“He doesn’t have pain, he has dementia!” That is an absurd declaration! The person has dementia but has feelings so please let’s not treat them as if they are hollow and extinct. The person may not have the usual way of expression so we must tune in to the other signs they give which tell us something is wrong.
It is up to us as caregivers, professionals, and family members to decipher what is going on. It’s not always easy to get to the bottom of their anger, striking out, or calling out. We will need to become detectives and flush out the meaning of those moans, groans, mutterings, grumblings, crying, and anxiety.
If, for example they have an issue with a part of their body such as wearing a sweater that causes itching they may try to pull off their clothing. They may not be able to figure out for themselves how to relieve the itchy skin, remove the sweater, or even tell someone that they itch. So, when they get upset and the clothes start coming off staff will call them uncontrollable, confused, or disruptive. Look for a way to fix the problem by checking for obvious issues since they can’t verbalize it clearly as they once could. If you see your loved one taking off their clothing, ask them one question at a time such as “are you too warm?” “Does this sweater feel itchy?” Then proceed from there to change out the sweater for some other more comfortable item. Also, tag that sweater so other staff don’t retrieve it another time for them to wear.
If they are walking about in the Assisted Living Facility grumbling, muttering, whispering to themselves or others and won’t go back in their room, find out why. Check out the environment in their room as being too cold, too warm, lighting is not appropriate making scary shadows appear, or they are looking for their favorite stuffed bear thinking it’s in the commons area. There may be several reasons that they are restless and pacing around but “they have dementia and that’s what they do” is never one of the reasons.
If your patient or loved one is groaning, anxious, restless, holding their abdomen as they move about tensely and shuffle to the bathroom frequently there is another problem that may be more serious. It is imperative to check for a Urinary Tract Infection or UTI which is very common in the elderly and dementia persons. Another sign is an elevated temperature and needs to be addressed immediately as UTI’s can lead to severe kidney infections and sepsis if not treated appropriately in a timely manner.
In summary, persons who have dementia count on us as professionals, caregivers, and family members to get to the bottom of their non vocalization behaviors by opening ourselves up to closely interpret those behaviors and alleviate the discomfort whatever it is.
