How to manage stress for dementia patients

Everyone probably has experienced some form of stress at one point in their life. For patients with dementia, feelings of stress and anxiety may surface more often and thus it is key that we understand the root causes of these feelings of distress and respond to them appropriately. 

In this article, we breakdown how patients with dementia can manage stress and how caregivers can come in to support

Signs of distress in a person with dementia

1. Shouting, crying to communicate needs or even shouting for no apparent reason
2. State of agitation – short tempered and starts using aggressive language
3. Withdrawing from the people around them and being unresponsive
4. Restlessness – causing the need to move around or pace

Common sources of stress

Oftentimes when someone in dementia is in a state of stress, it could indicate that the person is trying to communicate their needs and doesn’t know how else to express this need. It is important we understand where the stress stems from so we can better help address the need

1. Unmet needs – Unmet needs such as hunger, pain, feeling too hot or cold or emotional needs such as feelings of loneliness, anxiety can cause feelings of stress
2. Feelings of unfamiliarity and disorientation – new routines, having strangers in the same space or even changing of the placement of things in the bedroom can bring about additional stress
3. Past live events – Dementia patients have a tendency to get flashbacks of past traumatic experiences
4. Environment – Overstimulation by light/noises
5. Frustrated by inability to communicate needs

What can dementia patients do to combat stress

1. Practice relaxation techniques – relaxation techniques may include deep breathing, massage, meditation, Tai chi, Yoga, music and art therapy. Getting in some exercise or even listening to your favourite music are easy ways to relax
2. Identify sources of stress – once we know the root of the stress, we can target it more easily through the appropriate remediations. For example, if feelings of unfamiliarity is causing you stress, it is time sound out to caregivers and family that this is giving you stress
3. Establish boundaries – Establish your boundaries and let others know your limits. It is important to be as open about this as possible
4. Communication is key – By letting your caregivers and family members know what is causing you distress allows them to tailor their approaches and better address the situation

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5. Practise positive affirmations – Positive affirmations are buoyant and confident statements or phrases one repeats and inculcates in the mind to eventually foster a positive mindset. These affirmations can be about a variety of things – from self-improvement, personal goals or simply going through a tough period.

How can caregivers help

1. 1. Utilise effective and positive communication approaches. Patients with dementia may have difficulty understanding what is communicated to them so as caregivers, it is important to reduce feelings of distress through having more effective communication 
      1. Speak calmly
      2. Smile and nod to show you are listening and trying to understand
      3. Be patient and give them more time to process and answer your question
      4. Remind the person who you are
   2. Making sure the patient’s fundamental needs are met
      1. Ensuring that people are not experiencing pain – checking their pain levels and by providing pain relief on a regular basis before this leads to distressed behaviour

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      2. Supporting them with Activities of Daily Living (ADL)
      3. Ensuring good nutrition
   3. Responding positively to people with dementia who are communicating distress
      1. Use calm voices, gentle tones and short sentences
      2. Show you are listening and demonstrate empathy/understanding by using facial expressions and nodding your head in acknowledgement 
      3. Encourage the patient with positive affirmations and provide assurance that they are not in this alone

Conclusion

If patients with dementia are expressing distress, it is critical that the situation is assessed accurately and have the root causes of the distress identified. This helps both the patient to feel better and the caregiver to have a better relationship with the care recipient. There are a ton of resources and helplines online for both the patient and the caregiver so do not hesitate to reach out if you find yourself struggling and need help.