Mailbox Response

The question was submitted 20/07/2007

Subject: Dementia lady in Hostel that I work in

One of the ladies I take care of in a Hostel Aged Care Centre has become more difficult recently and I am really not sure on how to deal with her. She is the sweetest person and her sister has also moved into the Hostel more recently. However, the lady I am talking about seems to have moved into a new stage of her dementia and I find her sobbing uncontrolably in the early evenings before she retires for the night. She keeps asking me what is wrong with her and I tell her that she is just feeling a little down. I give her lots of TLC and when it is time to take her to her room, she is now refusing to go and no matter how much persuading I try, she still refuses. I am known to be far too soft with the residents but this is my nature and I will never be hard on anyone. Therefore, please would you give me some advice on how to help this lady as when I request help from the other nurses, they become agitated with me and tell me that I am too soft and to just "harden up". I feel helpless but can't give up on this sweet lady who needs my help.

Answer from DementiaNet

This is a very difficult situation for you. Because dementia is a progressive illness, people with the disease continue to deteriorate and change. Your resident appears to still have some insight into the fact that she is deteriorating (asking you what is wrong with her), and this seems to get worse in the evenings. As well as this, she does not want to go into her room in the evening and this may be because she is frightened to be alone. Depression is very common in people with dementia, and it is important that this lady’s doctor is aware that she is tearful and agitated, particularly in the evening, as this may be due to depression. Treatment with an antidepressant may well assist her in feeling better, although it can do nothing to change the course of the disease.

There are also medications for people with Alzheimers Disease that may help this lady if Alzheimers Disease is the cause of her dementia. It is likely that her sister would be the person able to make health care decisions for your resident, and perhaps the manager of your hostel could speak to this lady’s sister and the local doctor, and discuss the possibility of treatment with one of these medications.

Having a sympathetic carer is very important for people with dementia, and it is very good that you are able to provide a loving and caring environment for your resident. It would be good for you to ask her why she does not want to go to her room in the evening, and see if you can assist her with this. It may be useful to see if her sister might help with this in the evening, and perhaps they can have a cup of tea together.

The answer was published on DementiaNet 23/07/2007