Anyone who has spent time with people living with dementia knows that agitation can seem to strike at any time. In a church service or group this is no different.
However, sometimes the cause of the agitation can be prevented, or the occurrences can be reduced as often the triggers are things in the surrounding environment. In order to prevent or reduce this there are a number of things to look at:
Try and create a calm environment
Try and remove the things that cause stress from the environment.
This could be pre-service noise. For example if children are madly running around at the start of the service, whilst the worship band practice. Why not suggest to the primary carer that they bring the person living with dementia in once the service has started and provide a quite area that they can go to before the service and maybe sit down and have a coffee. If you have some Dementia Friends in the congregation maybe they could support the carer as well so they know that they are not alone and welcome.
As can be seen from this example the solution could involve moving the person to a safer or quieter place for a short period of time where they can recover their peace.
Equally you could change the environment and not have the worship team practice before the service and stop children running around.
The solution must fit within your church context and not put barriers up to others
So what other things may help?
· See if they are comfortable
This may sound obvious but all too often the agitation is caused because they are uncomfortable, and this is their way of communicating this discomfort.
· Check for pain,
· Do they need the bathroom (so often a full bladder is the cause of agitation)? Try and encourage the primary carer to take them to the toilet before the service/meeting in order to reduce the risk of this causing agitation
· Are they hungry or thirsty
Also try and make sure that the room is at a comfortable temperature.
· offering a security object (although it sounds strange, some people living with dementia respond well to teddy bears or twiddle mitts (knitted tubes with buttons and tassels on that they can put their hands in and fiddle with),
Be sensitive to the fact that frustration could just be a way that they are expressing a want and sometimes the primary carer may not be aware of this.
Try to avoid triggers caused by distractions
Noise, glare and background distraction. (such as a worship band rehearsing before the service or having music playing before a group meeting) can act as triggers.
Done all that and they’re agitated what should we do?
If it is in a church service or group setting let the carer know that it is OK to retreat to a safe quieter area in the church building. If this space can still have the service quietly playing in the background that is great, but it would need to be possible for the carer to be able to switch it off in case it is the service is causing the agitation.
If you have some dementia friends within your pastoral care team or on welcome or sides person duty who could go with them that would be great to show love and support, especially to the carer.
If it is a one to one situation try to back off and use positive, calming statements and try and reassure. Try to slow down, maybe you are going too fast for them to keep up and try and add lightness in the conversation, focus on pleasant events.
If you are asking for them to make a decision or answer a question, try to offer guided choices between two options.
Try to limit or reduce any stimulation.
How to deal with a time of agitation:
It may seem obvious but just letting the person know they’re safe, where they are and that everything is under control can help.
Ask if you can help, if they can help you or maybe some other way that possibly distracts them from the place they are in.
Maybe apologise and let them know that you’re sorry that they feel upset and that you’ll stay with them until they feel better if that will help.
Listen to the frustration.
Find out what may be causing the agitation and try to understand. Even if the answer doesn’t make sense to you this is their reality and causing them distress.
Are you causing the problem?
Have you raised your voice or argued, shown alarm or offence, backed them into a corner, is it too busy and crowded, criticised them, ignored them.
All these can be a cause of agitation and when you realise this sometimes you can back away from that behaviour and calm the situation.
Involve the person in activities.
It could be that they are feeling disengaged. If you are running a group try using art, singing, music or other activities to help engage the person and divert attention away from their anxiety and agitation.
Can you change the environment?
Try and reduce any noise and distraction. If that’s not possible see if you can move to a quieter area.
They might just need to move as they have pent up energy.
The person may be looking for something to do or just want to move and stretch their legs. Try and find out if this is the case and see if they maybe want to be involved more or maybe do something physical like taking a walk.
This list is not exhaustive but hopefully gives you some information and ideas that can help to point you in the right direction when dealing with someone who is beginning to get agitated. It is such a blessing to the primary carer when they feel that someone understands and is there to help and not judge. This in turn brings peace to the person living with dementia and in some cases even this makes agitated outbursts less frequent.