The 4 R's of Responding to Dementia Distress

[@DementiaCareblazers]

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[@larryschoonover7913]

I like these suggested 4 R's- I use these in times of my wife's distressful moments and i say they work! My wife's Neurologist keeps wanting to prescribe another medication. I say NO! I have learned that when I reflect with my wife, and tell her that her emotion at this time is not her fault and it comes and goes, and that I will be with her through whatever is happening in her brain, the symptom passes on its own and i tell her that I love her and she is not alone. Sometimes I have to retreat for awhile and some times i redirect her attention. These 4 methods work much faster than any medication and have no side effects as medication can have. usually my wife just needs to be held in my arms, or i sit beside her for awhile, and i like that too. holding my wife's hand helps me.

[@socalogp7296]

Hey Dr Natali! I want to add a 5th R which is what I call Resolution! I have used this countless times with my Mom and it has never failed me. In your example, I would simply tell my Mom, "It's ok Mom, your work just called me and I spoke with the lawyers and they told me that it was a HUGE mistake and there is no problem at all. You're not in any trouble and they're very happy with your work". Again, this approach has worked for me every time and I hope it will continue to do so. Maybe work for others as well. LOVE your channel and thanks for all you do! ✌

[@bollybelly]

I use Resolution as you eloquently put it,with my husband. I tell him for example “Oh I already took care of that for you,” or “I made that call for you and everything is fine now” etc. It is very effective. 😊

[@socalogp7296]

@@bollybelly That is so great to hear!

[@bethsummerville341]

Yes, giving the person with dementia who is adamant or upset or worried a direct, simple response of their problem having been resolved really does help. I cared for people on a dementia unit for some years. One dear woman nearing 90 thought she was a little girl. She was very often missing her mother or fearful she had not completed her chores or homework, or thinking she was late for school. We would say "oh, your mom said you could spend the day with me and she will walk you home later!" Or we might tell her "you have all weekend to get your homework done. It's only Friday afternoon!" We might even give her a small notebook or small chalkboard and help her safely to a recliner, etc., put a blanket around her & she might soon be asleep. Or at least feel she was completing her "assignment." One gentleman whose wife came once or twice a day would wake during the night, thinking they were decades younger and asking where she was. She was also part of her church family's soup ministry & played cards with friends years and years ago. Because her husband didn't really grasp that it was the middle of the night, we would say, "oh she was at church making soup and was going to play cards cards a little while." He'd repeat what we said and think about it for a minute, and usually be satisfied and calmed by our answers. It was helpful to know their families, backgrounds and likes and dislikes, too.

[@Kevslatvin]

i have did this with my mother-in-law who lives with us and retired several years before getting dementia. She will sometimes wake up talking about how she has to get up and ready for work, she's going to be late. I on occasion have told her that work called and she has the day off. So far so good. She usually say "oh, ok" and goes back to bed as it usually happens late at night or very early in the morning. I hate to lie so to speak but if I told her the truth there's a good chance it would end up in an argument.

[@UppsalaSal]

⁠@@Kevslatvin I have felt the same about lying to my wife when she imagines something causes her anxiety. My rationale now is I can provide a made up response since the concern she has isn’t real, and the ability to use logic is not a her strength now.

[@contagiousintelligence5007]

1. Reassurance (we are there to help them) 2. Redirection (comes only after you tired to reassure them, ‘let’s go have a cup of coffee in the kitchen’) 3. Reflection (when they talk about unreal things, just let them talk. You don’t need to agree with them, just listen) 4. Retreat (if they are upset with you, just withdraw from their presence with some pretence)

[@misslinda772]

Thank you! ❤

[@brendaann2915]

I was just about to list them. Thank you so much! Blessings, BA

[@eandsm4620]

Thanks! This is helpful!

[@FionaAntonovich]

Hi, this happened with my Mum yesterday just before I was leaving. I sat with Mum and reassured her but watching this now I could've said more. Thank you❤

[@cathyviviano1377]

I mention your videos when I explain to others how much I've learned about dementia which helps me deal with my mom. I have sent your channel link to my sisters to help them too. So helpful. Thank you.

