A guy yelled at me because I talk too much. Oh, and because I’m loud and annoying. And maybe he had a point.
I was doing a Memory Trunks program. I had a circle of about a dozen people in varying stages of dementia. Although I do my best to get people to talk, I was failing miserably on this particular day. Long silences. Empty stares. I’m used to it, but time was going slowly.
I like to think that it’s okay if people don’t join in the discussion. There is still value in them being there. But, to be honest, it’s a lot more fun when I’m not the only one talking.
A guy with younger-onset Alzheimer’s walked into the room. He stopped for a moment and stared at me. Then he started yelling.
“She’s talking too much!” he screamed. “She’s too loud! It’s annoying. Her voice is annoying. Make her leave!”
It’s not the first time I’ve been told my voice is loud and annoying. And not just by someone with dementia. I lecture to large groups and teach fitness classes in a huge gym. I’ve had students tell me that they sit in the back on my classroom because it feels like I’m shouting at them when they sit in the front. No one has ever complained that they can’t hear me. I guess I’m just loud. Maybe this guy had a point.
And really…I can see how he thought I was dominating the conversation. I even felt like I was talking too much. I was sitting with a large group, and I was the only one talking. If this had been a cocktail party, I’d have been one of those rude guests who went on and on about themselves.
The staff tried to reason with this guy. “She’s our guest,” one of them said to him. He wasn’t in the mood to hear it, and he continued his rant.
“She NEEDS to leave! I hate her!” he yelled. The staff tried again. They tried telling him that I was a very nice person, that everyone was enjoying my visit, even that he should sit down with the group because he’d probably learn something new.
But reasoning is an ineffective strategy when you are working with someone who is no longer capable of reasoning. To be frank, it doesn’t work to explain things to people with dementia. It’s not that they’re not smart. It’s that their brain is dying. You wouldn’t request that someone without legs run a 5k. Let’s stop expecting people with dementia to do things they aren’t capable of doing.
A better strategy is to change the environment. When something is upsetting someone with dementia, you cannot explain to the person with dementia why it shouldn’t upset them. You will waste a lot of energy doing this. And–think about it–when you are really upset, how do you respond to someone who tells you that you shouldn’t be upset? If you are like me, it only makes you more upset.
So you get them out of the upsetting situation. Or you change the situation that is upsetting. But you don’t tell them why they should change their response.
A better response to the guy who was yelling at me would be to get him out of there. Take him to another room, a room where he can’t hear my loud and annoying voice. Or you give him an IPod with headphones to drown me out.
As people develop dementia, they may feel compelled to do things that we don’t feel comfortable with them doing. Things like driving, mowing the grass, using the oven. I hear statements like, “I’ve told Dad time and time again that he CANNOT mow anymore,” and “I keep explaining to her that it’s not safe to use the oven.”
Families are frustrated and scared. I get it. And they’re doing the best they can. I’m not trying to be critical, but I try to gently point out that these strategies aren’t effective. If it worked to tell someone with dementia that they can’t mow the lawn, would you have to tell them “time and time” again? And if she could understand the reasons why she can’t use the oven, she’d probably be functional enough to use the oven in the first place.
So what do you do? You move the mower. You put it in the neighbor’s garage. Maybe you remove the oven and revamp the kitchen to make it a safer place. You change the environment.
What happens when you rely on logical reasoning when working with someone who has dementia? You pick a lot of fights and you get very tired.
As for the guy who thought I was loud and annoying…After his outburst, a staff member took him into an adjacent room and helped him get started on a puzzle. As I was putting on my coat, he came out and gave me a hug. It wasn’t an apology. He wasn’t making peace with me. I’m pretty sure he had no recollection of how he hated me 40 minutes earlier. Sometimes short-term memory issues aren’t all bad.