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Spectrum of Care with Dementia Darling: Dementia Symptoms and How to Respond

Hello caregivers, Dementia Darling here with some more information to help you with the daily challenges of caregiving for those living with dementia! If you don’t know them already, take the time to read more about each term listed below because they are so important for you to know! When we understand what our residents are experiencing, we can better care for them.

Important Terms

  • Hallucination: seeing, hearing, tasting, smelling, or feeling something that is not there
  • Delusion: false beliefs
  • Sundowning: state of “unrest” later in the day
  • Agnosia: inability to recognize people or objects
  • Apraxia: inability to complete familiar tasks because the brain can no longer communicate what needs to be done

Meet Them Where They Are

Meet them where they are

The best advice I was ever given in memory care was to “meet them where they are.” Meet your residents where they are, at that moment. This is important to remember when our residents experience hallucinations, delusions, symptoms of sundowning, and so on. Do not try and orient the person to your reality, as that can lead to agitation and feelings of upset. Our job as caregivers is to be a detective and figure out what they need from us. Are they upset because they are in the middle of a hallucination? Are they upset and agitated because they must go to the bathroom? Are they exit-seeking because they do not feel safe? Caring for individuals along the dementia journey is not black and white. You must learn to read the gray areas and figure out what your resident is truly trying to communicate.

Put yourself in their shoes! Practice empathy. Try and be considerate of what agnosia and apraxia do to someone’s ability to communicate their needs or to communicate anything at all. When you start to look at the whole picture of what is happening to your residents, you can start to understand and empathize with how difficult it must be for them to communicate effectively. It is in these difficult moments that you as a caregiver must meet them where they are.

A Therapeutic White Lie

Sundowning - heightened emotions starting later in the afternoon
It’s important to note that sundowning can look different for everyone. Symptoms of sundowning can be crying, becoming angry, pacing, exit seeking, and anxiety.

You may think it is unkind to lie; however, this term is called “therapeutic fibbing” and is essential for memory care. This is not something you take advantage of, but when needed, you can use this method as a very effective tool. Therapeutic fibbing is when you engage your resident in their reality which will require you to tell a few white lies. For example, I cared for a gentleman who often asked where his son was. His son died when he was very young, but I did not see the point in telling him that. In his mind, his son was alive and well. So, I said, “He is at school right now, he will be home later!” This created a sense of calm for my resident and led to a peaceful mood. If I had told him the truth, he would be catapulted into grief and sadness. No one deserves to live in memories of sadness.

Below are examples of meeting residents where they are with therapeutic fibbing:

Example 1:

Resident: “I need to pick up my children from school, get me out of here!”
Caregiver: “I heard they went home with friends today; they will be back for dinner. Tell me about them! How old are they?”

Example 2:

Resident: “I had a long day at work today!”
Caregiver: “You must be exhausted! Would you like a snack?”

Example 3:

Resident: “Where is my mom?”
Caregiver: “She is still at work; she should be home soon. Tell me about your mom!”

Technology to Engage and Relax Memory Care Residents

In preparation for sundowning time, try to proactively divert sundowning symptoms by starting a relaxing activity. Your distraction techniques may not always work but it is worth a try. A great iN2L + LifeLoop tool is to play a curated sundowning playlist under therapeutic music.

On your iN2L system, navigate to the locations below for therapeutic content:

  • Play a curated sundowning playlist:

NAVIGATE TO: Listen –> Therapeutic Music –> Sundowning

  • Begin a relaxing painting video:

NAVIGATE TO: Learn –> Art –> Wow Art

  • Watch a classic movie on Saltbox TV to redirect attention:

NAVIGATE TO: Watch –> Saltbox TV –> Movies

After engaging residents in conversation, you can redirect them to the iN2L system or tablet. Open a piece of content focused on something they are interested in, find a fun game for you two to play, listen to their favorite music, look at family pictures, or play in the lagoon for example. Use your system/tablet as a redirection tool during these times of agitation and confusion!

This blog shows just how unique and challenging dementia caregiving can be. Every resident, every day, and every hour is different, but it is NOT impossible! Together with these tips, your caregiving knowledge, and your iN2L + LifeLoop technology, you have access to amazing tools that make it possible for you to face these difficult symptoms as they arise. I encourage you to open the discussion up with coworkers. Talk about the symptoms and share strategies so that you are working together to provide your residents with the best memory care possible! Thank you for all that you do!

Dear Dementia Darling

Do you have any questions for me? I want to invite you to reach out to me with any questions you have about caregiving, iN2L + LifeLoop, dementia, and more! I will answer them through videos that you can access through our systems and on social media (@dementiadarling). Your questions can help other caregivers on their caregiving journey. Let’s support each other. I look forward to answering your questions! 😊

Dementia Darling
Carrie Aalberts, also known as Dementia Darling, is a certified Dementia Practitioner and Montessori Dementia Care Professional.

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