Caring for someone with Alzheimer’s disease and other dementias can be challenging to the point where restraints seem like a sensible solution. But there are alternatives to this controversial technique.
Globally, Alzheimer’s disease is the most common type of dementia to affect the memory, judgement and thinking of older people. There’s no cure or proven means of preventing this condition and, as the world’s population ages, more people are expected to take on the responsibility of caring for someone with some form of dementia.
Over 321,600 Australians are currently living with dementia and that number is expected to rise to some 400,000 in less than 10 years. Additionally, an estimated 1.2 million Australians are already caring for someone with dementia.
Even though dementia affects people in different ways, research suggests that between 60% and 90% of dementia patients will display aggressive or challenging behaviours at some point during the course of their condition.
Did you know?
Because Alzheimer’s disease affects the brain, and the brain is the organ that controls our behaviour, it’s safe to say that the disease not only affects our physical state but our mental state as well. The following are a few ways in which challenging behaviour manifests itself:
• Repetitive questioning
• Angry or tearful outbursts
• Pacing and wandering
• Disturbed sleep patterns
• Shouting and screaming
• Violence
One or more of these behaviours will usually occur during the moderate to severe stages of the disease, and can be a cause for distress for both the patient and the caregiver. And while the immediate reaction would be to restrain the affected person, one has to consider whether this is the best solution. The use of restraints is now widely viewed as abusive and undesirable, even though it was often used in the past.
More pain than gain
Restraints have been shown to create serious and sometimes irreversible damage to the already fragile physical and mental state of people with dementia.
Some of the side effects of improper use of restraints include:
• Pressure sores and infection of existing sores
• Muscle wasting
• Balance problems
• Constipation
• Incontinence
• Fear
• Frustration
• Loss of dignity
• Depression
So, what are the alternative measures for caregivers to use when confronted with challenging behaviour?
Learn to recognise the triggers
Firstly, it’s important to recognise the triggers of sudden agitation or aggression. This differs from person to person, but may include:
• Boredom, inactivity and sensory deprivation
• Lack of social contact and loneliness
• Not liking or trusting a particular caregiver
• Inability to complete tasks
• Over-stimulation
• Physical discomfort such as thirst, pain or sitting too long
• High noise levels from TV or radio
• Stress
Prevention is better than cure
Preventative measures may not always work, but there’s no harm in adopting the following steps when taking care of someone in the moderate to severe stages of Alzheimer’s disease:
• Look out for the warning signs of aggression
• Ensure the person with Alzheimer’s disease is comfortable
• Eliminate possible causes of stress
• Don’t place too many demands on the person
• Keep daily activities unrushed and consistent
• Try to keep the environment consistent
• Always speak in a calm and reassuring voice
• Avoid confrontation
• Make sure the person gets enough exercise
REMEMBER: These are merely alternatives to consider in place of restraints. It’s best to consult a doctor if the person’s behaviour becomes harmful and unmanageable.
