Memory Care with Teresa Youngstrom
Bizarre Activities You Might See With Dementia
(upbeat music) - Take care partners, Teresa Youngstrom with MemoryCare with Teresa Youngstrom. Thanks for coming back. So exciting to be sharing information with you. You know, I'm a seasoned or registered nurse and dementia specialist, but I didn't know as much as I thought I did. And really, it was a school of hard knocks in the beginning, so I hope you'll stick around, share this information, find more information in my podcast that will be helpful to you and your community, your private duty company, and feel free to share it with those companies. A private duty company could get so much information out of this, I've worked to help start one of those in the past, and this information's exactly what they should be learning. But you've got memory care units that need this, elder care law, organizations, and more and more. My goodness, your local fire and EMS. They really, I've taught and they really appreciate this information. So again, Teresa Youngstrom, a better approach to memory care. I wanna start today by talking about the bizarre things that people with brain change might do. And I've had plenty of clients call, just completely thinking they need to get new medications, because now mom's doing this, or mom's doing that. And I just wanna hit the pause button and unless she's endangering her life, I want you to just pause and not react. Depending on where they are in this journey too, you react too quickly and you've just asked for a fight on your hands. And so slow it down and let's evaluate what's really going on and how we can join them on the journey, come alongside and be part of the solution and not part of the problem. Pick and fight, part of the problem. I had a family who they stayed behind her because they were afraid of what she was gonna do next. And in my heart, I believe she thought she was alone. And so why was she screaming and banging on windows and carrying on? I think she thought she was alone. I know in my mom's situation, if she could be in her living room five minutes with no one around a caregiver, maybe we were in the back of the house doing something, she could get irate and it's just scary guys, we can't beat 'em up or blame 'em. They didn't ask for this, you know? They didn't want to have brain failure, but it's gonna happen to some and those of us that still have a good brain at least so far, we need to be able to come alongside, join 'em on the journey and see what we can do to come along and help. But just so you know, you're not the only one that's seen bizarre things. I'm gonna share a couple things with you and maybe you'll relax a little bit more when something bizarre happens in your situation or with your client or with your loved one, okay? Or maybe you are firing EMS and you're going out and coming across a lady who's doing this. So I'll never forget going into a home once and this poor woman, she had been left in her disease for quite some time and I think there were no close relatives, but some distant relatives who were at least bringing her food and making sure her needs were being cared for, but they really had no idea what to do with her and what she did on a regular basis. And so picture this, walk in, of course, there's lots of clutter because frequently these individuals lose the ability to stay organized, put things away, sequence things, it's just so tough. And immediately I noticed when I closed the front door, the entire front door was covered with post-it notes. You see, for some time she'd had some awareness that she was forgetting things. And so she was working so hard to try and remember things that she had covered the front door with things she needed to remember to pay a bill, right? To call somebody, to do this, to deliver that, to sell that, to buy this. And yet nobody was there to really come alongside and bring in the right help that she needed, at least not initially. There were pets in the house. There was a dog in the house, a big dog. There were five, six cats in the house at least. And so you can imagine what it looked like, what it smelled like. If you looked from my eye level and above in this beautiful, beautiful home and a beautiful, beautiful neighborhood from the outside, you never would have guessed that these things were going on. But I can tell you that the walls were covered with artwork from all over the world. She and her husband had traveled the world and had invested in some gorgeous pieces of artwork. But yet down below, things were kind of crazy. So I also was there when she fed the dog and she went to the refrigerator and she got a pack of lunch meat. And she took the slices and she just put them out along the front of the leather pouch. Dog was ecstatic. And he came along and just ate all those pieces of meat and was happy as a clam. Fortunately, there was a fenced in backyard and she did have the wherewithal to occasionally put him out. But I'm sure it wasn't very good. And if you looked in the basement, you'd know that sometimes he needed to go to plan B. All right, you get it? All right, so another thing that I saw once in a community was a gentleman with Louis body. And his family had made the decision to place him there. I didn't know about it prior to, but it was a newer community, a newer memory care. And I think they didn't really know what to do with him being so young. Louis body can strike when you're much younger and you can be on or you can be off, but then you can do very bizarre things. And you might even be suicidal. And this gentleman had stacked up the furniture. The windows were up high in this unit. It was beautiful, but the caregivers were all new and they didn't really understand the disease as well as, as I do and I thought I understood it early on too. And let me tell you, I'm still on an adventure learning. We'll never understand it all, we don't. We do not understand dementia. We know there's more than 120 diagnosis that can give you symptoms, but there's a lot to learn to take it all in. But I can tell you this gentleman thought that he was held captive. And so in his mind, what did he need to do? He needed to get the heck