Saturday, November 21, 2015

When Words Hurt

We must pray protection over the minds and hearts of our care recipients, because the devil has no compunctions about using the vulnerabilities caused by disease as conduits for his attacks. 

My mother's infrequent bouts of verbal abuse almost always happen while I am cleaning up a toileting mess, and though I do my best to be cheerful and matter of fact, she feels embarrassed. It is my theory that embarrassment triggers defensiveness, but whatever the cause, it is soul withering to have someone who is supposed to love me spew words so hateful and hurtful that I’m brought to tears, especially when I’m often on my hands and knees scrubbing waste from the floor when it occurs.  At times like these I’m helped somewhat to recognize that in her right mind, Mom would never treat me like this. When hatred flows through her toward me, its source is from the enemy, and the Lord is my shelter from evil attacks. It helps to pray for Mom while she is being hateful. This keeps me from responding in kind, and sometimes defuses her attack. 

In the past few weeks I've kept a list of some other situations that trigger Mom's negative behaviors and the solutions that have worked for us.  I hope these help others: 

  • Even if you were able to be a perfect caregiver, your care recipient would still sometimes exhibit negative behaviors. Dementia patients are often influenced more strongly by inward cues rather than environmental cues. This means that physical discomfort or negative thoughts can have a stronger influence on patient responses than anything we as caregivers can do to reassure or comfort. 
  • Don’t try to reason with an angry dementia patient. I have learned that my mother will cling to her emotion with the tenacity of one who has lost everything but what she knows she feels. The emotion is real to her, and no logical reasoning or kind words can make a dent in her conviction that her anger is justified. Much more effective are strategies of distraction such as offering an appetizing snack or a showing a favorite movie.    
  •  Lying is not ok, and we should never make promises we do not intend to keep, but some of us have a commitment to strict accuracy of detail that is not helpful in dealing with a dementia patient. For example, when dementia patients refer to deceased loved ones in the present tense, it is cruel to continually remind them that the loved ones have passed away. Another category of appropriate stretching of the truth is when the patient balks at some practice that is necessary for health and well-being. I tell my mom, who resists bathing, that the doctor has prescribed a daily sponge bath to help protect her from skin rashes (she doesn’t have rashes, and the doctor didn’t say she should bathe—though he would probably agree if I asked him!). Mom can’t take instruction from me, but, like many of her generation, a doctor’s orders carry authority for her. 
  • When memory of the immediate past is nonexistent, a dementia patient has only the present moment. Mom knows that when her digital clock says 12:00, she should receive lunch. If I am late with her lunch only one time in a six month period, she will ask, “Why is my lunch always late?”  And she is angry because in her mind this situation is not acceptable. My best strategy is to apologize, promise to do better, and to know that in five minutes Mom will have no memory of my perceived negligence. 

My mom was and is a positive and Christ-centered person. She often, even now, expresses love and appreciation for me. I must not allow her Alzheimer's-related negative behaviors to compromise my ability to love and appreciate her for what she has been and even for what she often is still, despite her disease. 
      It is  helpful for us as Christian caregivers to remember that hatred has its source from the enemy of our souls. We must pray for the ability to love our care recipients with God's love and continue to pray for them, even when the enemy uses their vulnerabilities to aim his poisonous barbs toward us.