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How can you help calm dementia parent in nursing home?

13 answers | Last updated: Mar 27, 2015
A fellow caregiver asked...

How can you help calm dementia parent in nursing home? My mom, who's suffering from dementia, is causing problems at her nursing home -- throwing food, hitting, trying to run away. I'm starting to get some flak from the staff about it. How can I resolve this problem before it gets any worse?


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Anita Silverman is a geriatric care manager in Lake Worth, Florida.
87% helpful
Anita Silverman answered...

See also:
How to Communicate Better With Alzheimer's Patients

See all 1031 questions about Alzheimer's and Other Dementias
Tell the staff you'd like to work with them to put together an intervention plan that will help your mom feel less anxious and upset. Ask the director which staff member you should work with and plan on spending some time at the home for a week or two to get at the root of what's upsetting her.

Ask a lot of questions -- both of your mom, if she's able to respond lucidly, and of the staff -- to figure out if she's just high-maintenance for the facility (or for certain employees) or if she truly is out of line. If her difficult behavior is a recent development, what's changed that could be causing it?

A great first step is to schedule a checkup with her doctor. Her behavior could be caused by something as simple as a urinary tract infection, which can be very uncomfortable and upsetting. Is she dehydrated or hungry? Is she in pain?

Get her to a neuropsychologist, too. If your mom is anxious, sometimes such an expert can prescribe a medication that will keep her alert and functioning but take off the emotional edge. It could also be that your mom's dementia has worsened -- people with dementia are often agitated and combative. If you think this is the case, talk to the staff about whether she should be moved to a dementia unit.

If you rule out medical and clinical problems, you can look at environmental explanations. Ask the staff under what circumstances your mom starts acting out. Does she have a roommate she doesn't like? Do noises, such as music and phone calls, bother her?

Once you have a sense of what's troubling your mom, you can start to work with the staff on a plan. I know a sweet 90-year-old grandma who nonetheless kicks her fellow residents. The staff figured out which residents irritate her and the best ways to distract or redirect her attention. And they know she needs to sit by herself at meals. If your mom feels lonely, bringing in a companion --available friends or a paid caregiver -- to spend time with her during the day may do the trick. If she's understimulated, getting her engaged in an activity she enjoys might help. The key is to let the staff know you're committed to finding a solution.


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72% helpful
anngw answered...

Anti-anxiety medications and anti-psychotic medications made my mother worse. It turns out that at 86 she has breast cancer and those medications were causing her excrutiating pain. The nursing home and the doctors kept giving her more and more medication until they induced pneumonia and that stiff muscle thing.

It took me months to get her off of all those medications,fighting all of "the experts". I had to change facilities twice more, but now she is much happier and much easier to work with. No sign of breast pain. Her doctor who had diagnosed breast cancer BY LOOKING AT HER hold herself in a stiff awkward position, said that he had never heard of those medications causing breast pain. I told him that he has heard of it now.


Janet7651 answered...

Hey, just returned from visiting my father and mother. My dad had been on medications that changed his demeanor. And now, since he has been taken off,some of the meds. He has regained a portion of himself. However, the dementia is apparent. He constantly walks back and forth to the bathroom.It seems that he can't stay still.He will only sleep short periods of time. He constantly asks for candy. We try to satisfy his craving with jelly and honey, but he still has candy craving.Any suggestions or comments?


57% helpful
Gina A answered...

My husband was going through this behavior. He was evaluated by a psychiatrist and put on Depakote. He had reacted badly to anti psychotics at another facility. This Dr did not want to use the anti psychotics. Now, instead of staff having to use 2 people to change him when wet taking 25 minutes, he can be changed with 1 staff member in a few minutes.His behavior is better. He still refuses some things, but is generally easier to re direct. Hope this helps you.


95% helpful
Karen W. answered...

Hi. I run an Adult Family Home and can agree with all the comments that the psychotropic drugs for handling elderly dementia is like mixing oil with water and stranger still - if you read the warnings right from the drug manufacturer they say NOT to use on dementia.. Sometimes it is necessary to "step into their world". For example one woman who was screaming and yelling at everyone wasn't handled until a caregiver really got in communication with her and found that she was looking at a painting of water on the wall of her room and thought she was drowning. Of course everyone else's actions were (to her) nuts as they were just calm and going about their business. Another example is a resident refusing a shower - may be because the water hurts their delicate skin. So, if possible (and I realize it isn't always) try and find out WHY she feels she needs to do these actions and then try and remove the things from her environment that set her off. Dementia patients have trouble with white sometimes as it just disappears for them - one resident would NOT sit on a toilet seat as there was "nothing there" - so colored toilet seat cover. I think you get the idea that it isn't always clear to use, but if you can assume her viewpoint and be a detective you might find ways to redirect or change her environment to be comfortable for her. Hope it helps and good luck with your mom!


80% helpful
An anonymous caregiver answered...

