Tips on How to Redirect a Loved One With Dementia

It’s happening again. Even though you’ve explained many times to Mom, who has dementia, that she can’t call her sister, Elaine, who’s been dead for five years, Mom insists on calling her right now.

To make matters worse, she’s becoming agitated, even paranoid. “What have you done with Elaine? Why won’t you let me call her?” Mom asks. But what can you do to calm her?

When a person has dementia, he or she is unable to process information like they used to. Dementia’s impairments aren’t restricted to memory loss alone. Neuronal damage causes behavioral disturbances and personality changes as well. This is because dementia compromises the “executive functioning” capabilities of insight, judgment, and reasoning inside the brain.

As a result, your loved one with dementia can be incapable of telling the difference between a hallucination and reality — and trying to explain why that person’s perceived reality isn’t true is pointless. Such an explanation can actually escalate already strong emotions in your loved one.

Heightened emotions in a person with Alzheimer’s or dementia typically emerge as what’s known as “behavioral expressions,” says Nancy Kriseman, author of “Meaningful Connections: Positive Ways to Be Together When a Loved One Has Dementia.” Kriseman is a geriatric clinical social worker and owner of Geriatric Consulting Services in Atlanta, Georgia.

“When your loved one with Alzheimer’s or dementia acts inappropriately, becomes anxious, or engages in unsafe behavior, knowing how to interact with the person to shift that behavior is a valuable tool,” says Kriseman.

Find ways to connect to your loved one with dementia so they don’t feel that you’re trying to bully or push them, which can backfire, says Kriseman. Instead, try to understand that your loved one’s anxiety, fear, or other emotions probably stem from frustration or feeling out of control over a specific stimulus or environment.

A person with dementia might even ask the same question again and again because they have trouble processing the answer, says Kriseman. Their frustration can stem from their difficulty in trying to communicate what they need. Knowing your loved one’s triggers and helping redirect them to something that brings them joy or serenity helps diffuse behavioral disturbances related to dementia.

For instance, when Mom insists on calling her sister, Elaine, it’s best not to remind Mom that Elaine has been dead for years, as that can cause more anxiety. Instead, ask Mom why she wants to call Elaine or what she plans to talk to her about, and then redirect the conversation to those topics.

Fortunately, redirection can alleviate frustration for both the person with dementia and their family caregiver. Kriseman offers the following tips on how to actively redirect a loved one with Alzheimer’s or dementia from a situation that’s stressful to them.

Maybe the room is too hot or cold but your loved one can’t find the words to express that. Is the space calm and comforting or noisy and chaotic? Sometimes, it’s the environment itself that needs redirection. Your loved one with dementia might project other frustrations if they are physically uncomfortable or overstimulated.

Let our care assessment guide you

If Mom keeps pushing furniture against the door and insists that someone is trying to break in, explaining that no one is attempting to get in probably won’t ease her fear. Instead, Kriseman suggests responding to the emotions behind the actions.

“You don’t have to say, ‘I believe that this is happening’ but you can say ‘I’m so sorry this is happening to you,’” says Kriseman. “You might say, ‘Mom, I really want you to feel safe. How can I help you feel safe?’” In this scenario, you’re trying to understand what’s causing your loved one’s agitation so you can redirect her feelings from a place of insecurity to one of security. She is more likely to respond positively to this because she feels like you finally believe her and are on her side.

“Try to step outside for some fresh air and a change of environment if you can,” says Kriseman. “Light and sunshine are healthy and help redirect the brain.”

Sometimes a simple change of scenery, especially a walk outside, can help shift the person with dementia’s attention away from what’s bothering them.

Talk with a Senior Living Advisor

One of Kriseman’s clients was a retired doctor and refused to take his medications while in a nursing home. To resolve this behavior, she had staff members create a chart that listed his medications so he could check them off when taken. This technique worked because the activity was meaningful to him as a physician. Introducing personalized activities favored or common to a person’s life is often the best way to redirect.

When communicating with a person with dementia it’s important to keep conversations simple and direct, otherwise you risk frustrating them. For example, if the person resists bathing, instead of saying, ‘I need you to come to the bathroom so you can take a bath and shave and I can wash your hair,’ a more simple ‘Dad, we’re going to the bathroom’ is easier to comprehend.

“Only ask for one thing at a time,” says Kriseman. “Keep it simple. They get lost in it all.”