Karen Tyrell jokingly calls herself the "dementia whisperer" but the nickname may be apt as she has as many problem-solving techniques and solutions as there are challenging behaviours.
You name it, Tyrell, has seen it in her years as a therapeutic support worker for people with dementia.
The signs of dementia are as varied as the people who acquire the debilitating disease: repetitive actions that seem to make no sense; wandering; disruptive or inappropriate behaviours - all of it looking like crazy behaviour unless you are the caregiver who is dealing with it and watching your trusted loved go into decline.
"They feel guilty. They feel a loss of hope," Tyrell said of caregivers. "That's the stage where families are struggling. They don't know how to cope."
While putting someone in a care home is one option, and some anxiety-reducing drugs will calm some patients, Tyrell believes non-pharmacological interventions offer promise and can keep people at home longer, in familiar environments where they do best.
With her newly established consulting business, Personalized Dementia Solutions (www.dementiasolutions.ca), Tyrell offers hope for families walking down this dark and rarely discussed path to a calmer, more peaceful future.
"If we can manage those behaviours, they may be able to stay home longer and families won't be burnt out as quickly," she explained.
Typically, caregivers call Tyrell as a last resort. A partner or grandparent is wandering and getting lost; or they are relieving themselves in the corner of the living room; or they pace endlessly or ask the same question over and over, and then they get angry or abusive when challenged.
Many of these behaviours are simply reflections of the individual's particular history or reality. Memory is like an onion, said Tyrell: When the most recent memories peel away, the raw emotions of an earlier time are left behind. With so much pain, suffering, worry or even boredom at the centre of these behaviours, Tyrell advises getting to the heart of the matter using a technique called therapeutic reasoning to talk the patient out of their agitated state. It involves more or less agreeing with the dementia sufferer to create a calm feeling.
You acknowledge the problem, said Tyrell, but offer a solution, such as "Your sister is looking after the children" or "The cows have already been milked, aren't we lucky!" These may seem like evasive strategies, but they do work.
"All behaviour has meaning," explained Tyrell, saying the caregiver needs to get into the head of the dementia sufferer to understand them.
In her experience, the wandering person is trying to get to a place that features prominently in an earlier memory - a former home, perhaps - or they may be looking for their children or their mom and dad. Sometimes, a solution is to tire the person out or remove a memory trigger, such as a coat rack, so they don't see their coat and think of leaving.
Tyrell describes a condition experienced by some dementia sufferers called "sundowning," where they get restless, usually at a time of day where they would have been active in an earlier part of their life, such as getting home from work or making a meal.
She advises hiring a support worker who can keep the patient busy with brain-stimulating activities, such as puzzles, sorting games or art therapy, even reminiscing, often followed by a walk, which reduces their anxiety and prepares them for a restful evening.
"A lot of families don't know this, they aren't taught this," said Tyrell, "But there are simple things that you can do."
The next free workshop on Cracking the Dementia Code for all caregivers is available Friday, May 25 at Dogwood Pavilion from 1 to 2:30 p.m. Karen Tyrell will also be available for free consultations at the Shoppers Drug Mart at Burquitlam Plaza on April 26.
