Fear & Dementia

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I received an interesting email from a woman who follows my blog posts. She wrote, 

“There is one thing I have not found much information about that I am hoping you might address in a future blog [post]: fear. Not fear of Alzheimer’s, or abandonment, or even dying. My husband has started to fret about things which neither concern him nor over which he has ever had any control…things like other drivers being pulled over, how the grocer displays merchandise, what type of shoes another person is wearing. I have read articles regarding fear, anxiety and anger in caregivers but can not find much on fear and anxiety in the patient.”

Fear in people with dementia is common. We usually call it “anxiety,” but I suppose it all comes back to fear: fear that they won’t “get back home,” concern about where loved ones are, anxiety about where they are and what’s happening next.

“Hey, where is my daughter?” Christina asked, standing in my office doorway. “She abandoned me, I know it!” Christina began sobbing suddenly. 

Christina regularly enters these fits of fear. She decides that someone has abandoned her, that her children are dead, or that she can’t find her cat (who lives at our community). 

I’ve found that the best solution for this type of fear is a combination of two things: anti-anxiety medication and a calming, reassuring caregiver and positive environment.
For many of my residents, just calming or reassuring them doesn’t work. Anti-anxiety medication can work wonders for people who need extra help. 

As I often explain to caregivers who are leery of “drugging” their loved ones, it’s not about “quieting someone”: it’s about taking the edge off of someone’s anxiety and fear so that they can breathe easy.
If someone with dementia is so upset and fearful that redirection and calming measures don’t work, there’s a problem there. Medication exists for a reason.

All the reassurance and redirection in the world won’t work if the person with dementia is so upset she can’t even hear you. As we know, people with dementia won’t remember what we said, but they will remember how we made them feel. 

They’ll be able to feel better, and focus on your words of positivity and reassurance, if they aren’t feeling as though the world is crumbling around them.

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Rachael Wonderlin has a Master’s in Gerontology and is the author of two published books with Johns Hopkins University Press. She owns Dementia By Day, a dementia care consulting company.

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