Every day I am reminded of what a trigger is. In the world of dementia/alzheimer’s a trigger is something in the environment that will initiate a negative response from the patient. The trigger can be a person, an animal or even a thing. Pay attention to changes in facial expressions and of general behavior and work on either a different approach, a distraction or eliminate the trigger.
The Trigger causes stress and stress can lead to her lashing out verbally and/or physically. The dementia mind feels they are being personally attacked and they will retaliate. Lashing out may begin because of the trigger but it is likely to last for hours after the trigger has been stopped or removed.
Here are some examples of a Trigger and how to redirect or remove your loved one away from the trigger. I’m going to use mom in these examples.* Trigger: Mom talks about family but seems to make mistakes in naming each person or she makes mistakes in how old each person is. – I continue the conversation without making corrections to what mom is saying. To keep the conversation pleasant and a happy experience for both of us I just go with the basic approach. There is really no reason to correct her. It isn’t necessary to be right about the facts. The goal is to have a wonderful experience with mom and most times she corrects herself anyway and if she doesn’t, so what?! It’s not worth an argument which will lead to bad feelings for both of us. With dementia, remembering facts correctly can be a challenge and you are not going to make her see it correctly by telling her the actual facts, so give it up! It’s just best to turn the attention to another aspect of the conversation. Changing the direction of the conversation means there will be no frustration and no argument. Arguments are not a good feeling for either of us. If this visit were to end with frustration or bad feelings that would probably cause me to feel apprehensive about the next visit and I would be more prone to put off the next visit because I just don’t want to be there. It’s unpleasant. Get a grip, mom has a disease, it’s called dementia, get over it and work with it because you cannot change what is happening with her brain. And it should be all about love in the end not about who is right and who is wrong. If you make it about right and wrong, you will loose every time! * Trigger: Dinner is finished and time for the clean up. Mom gets upset because you are doing the cleaning up. Because you tell her that you will do the cleaning up she feels useless and incapable. – To get mom to help with clean up place a dish tub, on the table and then ask her to put all the silverware into the container. While she is busy working on the silverware you can get the breakable dishes into the dishwasher. Then hand mom a dishcloth and have her wipe the table. All she wants is to feel useful. There are simple ways to make that happen. * Trigger: Don’t tell mom she is wrong. – Mom has been living at this facility for 3 months now. She has always been in the same room. She gets her room mixed up everyday and every time she is exiting the activity room. When she is leaving the activity room she must take a left turn to go to her room but she insists that the room she stays in is to the right. She has been known to crawl into bed in the wrong room. Hard to figure out why she relates to that room but she does. – So, what I do when we leave the activity room is I always say “Left Turn”. She always comments that she has two rooms and that she spends the most time at the right turn room. So after she makes her comment about the other room being the room she spends the most time in I tell her let’s go find the room where your picture is. I tell her that I like that room because you can see the garden right outside the window. Let’s go see if the afghan you made is on this bed. We find her photo on the wall outside of her room and then we open the door, sure enough there is her afghan and photos of her family on the wall. Then she decides this is a good room and she will settle in there. She is now getting so that she will tell me that she likes this room better than the other one. – To handle this potentially explosive situation I would never tell her she was wrong, I just guide her along so she could recognize her personal items in the room where she really does sleep. * Trigger: From time to time mom needs to have certain doctor appointments. This time it was an appointment with the eye doctor. – This is what we did. I planned for this to be a full day for mom to be on an outing out of the facility. I called the doctor’s office in the morning on the day of the appointment. I explained that mom has Alzheimer’s and we need to be creative with this appointment to make it work. When we arrived Bob the eye technician came out and greeted me with a hug and said “How are you, it’s so good to see you again”! (This guy was super good!!) He asked me “Is this your mom? We have a two for one special going on today and your mom can have her eyes checked for free”! It worked like a charm. It was fun and mom had no apprehension at all. My eyes were checked and then mom’s eyes were checked. All the questions that had to be asked for mom were asked of me in a private meeting while mom waited for her turn to see the doctor. When it was her turn she was happy to have her eyes checked and all went well. Mom thanked Bob and the doctor several times and she was quite pleased to have had her eyes checked.
I would say that the main trigger for mom is when someone makes her feel that she is not wanted and that she is not good enough. These two things are feelings, they are not words. When you combine those feelings with inappropriate words then we have potential for an explosive situation and at the very least, she feels inadequate.
It is partially the ‘dementia mind’ that creates the trouble of making her feel excluded, unworthy, rejected, stupid, unloved, not being cared about, nobody wants to be around me anymore and so many more of those horrible feelings. But again, the feelings began years ago with isolation and depression which led to the feelings of inadequacy.
Now we have been placed in the position of leaving her in a living situation where all the people who live there have problems and these are not her friends and she feels alone. There is no way to change that. All we can ever do is to be there to visit every single day and make sure she doesn’t spend every moment of every day feeling abandoned. I think we are doing a good job of that and I feel like she is pulled into life and it’s routines much quicker now than before we moved her.
Reminder: I am not a professional and I am not qualified to give advice. These are my thoughts and my opinions.