitation.
After attending a dementia care seminar, the staff learned to recognize the underlying feelings behind Mrs. Johnson’s actions—disorientation and anxiety. Instead of correcting her, they now offer comfort by discussing memories of her childhood home, providing reassurance, and offering comforting gestures like a warm blanket. This compassionate approach meets her emotional need for security, and over time, her attempts to leave the facility became less frequent.
How the ADDC Seminar Can Help
Understanding the feelings behind actions in dementia care is essential for creating compassionate, effective care strategies. In my Alzheimer’s Disease and Dementia Care (ADDC) seminar, we explore this topic in depth, offering practical tools and real-life examples that caregivers can use immediately. We discuss how to identify emotional triggers, implement person-centered care, and foster environments that promote comfort and security.
For those who qualify, the ADDC seminar is also the prerequisite to obtaining your Certified Dementia Practitioner (CDP) designation from the NCCDP. This seminar is a valuable step in advancing your career and expanding your expertise in dementia care.
If you’re looking to enhance your understanding of dementia care and improve your ability to respond to challenging actions, join us for the next seminar. Last-minute sign-ups are always welcome, and we offer a relaxed, engaging environment where you can learn from both expert knowledge and shared experiences.
Sign up here: https://www.dementiaknowledgenetwork.com/booking-calendar/alzheimer-s-disease-dementia-care
Questions? Contact me directly at rwalters@dementiaknowledgenetwork.com
This blog was very helpful in explaining some of the behaviors that dementia patients present. Caregivers can easily become frustrated- especially when they don't know the underlying reasons for the behaviors. This helps us understand and respond appropriately.