[@eandsm4620]

#'s 3 & 4. Watched this video when it came out. And it was in my recommends today. Last week was a very hard week. Things that he does with no problem, became problems last week. (re: making coffee w/out water, overwatering the plants, deleating important messages from our answering machine, and going shopping (w/ a small list) and he calls every 15 - 20 minutes for some reassurance). So late last evening he wants to put in Rid-x for our septic tank. Already too late in the evening to fully sit for the 8 hours needed. I simply said no when he asked about putting it in. Yet his tone (which is getting worse by the day) before bed clearly says that I gotta watch out in the a.m. for any further backlash for saying no to him. Or, he may get up in the a.m. and even forget what he said to me before bed! Fingers crossed he has forgotten. If not, will try for #'s 1 & 2. Thanks for your videos! They are so helpful!

[@annetakubiak3374]

TV is a great helper, nature / geography programs , cooking channels, talent shows . Also reading is good for them . My own experience with my mom . I'm the one who encourages her to read or watch TV, she won't do it by herself. I give her children story books, she loves it.

[@cathyviviano1377]

Thank you for posting this advice. My mom often gets upset and reassurance doesn't work when she feels frightened. She wants us to agree with her delusions and doesn't respond well to redirection. Reflection is such helpful advice. Today when she called to tell me people stole from her room at the retirement home again (that is what she calls about regularly and we know it isn't true as a camera has been installed in her room), I wrote down what she said to give me something to do and then read back to her a few things and at the end, she said: "thank you for listening". I did tell her I would help her look for the items when I visit on the weekend and we'll figure it out.

[@ronwilkinson3587]

I guess I used redirect the other day, my husband fell, emt’s couldn’t get a blood pressure because he was so scared and shaking, I just made eye contact up close and softly sang ‘You Are My Sunshine’. He calmed and emt got their reading. I saw a video where Teepa Snow sang to an Alzheimer’s patient . I’m sure it wasn’t my not so great singing, but gave him another focus.

[@denisetucker1659]

@ronwilkinson3587 Yes, and hearing that particular song choice probably made him feel very special and adored.

[@H.of.A]

Dr Natali, thank you for the 4R’s. I am putting this up on my kitchen wall for quick reference. I needed to hear your statement- nothing we can do will prevent our loved ones’ experiencing periods of distress. That has eased the guilt gnawing at my soul that I am failing my mom.

[@amtrue_]

I'm a daughter, sister and amazing caregiver. The four RRRRs have been test driven by me and my brother. I'm a member of the Careblazer Care Collective Community aka the four CCCCs. You will start to count your successes in caregiving and less on what doesn't seem to be working. 😊

[@10538overture]

Asking questions without actually agreeing with (reinforcing) her worries does seem to help with my mother, as does using a calm voice and holding her hand as we're talking. At the moment, she mainly blows things out of all proportion. Trivial things become massive problems to her. I find dealing with the problem straight away, and telling her I'm dealing with it, does move her on.

[@ronica2623]

For me, the only things that work are redirection (changing the subject) or retreating (oh, I forgot to check your mail for you). The other ones don’t work. If I tell him I’m there to help him, I get “IF YOU REALLY WANT TO HELP ME JUST DO WHAT I TELL YOU TO DO!!!!” Etc….

[@AnneRault1]

Thank you for your help, Dr. Natali. I mention your KZbin videos when I am talking to anyone about dementia because they were so helpful to me when I was caring for my husband with the disease. Sadly he passed away on March 30 this year and is finally at peace. I will continue to watch your videos to educate myself so I can be helpful to others dealing with caregiving. You are an absolute treasure!!!

[@DementiaCareblazers]

Thank you for your kind words, Anne! I so appreciate them. Most importantly, thank you for being there for your husband when he needed you most .

[@teribeefplate]

❤ Probably the most helpful video I've found yet. Thank you.

[@robertar.5189]

Hello and thank you. I sometimes have to use all of them.