out of there. And so what did he do? He started stacking up the furniture. He had, he pushed the dresser under a window that was up tall. He took a bedside table and put it on top of there. He took a chair and stationed it on top of the bedside table in a way that he could get on top of. And in his mind, it was the only way to survive. He was a survival mode guys. His brain felt like he was being threatened to attack. And so in his mind, you know, his limbic system, bite, fright, flight, freeze, his limbic system was I got to get the heck out of here. And that was his goal. And so they found him on top of that stack of furniture and all, and you can, needless to say, they realized that they couldn't handle him there. And that's when the family called me and said, now what do we do? And so we had a new conversation, had to come up with a new plan on how to love him through this. With people who had more experience on caring for him. And so it is important that when you go to a community to go in, to smell things, to listen to things, visit on off hours, okay? Visit when it's not really visiting hours. And see what you hear, see what you see, how much help, how are they interacting with their residents? No one should be yelled at, okay? That's just not how we respond to this disease. Okay, something else, let's see. Oh, packing your bags. So we see this a lot, even though they're still in their own home. Sometimes they pack their bags once they've moved into a community 'cause they do wanna go home and they're packing their bags. But frequently, they don't recognize their own home as their home. That's just the disease, guys, okay? They may pack up their bags and be ready to go. And if I'm you, that's my mom packing her bags. It isn't something my mom did, but if it were something she did, I would have just said, oh, so you're ready to go. Okay, well, thanks for letting me know. Hey, hey, oh, oh, oh, hey. You know what? I was thinking maybe we'd bake that apple pie. I know it's frozen, but you know what? Bake that apple pie tonight for you and I. Let's go see if we can find it in the freezer. And I'm gonna ask her to come help me do anything to take her away from that worry, to take her away from packing those bags. And you know what? I'm not gonna unpack them in front of her. I'm not. I'm gonna wait until she's either asleep or maybe, maybe there's someone else who's helping you. And by then sounds like you shouldn't have someone else helping you. But maybe someone else comes in, takes mom, takes her out to lunch, takes her to church, takes her whatever she loves to do and feels comfortable doing. Maybe it's just for a walk. And you would pack those bags and put them away. And then we go on. But I don't see any reason to call the doctor at that point. You might have a reason to call it, you know, someone who's gonna help you. Maybe it's time, if you do need to go to a community, maybe it's time for that next step. But I don't see any reason to add medication at this point in time. I had a woman who did move into a community. It was an all memory care building. And she looked good. She had front to temporal. Those folks can look good. Their mouths got them in trouble frequently. But she was still very tuned in to her appearance and her hair and she was in her 80s. And let me tell you, she wanted her makeup on. She wanted her lipstick on. She wanted her hair done right. And she still did dress appropriately, which was so interesting. But she had an awareness that she was quite afraid in this new place. And the thing was, in this community, people didn't knock to come in. They just came in. And that made her feel threatened and stressed. And so her limbic system said, no, no, no. I'm gonna protect myself. And so she did go in her room and you couldn't lock the door, but she blocked the door with lots of furniture. And of course that upset them. And when they kind of chastised her, she didn't see any other thing to do, but pull the fire alarm to get that next level of help. Now you gotta back up and look at her thinking process. There were some good things in there from an emergency perspective. She was connecting some dots. She was. It wasn't the dots they wanted, but obviously they didn't know how to come alongside, joined her on her journey, put her fears down and redirect her to something else, maybe engage her in something that she loved. Find out from the family what she loves. And can we engage her in that direction? Maybe she needed caregivers to transition her into that community. Maybe if we had some familiar people moving in with her initially and staying, her caregivers from home that she loved. And then we ease them out once she acclimates and learns the new routines and learns what's where, where the dining room is and things like that. But I think what got us in trouble really was that she looked so good, yet she was much sicker in her brain than she really looked. And so they put her on a unit that was above where she needed to be. So that was kind of what happened there. We sometimes have individuals who will put several layers of outfits on and not feel like they ever have to take a shower. You know the hygiene thing is usually an issue. So if they're in a good routine of showering or washing up in the morning or washing up before bed, boy, hang on to that. I would maintain those routines as long as you can. But sometimes we're seeing individuals who are layering up because they are, yes, cold, they're cold. And those of you who want the thermostat low to save money, well, I would say when our loved ones are going through a season late in the disease and you can't just use any logic or rational thought, it isn't the time to turn down the thermostat, okay? Let's keep the thermostat up. I was in a home the other day, it was set at 70 and this lady was so irritable. And so I asked the family, do a test, put it out between 75 and 80 this week and just see if she has any improvement in her attitude. I mean, she was about this big round. And so I think that that would be a game changer for them. You never know. I had someone who would put their food from their plate into their drink, whether it was