May 17, 2017

Are You a Good Dementia Detective?

If you are a good Dementia cop, you probably learned that your Alzheimer's patient is not guilty of a crime. If you are a bad Dementia cop, you are probably upset all the time by the behavior of your Alzheimer's patient.

By Bob DeMarco
Alzheimer's Reading Room

If you are a good Dementia cop, you probably learned that your Alzheimer's patient is not guilty of a crime.

It is pretty easy to blame a person living with Alzheimer's for everything they do.

It is not unusual for caregivers to tell me that their loved one is mean or a real challenge to manage. Most often when I ask, have you given any serious thought to why they are mean or hard to deal with they answer no.

The bad cop might conclude that Alzheimer's patients are "bad" by nature. A good cop on the other hand might decide to investigate and look for clues to the behavior.

Experience tells us there are two major reasons (among a long list) why Alzheimer's patients are mean, or express challenging behaviors.

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One thing that makes Alzheimer's patients mean is infections, most often urinary tract or bladder infections. Most Alzheimer's patients cannot tell you when they have an infection, are not feeling well. As a result, they tend to get ornery.

Doctors and doctors aides are not good at detecting urinary tract infections (UTI). Why you ask?

They typical personal care doctor in America schedules patient appointments every ten minutes. The goal to get the patient in an out the door every ten minutes.

The doctors aide is the one that usual collects information on the patient including taking the patients temperature and blood pressure. I have yet to meet the doctors aide that knew that in the normal course of aging a persons core body temperature drops. So, if the patients body temperature is near the normal (or below) 98.6 the aide assumes everything is fine.

Lets take the case of Dotty. My mother's core body temperature at the age of 90 was 78.6.  I determined this by taking my mother's temperature each day. I learned over time that my mother had a long series of urinary tract infections that went undetected. This explained in part why her behavior was so "bad" from 2003 until 2006.

How did I discover this? By being a good cop.

Whenever my mother's temperature would rise over 82 I would call the doctor for an appointment to check her urine etc. The nurses aide after taking my mother's temperature would tell me there was nothing wrong. by then the temperature was usually around 84. I would simply request a test of her urine. In all but one instance my mother had a bladder infection, and when it wasn't a bladder infection in the one instance it was an infection that was worse.

So, are you a good cop or a bad cop? Do you take the temperature daily? Do you know your loved one's core body temperature?

A second example of why Alzheimer's patients are sometimes "bad" or "mean" is because they are left alone.

Read this carefully. Alzheimer's patients cannot be left alone. If they are left alone they will likely become mean and challenging or worse.

You don't have to take my word for this. Be a good cop. Buy a notebook and start taking notes. Does your patient become harder to handle or deal with if you leave them alone? By alone, I mean go out the door and leave them alone for more than a few minutes.

Does your patient ever tell someone else that you leave them alone even when you don't? Do they accuse you of being up to something when you go out? Listen to their words. Be a good cop.

The bad cop might hear the words, but might not actually be listening. A good cop listens to the words, and then when they are negative, reads between the line in an effort to discover what those words actually man in a a world filled with Alzheimer's disease.

Here is the real message I am trying to convey.

We are Alzheimer's caregivers, but in a real sense we are detectives (cops).
  • Try to learn to use positive reinforcement instead of contradicting your loved one.
  • Negative statements usually result in negative feelings and behavior.
  • Positive statements engender feelings of happiness and contentment.
  • Try to remember you are fighting a disease and not the person.
Make love, not war.

Related Content

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Positive Thoughts Drive the Dementia Caregiving Experience

The Frightened, Angry, Anxious, Mean Dementia Patient

3 Ways to Redirect a Dementia Patient and Embrace Reality

3 Ways to End the Dementia Care Blame Game

How to Get Answers To Your Questions About Alzheimer's and Dementia

Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob is a recognized Influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide.

"I now include the Alzheimer's Reading Room in my list of caregiver resources for every dementia patient I work with. My colleagues are doing the same. 
The ARR is a fantastic resource. The writing is clear and jargon-free. The many experts who contribute to this site also keep the content up-to-date and useful."
Rita Jablonski-Jaudon, Director, 
National Hartford Center of Geriatric Nursing Excellence at UAB

Citation Alzheimer's Reading Room