[@tehanua4383]

I'm dealing with a client right now who seems to weaponize her emotions against her caregivers. She gets upset easily, and talks badly to her family on the phone about the people who try to care for her. Really frustrating. She's very dependent and doesn't seem able to admit this, either. Can't stand on her own, or even turn over in bed sometimes. I love this job, but man some clients make it really hard.

[@sugarfree1894]

If the family are aware that she weaponizes people against each other it will be OK but if they're in denial about that you're probably in a different job now! Best wishes in any case.

[@janicenewbold70]

WOW RETREAT !!!!! Brilliant ❤️

[@kimramsdell4185]

Thank you for all you do

[@lyta1138]

I just did all of these yesterday. It took a good two hours for her to calm down. There is no magic bullet. Listening, going for a drive "home", trying to tell her the people she thought were supposed to be at the house when we got back weren't due until next week (immediately rejected), reflecting her emotions. She was almost crying from anxiety, it was so hard to watch. For retreating I would also add that you can retreat by being silent, not just by physically withdrawing. She didn't speak while we drove, and she didn't want to talk so I just left the radio on and let her be. I had my brother call and distract her by telling her all about the genealogy research he was doing. She finally distracted herself with some her old collections and eventually got some peace and sleep.

[@amtrue_]

You have great tips. I keep a CD in my car of the mormon tabernacle choir. My mom loves to sing. I can get 20 minutes if quiet driving around town getting her to reset.

[@ellendaniels3026]

SO hard, while it's happening! Try to take consolation in that she won't remember the distress episode.

[@gregoryglen4090]

Thank you so much. I just had an episode with Dad. He thought he had accidentally killed a person. He was terrified and I didn’t know what to do. I wish I would have watched your video on using the 4 R’s sooner. But at least now, if something comes up I will have some tools to hopefully handle things better for my dear Dad.

[@ellendaniels3026]

He's okay, Dad! I checked, & he just fainted! Or: the bullet hit his phone case! He's okay! Or: He rolled UNDER the car, & only got a scratch! Isn't that amazing? Continue to lie, if there were gory details! "His bottle of cherry juice broke, & it looked like blood!" Whatever it takes, to reassure him!

[@gregoryglen4090]

@@ellendaniels3026 you're an idiot.

[@gregoryglen4090]

@ low IQ?

[@gregoryglen4090]

One subscriber! 😂

[@gregoryglen4090]

@@ellendaniels3026 Go back eating your Cheetos in your moms basement. You overfed adult baby.

[@pattilowery2313]

Really helpful, so much anger, nice to have some choices!

[@culturematters4157]

Dr. Natali, thank you for your sage advice. You're a big help!

[@FlorencaEleni]

Thank you so much, is very helpful ❤

[@mama4nana1]

My mom is in the hospital and that’s when it’s the worst. I understand why. I ended up having to retreat and she fell asleep

[@ginatartaglia236]

Very helpful! I've utilized all effectively except REFLECTION, and Will definitely try this method Grateful for YOU miss Natali!

[@BabsCote]

Thank you so much for all you do ❤️🙏❤️

[@tinabonitatis]

I find all of your videos helpful. My husband has MCI and sometimes he decides he wants to go to bed for the night when it is only 4:30 or 5 pm. I have used distraction but wonder if you have done any videos on this?

[@marybethingberg2802]

These are helpful "Rs" ... good reminders I'll have in special places for just me to see.

[@csillaczako1582]

Any advise for caregivers how to stay calm and have patience while taking care of someone with dementia

[@danielcole9670]

My wife lost her sense of empathy. It was like raising a three-year-old. She tried my patience sometimes, but you hold your anger when dealing with a child. So yes; learn to stay calm and patient.

[@steviem5279]

You're only human and you'll get agitated yourself but what worked for me is that I understood that wasn't my dad anymore, or at least not the old him and that he was suffering a lot more with this disease than i was as a caregiver. You'll learn a lot about yourself and find out you're a lot stronger than you ever thought you would be. It's never easy but always remember that the person with dementia is suffering too My dad had frontal lobe dementia and I remember there was a point in the disease where my dad had moment of clarity and I heard him say to himself that he couldn't believe he was saying what he was saying. You just have to take it one moment at a time and that's all you can do.

