Angela LundeAngela LundeAngela Lunde is a dementia education specialist in the education core of Mayo Clinic's Alzheimer's Disease Research Center at the Abigail Van Buren Alzheimer's Disease Research Clinic in Rochester, Minn.
The transfer of information about dementias, as well as understanding the need for participation in clinical trials, is an essential component of the education core.
Angela is a member of the Alzheimer's Association board of directors and co-chair of the annual Minnesota Dementia Conference. She is a member of the Dementia Behavior Assessment and Response Team (D-BART), a multidisciplinary outreach service assisting professional and family caregivers in understanding and managing difficult behaviors often present in dementia. She facilitates several support groups, including Memory Club, an early-stage education and support series, and more recently, helped to develop and now deliver Healthy Action to Benefit Independence and Thinking (HABIT), a 10-day cognitive rehab and wellness program for people with mild cognitive impairment.
Angela takes a personal interest in understanding the complex changes that take place within relationships and among families when dementia is present. She is particularly interested in providing innovative and accessible ways for people with dementia and their families to receive information and participate in valuable programs that promote well-being.
"Amid a devastating disease, there are tools, therapies, programs and ways to cope, and it is vital that families are connected to these resources," she says.
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July 27, 2010
Tips for diffusing anger in those with dementia
By Angela Lunde
Vickie, 57, wrote in previously about caring for her 74-year-old husband (I'll call him Dan) who has dementia. She shared that they recently went out of town with two other couples. On the second night, Dan began saying he wanted to go home. But because they came with another couple and were 300 miles from home, that was impossible. Vicki told Dan they couldn't go home and he got very angry. After a while, a friend took Dan for a drive and he calmed down. Vicki asked for suggestions in handling these types of situations.
The desire to "go home" is not unusual for people with dementia. Home is a place of security, comfort, familiarity and routine — being away from home compromises each of these. Vicki's story probably resonates with many of you, so let me offer some thoughts that may be useful in these situations.
Whether we have dementia or not, each of us desires a sense of control in our lives. When Vicki told her husband, "Dan you can't go home," his sense of control was threatened and he became angry.
In people with dementia, when we use phrases such as "You can't," "I want you to," "You need to," "I told you," "That's not what I said," and so on, we can make a tough situation worse.
Yet, I completely understand the reality of Vicki's situation and that it wasn't possible to take her husband home. Vicki was simply being honest with her response. Vicki employed a good strategy in having a friend take Dan for a drive- an attempt to redirect Dan's attention.
Consider this, if we as caregivers can respond to our loved one with dementia in a way that offers them a sense of control or an illusion of control, we can diffuse reactions of anger and the outcome may be more desirable. A way to do this is by validating their feelings, joining their agenda, and lastly redirecting. Think of it as a 3 step process. Here's what this could sound like using Vicki's scenario:
"Dan, I can tell that you'd rather be home right now. I want what's best for you because I love you (validating Dan's feelings). If you give me some time maybe I can work something out (joining Dan's agenda). In the meantime, George would love your company — he's going out for a short drive, let me grab your coat (redirection)."
Dan may now feel that he's been heard and his needs are being addressed — as a result he is more likely to be redirected and accept the invitation of a car ride.
It's also at this time when we need to leverage what the disease gives us — short term memory loss. Once Dan is redirected to another activity, time will pass and there is a good chance he'll forget about wanting to go home. At least, he may forget for a while and that's not a bad outcome either. The next time Dan wants to go home, which may be in 15 minutes or the next day, you can cycle through a similar process.