milk, water, whatever. But you don't wanna stop that, that's not right. Don't waste that milk, okay, wrong answer. What do we wanna do? How can we come alongside and love them there? Well, I'm gonna come to the table and I'm gonna make sure I'm in front of them. So they see me, I'm gonna greet them, introduce myself, give them a compliment, sit down. You know, if it's your family member, you don't need to be quite as structured and you're greeting because there is that familiarity. But I don't swoop in and correct things. Goodness, gracious, what are you doing? We don't do that. Okay, wrong answer. That's gonna get the dukes up. That's gonna fire them up. They're gonna get defensive, right? Listen, if they knew it was bizarre or wrong to put their meatballs in their glass of milk, they wouldn't have done it. But in their mind, in that moment, it made sense for some reason. Can you and I understand that? No, do we need to medicate it? I don't think so. I don't think anyone was harmed by it. She wasn't leaving the property unattended or sneaking out or harming somebody or harming herself. And so I just wanna hit the pause button and sit down with her. And this happened once with my mom. Well, it happened several times, honestly. And I would say, oh my goodness, mama, I've given you a dirty glass. What was I thinking? And you know what I would do, guys, is make it my fault. Make it my fault, you know? And in her mind, she was always right, never wrong. She had that anisognosia, that inability to see her disease. And so she thought she was right all the time anyway. So if I'd have chastised her about that or corrected her, it wouldn't have gone well. It has somehow come back on me. And I just wanna advise you, if that's your loved one, they don't see their disease. They don't have that awareness, that they're sick, but they're making mistakes, blame it on yourself. I would say, oh my word, I've given you a dirty cup. What in the world was I thinking? And I would show it to her. I don't race in and grab things and rip things out of their hands, whatever, and replace it and give her a clean cup. But in my mom's case, her field of vision was really narrowing. And so I was able to put that glass when I was with her out of her field of view, and then she was less likely to then put her food in the cup. I don't know, I still to this day wouldn't know why she did those things. That was something I'll have to ask her when I get up there in heaven with her. But for right now, who knows? And so we would just take the cup and sit a little further out of her field of vision, and then offer it to her every few bites. So that might work for you, it might not work for you. All I wanna say is hang in there and keep working with them and keep trying things. Let's see, oh, reusing the dirty briefs, that's a real common one. So you might have individuals after they do agree to wear the briefs, which can be hard. In continents, it's a real common problem we see with brain failures. And if they have awareness, they'll be more likely to be inclined to want to wear a pad in their underwear or put on a brief. But if they don't have awareness and it's all your fault, they're always the victim. It may take, we've had to, for some individuals, put briefs in the drawer because the laundry didn't get done again. Dang on, it's all my fault. I didn't get to that laundry today. I had so much work too. I'm so sorry I'll get it done tomorrow. But for tonight, we're just gonna wear a brief tonight and then tomorrow we'll get the underpants where it washed him back in here. And we did that every night for a while with this individual and eventually she acclimated and she was okay. She did kinda go, guess you didn't get the laundry done. And we just had to eat that and say, I know it's hard to find good help. And just love her through that and just accept and agree. It's okay. It's not worth fighting for. We were getting our way and she was wearing the brief. But then what you might find is that then when they take the dirty brief off, if they take the dirty brief off, now some of you were saying, "Well, she won't change the brief now." Okay, yep, absolutely, that can happen. But sometimes they will and but they might, I walked into a home one time to assess a lady and she had briefs lining the back to edge of the bathtub and around the towel racks. And because those are reusable, you just gotta let them dry out and then you can wear them again. And did you know that people with dementia typically lose their sense of smell? Yeah, and there are some studies out there about the sense of smell. And if that's an early indicator of a dementia, I'm no expert on that, but all I can tell you is they frequently lose the ability to smell their own body odors. That's why they don't need a shower, they've already done that. And they don't recognize that their brief is dirty or wet or that those clothes are smelly from last night. They will put on the same clothes. I frequently am instructing caregivers to come in and be able to put out clean clothes and take the dirty clothes before they've changed their clothes, if they can. And you know, there are times when some individuals, they only want to wear that same outfit. Well, if you can go find five more pants like that and tops like that, who cares? I'm gonna have them wear the same outfit, let them think they're wearing the same outfit all the time. Just let them know you washed it up for them and here it is ready to go. And so, but rewearing briefs can be a real problem and you don't want them to do that. I'm so sorry. Let's see what else was I'm gonna tell you about. Yeah, so there was another woman who, for some reason, the family called and said, "You're not gonna believe what she's doing. This is so bizarre." And I'm thinking I'll probably believe what she's doing. Guys, the list just keeps getting longer and wait till you read my book and find out even more examples of bizarre things. And some of these things we're talking about would definitely be in there. But there was a woman and after she used the potty in the bathroom, she was good about that. It was great. You could remind her to wash her hands and she would. She was