[@aprieto7998]

I'm taking care of my 96 yr old mother with dementia. She is no longer the mother that raised m

[@aprieto7998]

Sorry about the message above it posted as I was writing. So she's no longer the mother that raised me. She was a person who didn't curse or offend anyone. However she gets upset and confused and calls me all kinds of names. Telling me to get out of her house, but she lives with me. She talks about her mother and relatives as though they're still alive. We have to watch her constantly. Stay strong and do what you can remember they have changed.

[@csillaczako1582]

@danielcole9670 yes, it's a learning process for me as well, to acknowledge I gave up my life to take care of loved ones, just as they did when they brought me in this world.

[@StevenDunigan-m7j]

Helpful advice

[@mahomedfaroukpatel630]

Thank you I use the third one and it works ❤

[@danielkwan1380]

That is so good. I keep that in mind

[@maureenlogan7674]

Your channel is so helpful, and supportive 💖

[@pammi100]

Thank you. That’s helpful 🙏

[@sandylaffan6486]

Reflect

[@Carolynnin]

Thank you.

[@MJBilbo]

I have discovered something interesting in keeping my wife settled down. She's 86 and in what I suppose are the "early stages" of dementia. When I prepare our meals, I'm only using what I'm calling "Happy Bowls" and "Happy Plates" and "Happy Cups or Mugs" - of all things, it's the Pioneer Woman stuff from Walmart in those floral patterns!!! The other ones she likes are those plain yellowish, greenish, bluish bowls, plates and cups from the 1940s and 50s, and thank God the Chinese are making reproductions of those (and of course the Pioneer Women stuff). I've gotten rid of all the Correll stuff and everything glass, except she does like the tall, thick glass style from, again, 40s and 50s that they used to have at soda fountains.

[@ellendaniels3026]

We couldn't bear to throw ayay our childrens' Sesame Street, & other, plates. The pictures make him happy, now.

[@jenyaalexandra4144]

Thanks

[@DementiaCareblazers]

Thank you so much! 😊 💖

[@AZrose-mm9fn]

My mother is non-verbal now and has advanced Alzheimer's. In many/most of visits with her, she weeps the entire time. She cannot tell me if she is scared, hurting, or what is upsetting her. I try to connect through hugs and kisses. I try to re-direct. But the tears continue. How do I handle this?

[@judyfeldman1315]

We need to move. Too many stairs and I need to be closer to my daughter. My husband has MCI and is furious. Change is obviously frightening to him. He has now gotten aggressively hostile about it. Suggestions?

[@leslierisan7603]

I have heard that enlisting another family member (son in law) or trusted friend to discuss this with him may help. It’s no fun if the move creates animosity between spouses.

[@JBrumley]

No real suggestions as have just come through this with mine. As yet undiagnosed but high probability of frontal lobe vascular imparment. Just wondering if there aere any ways it can be made more about the benefit to him. For us it was looking for less maintenance and being able to drive for longer and finding a place near a lawn bowling green and library. It is hard!

[@judyfeldman1315]

@@JBrumley Thank you. Change is difficult for my husband but we have no choice. I’m hoping when the move is complete he’ll be happier.

[@rhealynpanisigan]

Any advice how to calm my patient when she is always angry evrytime i give her food and doesnt want to eat

[@ellendaniels3026]

I don't know if this would work... Could you try bringing yourself an applesauce cup & spoon, & ask her to please eat with you, because "I just hate eating alone?"

[@suer.1044]

Hi Dr. Natalie, How would I respond to my mom when she is angry at me.... I'm the one who takes her to doctor visits, store, stops to help her always, but she seems to always get angry at me.

[@amtrue_]

Your mom and my mom have much in common. In the care course we learn techniques how to manage that.

[@JBrumley]

Maybe because it is safe for her to express her frustration at you. Something like when our young children let loose when they get home to mum after being on best behaviour all day.

[@Help-j5d]

What about if your husband who has dementia is a prone to yelling and always has been. Plus he has not been faithful to me. How do you handle dementia care.? He also logs on to porno. I hate it and I have been struggling on how to deal with that.

