Recently, I had some success helping mum move from fear and distress to being able to smile again. Deep breathing and mindfulness helped. If you care for someone with dementia who is sometimes fraught, this might work for them too.
When I arrived to visit mum at the care home, she was in the living room asking a care worker how she could get out. She was clearly agitated, and visibly relieved to see me. In tears, she explained that she had just been dropped off, she didn’t have any money to pay the woman, she couldn’t pay for petrol, she wasn’t allowed to drive anymore, the woman had taken the car, and so on. I gently encouraged her to continue. She became aware that her recall wasn’t quite right, she couldn’t remember exactly what happened, and was feeling confused.
Stress triggered by outing
I organize for private care workers (separate from the care home) to spend time with mum twice a week to engage her and break up the monotony of the day. The care workers are instructed to take mum out if she expresses a desire to go, which she often does. Problems sometimes arise when mum is brought back to the care home. She worries about paying the woman, or is confused as to why she is left in what seems like a public space, instead of at her own home. The trips sometimes cause distress, even if she had a nice time during the outing. The carers have agreed to sit with mum for a while back at the home before leaving, so it is less confusing for her. This doesn’t always work.
Breathing exercise and mindfulness
First, I attempted to reassure mum. Reason rarely works when mum is wrestling with overwhelming feelings. Mum said she was scared. So, I changed track, and led mum through an adapted breathing exercise and a mini body scan (a mindfulness exercise).
Having just watched a video of Teepa Snow demonstrating a breathing exercise for carers, I led mum through this. I describe the purpose and the steps of the breathing exercise in a previous post, but it’s better to watch Teepa demonstrate the technique. When we become anxious our breathing becomes shallow and we don’t get enough oxygen to our brain, which makes us feel worse. The exercise helps to correct this.
Following the breathing exercise, I asked mum to sit upright and in a comfortable position, with her eyes closed. After spending a short while focussing on the movement of her breath, I asked her to become aware of any physical sensations in her body. She felt a knot in her stomach. So I then asked her to imagine breathing into and out from the physical feelings in her stomach, and to stay in touch with them as they intensified, lessened, changed or moved. I was surprised how willing mum was to follow my instructions, and suspect she may have experience of similar exercises pre-dementia. The whole exercise took around ten minutes. You can see instructions for a full body scan (PDF) here, or hear a short body scan being led by Mark Williams.
Hallelujah! The fear had passed
Just as we were coming to the end of the mindfulness exercise, a visitor popped in. She was retrieving a guitar as she was about to lead a sing-along. I asked mum if she wanted to join in, and she did. I checked if she still had any sensations in her stomach. She said, ‘Not now’, and moments later, after giggling about something silly on the way to the lift, she added that she could now smile again. Hallelujah! The strong emotions and physical sensations had passed.
I am not entirely sure what worked, but I guess the critical elements were:
- Being heard and being able to express her feelings, however confusing they were;
- Through Teepa Snow’s breathing exercise, increasing the oxygen levels to her brain;
- Spending a short while being in the moment, being more in the body than the head (mindfulness).
Not only was I excited that mum was feeling better, I now had a very tangible exercise that I can try again.
A note of caution. I have tried variations of these exercises previously, and I have tried again since. While there is always some positive impact, I’ve not had the same level of success. However, while I am not actually sure what the magic ingredient was in this case, I feel sufficiently encouraged to keep coming back to this combination of activities to help alleviate mum’s high levels of distress and anxiety.