Tuesday, June 9, 2020

Deconstructing an Alzheimer's Meltdown

I was once in a class on "How to deal with difficult behaviors in Alzheimer's and Dementia". I left that class very disappointed, why? well, when an audience member asked the presenter, what was a meltdown? listening to her reply was almost embarrassing. She proceeded to describe a Meltdown as, being very upset when things don't go your way. I was what!! if you have witnessed a person with AD or Dementia have a meltdown, it is more than being upset!. It is a full-blown anxiety episode,
Where the person might be pacing back and forth, asking constantly, when am I going home? Many times the home that they are referring to is not their present home. When you realize this, you will figure out how to best help them. Stating that their mom is waiting for them when the mom has been deceased for a few years. Or maybe insisting that they are going to be late for work when they have been retired for some time. It is their reality at that point and time. It has to be acknowledged and dealt with a lot of patience & caring. As it can easily escalate, within seconds.

Whatever their fixation is you have to manage it as best as you can, it can be a mild case of just needing redirecting, changing the environment, or completely changing the subject. You have to know that whatever the cause for their anxiety is, it is very real to them. Don't mock, don't try to argue, don't try to rationalize with them or scold them. If you do any of these things you will probably end up with them having a full-blown meltdown. I have known of situations where the situation escalated to a point where the police had to be called. Trust me when I tell you, you don't want that. 

The police department and the  fire department keep records of those types of incidents if they notice a pattern they will call APS(Adult protective services). Try the best way that you can to keep them inside the house, that is if you are at home. If you are out and about, try to convince them to go to the car (remember rear seat, child lock on). Do the best that you can to prevent a situation where the police have to be called.  As explained in a past post, be mindful of your tone of voice, body language, and your gaze (how you look at them) they are very receptive to your emotional state. 

You have to remain as calm as the sea don't antagonize them, It is not a good idea
Get ready to walk into their world when they suddenly say, "My mom will be worried if I don't get home from school" always validate their concerns, reassure that you understand and will help to find a solution to their problem. Be empathetic. Even if you know that what they are saying is not true.

Pay attention to how their day is going, keep an eye out for any potential triggers that may cause an unfortunate situation. Always have your plan A, B, C, D, E F, and G, Be prepared! creating these contingency plans is a lifesaver, if one plan doesn't work, then move on to the other. Seriously, it will get to a point where you will be grateful you prepared yourself. keep an ongoing mental notebook and a real one, of what they like(makes them happy, changes their mood in a positive way), the same for what causes a meltdown, always pay attention to the time of the day, is it becoming a pattern? How can you change it? 

What is a contingency plan in the world of Alzheimer's, well, it is basically flipping a negative situation to a positive one, with various choices on how to obtain that. It can be mundane things, ice cream, music, eating a light snack, changing environment, go out to the patio, maybe call a person that has become their security blanket, that can calm them down. Figure out what works for them. I can not emphasize enough that it is in your hands how these meltdowns will play out. 

If you have outside help, being a caregiver or family member, ALWAYS give them a rundown of what to expect and what works for the individual. Be painfully specific.
Do not assume that because the caregivers have years of experience, she will know what to do, in a meltdown situation. All human beings are different, even Alzheimers and Dementia individuals. 

Be Prepared, Be Informed, Be Empowered and Be as Calm as the Sea.