really great about that. But for some reason, she was inclined to take the toilet paper and tear it off into squares and then line the perimeter of the bathroom with it in her mind. And the family was just beside themselves with, "What is she doing? We need to call the doctor." Well, guys, let me just step back and say, "What could the doctor do for that?" Anybody? Any ideas? If we nail her with another medication, is it gonna make her walk more safely? Is it gonna make her transfer more safely? Getting up from the bed to go up with her walker or transferring to her wheelchair to pedal around or just to her easy chair sitting next to her bed? Is any of that gonna be safer because now we've added this additional or we've just doubled the doses or something? Is any of that gonna be safer? Is it gonna make her think more clearly or use better word choices? Be more patient with me. I think the answers are usually no. So can you just go around that bathroom, scoop up those squares and make two points and life goes on? That's really what I'm hoping we can do. I'm hoping by sharing these bizarre stories, a few of them, this is just the scratch on the scratch and just some things that we did to come alongside that maybe it'll help you understand that this is brain failure. It's brain failure and it's very bizarre and it's different for everybody. You cannot do A plus B equals C when you're caring for these individuals. It doesn't work. It doesn't work at all. They're all different. The best thing you can do is come alongside and figure out what she likes and figure out what he doesn't like. And then let's cater the care to come alongside. Let's think about their nutrition. Let's think about better nutrition. Let's think about if they're having trouble swallowing at this point. Do we need to cut up the food out of their site or maybe we switched to soft food in our preparation? How about that? Is that gonna help them not choke off? Things like that. Think about those things when we're coming alongside. And just how can we love them through this and make adjustments to serve them on this journey? They're all different. Some are gonna have trouble ambulating, walking, and we're gonna start to experience falls. Some are gonna bang on the windows and disturb everything. Why are they doing that? Can we be a great detective? You've heard me say it before. We have to learn to be a great detective when it doesn't make sense. Not coming in finger wagging. Don't you do that? Don't you say those mean more? Don't tell you. Don't you act like that with me. I'm here giving my time. Oh, guys. Wow. What's it all about? What have I told you before? It's all about the relationship. The relationship with you and this person. Whether you are the caregiver, whether you are the daughter, the son, the parent. Okay? Whether you are the spouse, whether you're the neighbor. If you're in a position to care for someone, it's all about the relationship and it's not time to finger wagging them down or raise your voice or correct. Okay? I want you to try and accept and agree, but you better get yourself right before you come in correcting them. One other thing I wanted to make sure I told you. Well, let me remind you, we have a bonus page for the month of September. It's called Start and Stop. What are the things you should start doing when you run into trouble caring for someone? What are the things you start and what are the things you stop doing? Okay? The bonus page can be found in the show notes this week, all the month of September. You can find the bonus page. You go in, put your email in and then that will email to you. It's two pages. You're welcome to use it. Okay? So don't forget about that. I wanted to make sure that I got that to you. So check out the bonus notes. For September, we're doing the Start and Stop page. Okay? So there's one last thing I want to share with you, and that is to be very cautious about not being part of the problem with these bizarre activities. For example, make sure when you're in the presence of someone who's struggling with brain failure, memory challenges, dementia, one of the dementia's that you are sharing positive, healthy things with them and that you're not influencing them in a negative way. So I had a lady once that I came in and I said something about whether traffic was so bad. There were fire trucks and ambulances and all these things. The police officers. I was sure someone had gotten hurt. La, la, la. So it wasn't long that I was visiting this lady in the nursing home and she did have some memory challenges. I guess I didn't realize how significant, but it wasn't long until her caregiver came in and then she's sharing that with the caregiver that there are police everywhere. And so I put that fear right into her. Can you see that? And so we have to be so cautious. And that's why we usually are concerned about what are they listening to? What are they watching? You know, are they watching scary shows? Are they watching the news all the time? And is there a way we can redirect that? Because I got news for you. That stuff will become a part of them. And the paranoia and suspicion, if that's part of their symptoms, it's only going to get worse guys because it will become a part of them. And so I just want to warn you about that. We need to love these people as best we can and try and be part of the solution. Not the part of the problem. Don't come in sharing because they can be an easy target right there for us to an unload all of our problems on. Don't do that. And as a caregiver, you guys know better. We don't do that to our residents, to our clients, to whoever we're caring for. We don't do that. We want to be part of the solution. Okay. Up and up. That'll make a great caregiver and it'll make a great relationship with that person. Okay, guys. That's it today from Teresa Youngstrom. Memory care with Teresa Youngstrom at a better approach to memory care. I hope you'll share this and I hope you'll like and subscribe and send this out. Hey, and don't forget the bonus page. It's going to be in the show notes. You'll want to click there and get that email to you. All right, team. And you know you got this. [MUSIC]