[@ellendaniels3026]

You are an important person, with only one life to live. Do you love him? If not, may I suggest a facility might be appropriate? You are not morally required to give away the rest of your life to care for someone who abused you when he was well, if that was the case. You count, too. If family reacts badly, tell them you'll be fine with hsnding him over to their care. Be strong.

[@Snookscat]

I wonder how this can be applied from a distance. My Mom has started wandering, and leaves her (rented) apartment, thinking someone (sometimes me, sometimes a friend) is coming to pick her up and take her home. She lives alone, and is on a waitlist for a spot in a care home. I live too far away to visit. If I tell her I’m coming, she looks for me. If I tell her I’m not, she gets mad and/or panicked and cries. Last time she talked about purposely getting lost and I was on the phone with multiple people including her care team, and eventually 9-1-1 (a couple of times). Police couldn’t do anything because she was currently at home. Fire can pick her up if she falls, etc., but can’t do much else. Eventually (hours later) paramedics checked on her (thankfully she stayed inside at that point) but couldn’t take her to the hospital because she refused to go and they can’t kidnap her from her bed. I understand their situation and the lack of spaces, etc., but I just feel so helpless. And it’s all because the “powers that be” wouldn’t sign off on my guardianship/power of attorney (that we had in place years prior) and kept quoting newer “consent laws”, saying“people with Dementia can make their own decisions, even if we don’t agree with them or they’re bad decisions.” She should have been in a home or on the list for a space a couple of years ago, but no.

[@eandsm4620]

🙏

[@ellendaniels3026]

​@@eandsm4620 I am an R.N.. WHO is telling you that?! If your mom is certified by a doctor (have her evaluated) to not be competent to understand & evaluate informatikn, or assess her own situations clearly enough to make decisions that protect her own best interests, and you are her heathcare DPOA, YOU make the decisions, even if over the telephone (if your legal DPOA is on file with them.) Have her evaluated for competency; by doctors, at a preset appointment, reasonably voluntarily, or by petitioning for a court order, if you believe she is at risk because of dementia. If she goes to hospital, for anything, & staff see inappropriate responses, make certain that they note them, verbatim, in her chart, & ask for a consult to determine competency. If dics agree & sign, & you are her healthcare DPOA, nobody can legally deny your decisions, unless they would cause harm to her. Be FIRM, & tell them to comply, or to contact their legal department immediately, or you will contact yours! Be calm, & polite, but very firm. Again, they must be able to have a copy of your legal healthcare DPOA. You can have that on file at her hospital(s.) You might need to provide the original document for them to scan-DON'T leave it with anyone! Wait to receive it back immediately after scanning! Without a declaration of incompetency by a physician, your DPOA is not yet legally in effect. It is only when a physician declares her incompetent that the DPOA comes into force. Before that, it is merely a document saying who WILL be her DPOA IF & WHEN she is no longer sound of mind. Good luck!

[@clynnadams32]

Thank you so much for this channel. You helped me tremendously during my caregiving. Sadly, my watch ended on June 1, 2024 at 2:48 am. My sweet husband entered into his eternal life with Jesus. I'm heartbroken 💔💔

[@juliagriego7693]

Deepest condolences ❤️🌺So sorry for your losses; first of all your husband and the many changes this brings. Keeping you in my prayers 🙏❤️💜

[@clynnadams32]

@@juliagriego7693 thank you 💜 💜

[@francesaldrich3714]

It sounds like you put a lot of thought and effort into caring for your husband. Now it’s time to take care of yourself - you deserve it. Sending you thoughts and best wishes.

[@clynnadams32]

@@francesaldrich3714 thank you. He was my soulmate. I was with him every minute of every day and now my days are empty 💔💔

[@marybutlin5605]

How I wish I had you 7 years ago

[@carolblair2845]

Most Christians believe that your soul is your mind, emotions, and will. If that is true, then when is a person with dementia no longer responsible for the sometimes horrible and cruel things they say and do?

[@eandsm4620]

🙏 God is good!