This is a situation I've always found bewildering and exasperating. Isn't the staff at the nursing home supposed to be trained to handle these situations?! Isn't that why the families are paying them huge amounts of money to take care of the relative?!

When my dad had dementia and they found him too much trouble, he either got kicked out or the family was supposed to do something about his behavior! Now it's the same thing for my mother. She required more attention from them so we were charged an extra $400.00 a month, yet I am still contacted and expected to do something about her behavior.

I wish I had some good advice, but it's a problem that I continue to battle myself.


100% helpful
kilmatead answered...

hi janet try weaning him off candy and substituting candy or sweets suitable for diabetics or even make some home made sweets from fruit and honey .I give my mum some dark hocolate whih seems to satisfy her cravings...



100% helpful
Amber_CNA answered...

I am a aide in a nursing home so I have first hand experience with dementia residents.
It can be very difficult for me going to work and getting punched, having my glasses broken, kicked and scratched. I treat all my patients with respect and dignity but it is frustrating to us staff when someone needs to be on medication and the family completely refuses to consider it because they think "Mom won't be herself anymore" or she's always sleepy. The likely reason Mom is sleepy is that she's up all night with me trying to climb out of bed, yelling or trying to leave facility.
We are trained to deal with combative residents and it does take two aides and 15 minutes to change a brief of someone who thinks we are there to harm them. Aides often work short staffed and when we get in residents who are clearly in need of 1 on 1 care it makes for a very difficult shift. We do hope family will step in to help calm a family member so we can also care for our other 13 residents we're in charge of.


100% helpful
LauraKay answered...

Hi Amber - I feel your pain. I'm a high school teacher who is responsible for 120 kids every trimester. Some kids read at a kindergarte level, some nearly at college level. It's so hard to dedicate so much time to the neediest kids while feeling that I'm depriving those who are behaving appropriately. However, at the beginning of the year, I talk with each parent (even if it's only through an email) and let them know of my concerns (if any) about their child and explain that, while I would love to have the hour to dedicate, I simply cannot. I ask for things that the child likes to occupy them while I take care of some of the other students (a puzzle book, word quizzes, etc.) or any ideas about how to give their child what they need. I've gotten plenty of "He's your problem when he's with you" type of responses, but I've gotten even more "How can I help". Do you have frequent, direct contact with family members? Is there much awareness in the partients you're dealing with? We need many more loving, nurturing, patient caregivers - hang in there!


100% helpful
1whocares answered...

I can so relate to your concern for your mom. When I first started this journey with my dad five years ago, these were the issues I was faced with as well. My father was diagnosed with Alzheimer’s and a mood disorder. He also suffered from extreme denial, paranoia, hallucinations and resistance to care. I wish I could tell you there is a simple fix, but as you can see from the advice that Anita Silverman offers, it requires a great deal of detective work. Having been through it, though, I can tell you that her advice is very sound and will bring you the answers you need. She has consolidated a lot of wisdom into a few paragraphs. It took me upwards of three years to discover on my own the step by step advice offered here. My father was kicked out of the first nursing home due to his behavior and; in large part, due to my lack of experience in dealing with his disease and not knowing how to work with the nursing home. I continue to spend a great deal of time talking to the staff and my father to be proactive in preventing problems before they get out of control. I liken this to caring for my daughter when she was a toddler, often unable to make her needs known. By the time you figure out one problem or stage, the next is nipping at your heels. The difference with my father, though, is that he comes with a lengthy history of experience, knowledge, habits, and preferences. And he was very intelligent. His intelligence almost became his own worst enemy. As his mind slipped away, he became more and more angry; intent on proving he still knew what he was doing. He had always been the helper, not the helpee. He resented being in this position and especially being told by others what to do. He was the father of five children, a teacher and lecturer. How could he now be told to hold onto the bathroom sink while his diaper was being changed. The humiliation of this disease is often more than he can bear and I don’t blame him a bit. So when he gets angry, as hard as it is to deal with, I have to take a deep breath and remember what he is faced with day after day. When I just can’t deal with it, I have to walk away, regroup, and come back with an attitude adjustment. In my opinion, there is no easy way through this journey. But it is not without humor, joy, or love. My father continues to teach me and expand my understanding of love and commitment. You have come to the right place for answers. I’ve spent many a late night scanning articles at caring.com, looking for direction. Don’t lose hope. Be patient and the answers will come. I wish for you and your mom a peaceful resolution to her agitation.


An anonymous caregiver answered...

Emily, I think you should have at least TRIED to answer Emily's question. It seems like you are putting-her off to me--think what she must think. Your's was the most UNhelpful post I've seen on this forum in years!


An anonymous caregiver answered...

Thank you, Emily, for giving us more information regarding how to get additional advice from those who are also in our situation. Getting as much input as I can from others on how to best care for both of my family members with dementia has been the most valuable help I've received!