I think everyone has hit on the most important issue: that of depression and that it needs to be treated medically. Even when you don't detect depression, medicating for it can be used as a trial to see if it is depression.
There is one other issue that can be raised after the above has been tried. Some people with moderate to advanced dementia, partiicularly Alzheimer's, vascular dementia, or frontotemporal dementia have emotions very close to the surface. Thus when anything happens, they cry of laugh spontaneously. If you ask "Is something the matter?" they will say "no."
One patient I had literally had tears drippiung off his chin. I asked the second question: "Are you sad or blue?" He replied while weeping "No, I'm happioer than I've ever been in my life!"
We always try antidep[ressants on people who cry but then add some envirnmental measures too such as videos of babies, a baby doll or stuffed animal that liiks like something from their past. Sometimes a stuffed bear can help. Special prodiucts can be found online at www.alzstore.com. If the person is lonely and fearful this can be a great help.
If the patient has advanced dementia meaning they generally are dependent in all activities we have some other things to try such as:
- Massagiung hands and feet with lavendar oil
- Making sure the patient received scheduled acetaminophen (Tylenol) , 2 500 mgs tablets morning and evening (check with the primary doctor before trying this but people who are advanced often have pain from muscles and cramps
- Reading a book called The Sun on My Face
- We have a hospice that had an actor record psalmes (with the smites and smotes removed. It is wonderfully comofrting to people who practice a religion
- Quiet or favorite music played softly can help
- Hanging crystals in a window to create rainbows.
- Asking the patient if their (deceased) relatives are coming at night and listen to the answer without judging it or emplaining that "You know your mother passed!"
- Making sure the patient is not constipaed or having problems urinating
- Offering something sweet.
- Sitting quietly or laying in the bed cuddling and softly reassuring that you are there for the person -- always.
But sometimes tears are just a manifestation of increasing brain damage. The problem is it hurts YOUR heart.
Professionally we would never use an antipsychotic as the danger of developing a Parkinsonism is just too great,
Geri Hall, PhD, ARNP, GCNS, FAAN
Advanced Practice Nurse
Banner Alzheimer's Institute