Maintaining Sanity During Dementia’s Cognitive Decline

by Christy Cuellar-Wentz

I winced.  The woman in the grocery store reached her breaking point as the elderly man in her care grabbed handfuls stress, dementia, caregiverof gold wrapped chocolates and shoved them in his pocket.  Her words spilled out in a rush.  "Don't you understand that you're not allowed to have those?  They give you diarrhea, which I have to clean up!  And even if you could eat them, we have to pay for them!  You're driving me crazy!"

While this was an uncomfortable moment, I don't blame her at all.  I understand her frustration, having been closer than I'd like to admit to the edge of my patience on a number of occasions.  Perhaps you have, too.

The good news is that elderly charges suffering from dementia aren't actually trying to drive their caregivers crazy.  They are simply functioning the best they can with rapidly diminishing mental resources.  Here are some strategies that help me keep my cool:

Revise expectations.

Let's face it.  We are used to interacting with people who have their mental faculties solidly intact.  Cognitive changes in dementia require that we re-evaluate our expectations in light of the changing state of our loved ones.  Who they are now may be quite different than who they were six months ago.  If we understand that they can process very little outside of the immediate moment, we can reduce our stress levels (and often theirs) by communicating accordingly.

Choose your battles.

As caregivers, there will be thousands of times that we disagree with something our loved one wants to eat, wear or do.  Only a fraction of these will be truly relevant to their health and well being.  I don't always succeed, but I find that everyone is happier when I limit confrontations to safety issues.

Reduce reasoning and explanations.

As mental processing skills decline, it becomes more difficult for people with dementia to think things through.  Abstract ideas like time may become irrelevant in their world.  Arguing becomes an exercise in futility as the target of our carefully crafted arguments are not likely to "see the light" and come around to our way of thinking!  Offering fewer explanations and choices around essential daily activities decreases everyone's frustration.

Do you have a strategy for coping more gracefully with loved ones living in the "ever-present now?" Please share with our caregiver community by commenting on this blog!

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  3. This is all excellent advice. I care for my m-i-l 24/7 and I think we all really just do the best we can. It is certainly trying...