Redirecting away from the negative

“I do not have to attend every argument I’m invited to.”

These words can be kept in the back of your mind as you, the family caregiver, spend what can be some very frustrating days with your loved one. This month try to remember:

When a loved one or close friend is upset or concerned about something, it’s part of our nature to listen, empathize, and possibly help them resolve the situation. As caring people, we do what we can to make those close to us feel valued and respected.

However, when someone is diagnosed with Alzheimer’s disease or dementia, another dimension to feelings of anger, confusion and fear in the affected person is added to the situation, due to impaired memory and altered cognitive abilities.

Alzheimer’s disease or dementia can blur the lines between imagination and reality. Although your intentions to help are grounded in good intentions, trying to explain to the person why their perceived reality isn’t true won’t help the situation, and can be taken by your loved one as an attack. This can escalate already heightened emotions and increase volatility in their behavior, and cause frustration among family and friends who aren’t sure how to respond to unexpected outbursts.

Staying connected to a loved one is a matter of understanding what’s rooted in their anxiety, and taking positive action toward a desirable outcome that not only changes the negative behavioral expressions, but also leaves them feeling supported, respected and listened to.

What is redirection in elder care?

Redirection is a technique that shifts the focus of the loved one away from a situation that causes them fear, anger, anxiety, or from engaging in dangerous and unsafe behavior, toward a situation that’s more calm and pleasant.

We accomplish redirection in four simple steps:

1. Validating their concern. Your loved one with dementia simply wants to know that they’ve been heard and acknowledged. It’s often helpful to repeat what they told you and show that you’re taking their concerns seriously.

Show respect and acknowledgment: “Do you think someone has taken your keys? I can see why you’d be upset about that.”

2. Joining in their reality. Helping the person with their request builds trust and communication and will provide you the opportunity to lead them to a positive distraction. Build trust by joining in: “I think we’d better find those keys. You know what? I lost my book too. Let’s look for them together.”

3. Leading them to a distraction. Proactively create an environment with creative activities, snacks, drinks, music, puzzles and other meaningful activities that the person enjoys. This step is especially effective with people who have severe memory or attention issues. Lead them to a preplanned distraction: “Let’s try looking by the piano for your keys.”

4. Redirecting their attention. Invite them to participate in one of the activities to adjust their focus and de-escalate the situation. Successfully use redirection on a regular basis, which brings your loved one dignity and respect. Use the distraction to de-escalate: “I love hearing you play ‘Amazing Grace’ on the piano. Can you play it for me now?”

Take care not use negative verbal redirection. It’s important to always avoid negative verbal redirection in an attempt to simply reassure the person that there isn’t anything wrong at all. As good as your intentions might be when doing this, being dismissive, or negating or ignoring their concerns might actually make matters worse by not joining in their reality, upsetting your loved one even further.