Changing the Focus

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I get asked all the time how to deal with a loved one who is combative, asks repeatedly when am I going home, or who has begun to exhibit an ongoing behavior.  It’s tough. Communicating with a loved one with Alzheimer’s can be frustrating, exhausting, and downright challenging not to mention leading to potential care-giver burnout.

But, it’s not impossible.

Redirection is a great tool family care-givers can use within the situation.

What is redirection?

Simply put, its changing the focus or subject.

We’ve all done it.  Heck, I’ve used It on my husband as he has with me.  In conversation, we change the subject. We segue into a new conversation.

For family care-givers, it’s taking a new path — to move or lead your loved one away from a behavior using patience, objectivity, empathy and creativity.

Apply patience and objectivity.

Mom says she doesn’t want to take a shower.  It feels like a battle every time, and no matter how much you try to explain to Mom that she needs to bathe, she just seems to fight you.  It’s hard not to react and take it personally.  It’s easy to get sucked-in especially if we are exhausted.  When exhausted, our tone changes and our pitch rises which can escalate a situation.

But here’s the thing.  It’s not Mom. It’s Alzheimer’s.

Be patient.  Take a deep breath and step-back. Remove yourself from the situation.

Yes. This can be difficult.  It requires considerable strength and self-control but necessary since it’s not just your loved one with whom you are communicating – its Alzheimer’s – that zig-zagging maze of behavior, feelings, and physical conditions.

I know it feels like they are doing it on purpose and that they have an agenda. That’s simply not true because this disease robs your loved one of the ability to effectively reason and communicate what is happening to them.

Explaining to them why they have to start or stop something or offering logic won’t work.  And yet, it tends to be the go-to strategy that we were taught to use to communicate with others – offering sound arguments and logic to convey why something should or shouldn’t be done.  Alzheimer’s takes the logic map away requiring us to apply a different talk.

Validate.

Validation is an important tool in redirection offering a practical way of communicating with your loved one that is built on an empathetic attitude and holistic view without judgement. A therapy developed by Naomi Fiel, it allows your loved one to feel acknowledged and to process what is happening to them. While the memories, logic, and communication fade or become jumbled, the emotions don’t.  They are real.

Redirection with validation changes the focus by leaning in … leaning into their world.

Let me explain.

It’s not uncommon for a loved with Alzheimer’s to repeatedly ask, when can I go home and sometimes even when they haven’t been moved.

It’s possible Mom or Dad is experiencing a sense of loss and actually referring to their childhood home.  When you validate, you allow your loved one to process this emotion.  The redirection occurs through exploration.

Consider asking questions such as what they liked best about their home, what did they do, or who were their friends?  Its creative dementia speak and a conversation without judgement.  I encourage my families to allow a give-and-take in the conversation. Follow their lead.  Try using phrases from back in their day.

Be Creative

Creativity means variety and openness.  In redirection, we are leading our loved one to a new focus. A family care giver may face the same questions or resistance feeling that nothing is working.  Having alternatives will help.

Music is a wonderful tool in redirection especially if your loved one is feeling agitated.

My client Wanda is very combative, abusive and cusses A LOT— common characteristics with this crazy disease.  I learned that Wanda used to play the viola.  While in one of her combative states, I just played viola music.  She literally stopped, listened, and said HEY! I used to play the viola.

As she began to connect to the music, it redirected her combativeness becoming calmer and more lucid.  Her cussing and swearing were replaced with stories about her playing and how her grandson plays the viola and her granddaughter plays the violin.  It was wild and wonderful.  The music changed her focus.

Consider other activities or stimuli such as ice cream, looking at family photos, brushing their hair, or perhaps introducing some new smells such as lavender to promote relaxation.

Finally, and above all, be kind to yourself.

Alzheimer’s is exhausting. Be patient.  I know, easier said than done.  Take a time-out for you.

Join a support group.  In the groups I facilitate, we discuss a variety of activities that can be very effective in redirection.  A support group also helps family care-givers process what is going on with their loved one not to mention providing a break.

Let me know what’s working for you. In the meantime, be well.

Note: The above should not be construed as medical advice. Please consult your physician to rule out any physical issues.

*Client names were changed to protect anonymity

Lauren Spiglanin is CEO of Family Connect Care and a leading authority in care management, specializing in helping people challenged by Alzheimer’s and dementia. She has been providing caregivers with peace of mind and advocacy for their loved ones since 2008 and speaks widely to caregivers offering solutions to mitigate burnout. She is a certified Gerontologist and member of the National Association of Professional Geriatric Care Managers, a designated Alzheimer’s Association Educator and holds certifications in Wound Management, Facilitation, Mediation, Validation Therapy and Residential Care Facilities for the Elderly.  She also holds a Bachelors’ degree from the University of La Verne.

 


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