Emotional Distress with Dementia

The short video clip below shows how to help dementia patients cope with their emotional distress (time: 3 minutes).

Emotional distress is common for people with Alzheimer’s disease and other dementias. Knowing how to handle a dementia patient who is highly anxious or extremely upset is key to calming the person down and preventing emotional escalation. The following tips will assist in deescalating the emotional distress of an individual with dementia.

First, approach an individual with Alzheimer’s who is in distress using the positive physical approach. This method of approach includes slowly approaching (one step per second) the individual from the front and upon reaching the person, facing him or her from the side, which allows the individual to look away if desired. This body positioning is called the supportive stance.

From there, try to determine which emotion, such as fear, anxiety, anger, frustration, etc., the individual is feeling. Express empathy and utilize phrases, such as “it looks like you are feeling frustrated,” “it sounds like you are really angry,” and “it seems like you are sad.” Doing so allows you to make note of the situation and reflect it back to the individual with dementia, which expresses empathy without making your opinion seem like a fact, and it gives the dementia patient a chance to express what they’re feeling, if they can.

With an individual in an earlier stage of Alzheimer’s disease, one can decrease their emotional distress by moving their attention in a slightly different direction without totally changing the subject, a technique known as redirection. You can see an example of redirection in the video below when an individual with dementia is upset and anxious and looking for her mother because she needs her to fix her dress, and the caregiver redirects by asking the dementia patient, “She did a lot of sewing, didn’t she?” This leads the woman with dementia to talk about how her mother handmade everything, including her wedding dress. The caregiver then asks about the wedding dress, and the woman’s need to find her mother to fix the dress she is currently wearing is forgotten.

For those who are in the later stages of dementia, distraction rather than redirection may be required. Distraction is taking the dementia patient’s attention away from what they are feeling and/or thinking by distracting them with something else entirely. Since language becomes an issue as the disease progresses, distraction will need to be done with an object. An example of distraction is as follows: A caregiver uses a positive physical approach and hands a highly agitated Alzheimer’s patient (who loves cake) a slice of cake. This causes them to forget about their distress because they are focused on eating the dessert.