You come bee-bopping in, ready to take on the day and help your loved one. Ah, but wait, all is not well in Alzheimer’s land (or any dementia). A stressful situation seems to be in progress. You scan the area for clues to reduce stress. Nothing seems to be amiss. You look at your loved one, but you do not see anything visible that could be causing the distress they seem to be in. Your loved one is sitting there with her head in her hands saying, “Help, Help, Help,…over and over again. Ask them what they need help with. They may also say, “I want to go home.” Over and over again. Crying inconsolably sometimes happens.

 You can also try reaching out your hand for them to take. When they take it, move to somewhere else while making a statement of, “I think it’s time for a bathroom break and a snack.” Sometimes, even going outside for a few minutes will help. Ask them to help you with something, give them a purpose and a job to do. You will become more skilled at helping during meltdowns. Do something physical to get them moving. Physical activity seems to bring stress relief or at least stress reduction. 

Find it, Fix it

You have to immediately go into “find it, fix it” mode. You have to check on all the things running through your mind at warp speed. First, you speak to them calmly and tell them who you are and that you are here to help them. Sometimes, your loved one may be able to tell you something. Now, it may not be what is causing the problem or issue, but they will tell you something. Both of you are experiencing a physical stress response and an emotional response to stress. All your brain wants is RELIEF. 

The things you know to check for include:

·       They need to go to the bathroom.

·       They have had a pee or poop accident.

·       They are in pain.

·       They are experiencing discomfort (shoes, feet, arms, legs, neck, clothing, etc.).

·       They are frustrated or overtired.

·       The environment they are in is too loud and/or distracting for them.

·       They are having hallucinations.

You quickly go through the list checking on everything and doing what you can to help. Sometimes, that works and sometimes it doesn’t. Sometimes, it is sundowning and it sucks. You provide comfort, distract and redirect as best you can because logic and reasoning won’t work. Taking care of the need is what usually settles everything down. The trick is to find the need. Crisis moments or stressful events need us to be able to help reduce stress levels. 

How does this get you to destress while in the moment? How does this decrease your cortisol level? How does this help you decrease your own anxiety and stress? Your psychological stress is related to their highly stressful agitated state. Watch out, you both can feed off of each other’s stress. They cannot manage their stress so you need to manage your stress.

You will automatically go into “find it, fix it,” mode and you won’t think about what you can do for yourself to calm down. The situation has already caused your own stress response to kick in and your brain has been hijacked due to the release of the stress hormones (releases adrenaline and cortisol). Breathing techniques work really well. You have to remember to do them. They really do help you to focus your mind and deal with what is in front of you. 

The best thing for you to do

The best thing for you to do is to deep breathe. Breathe in deeply and allow your belly to expand. Inhale through the nose for a count of five. Hold for a count of three and exhale through pursed lips for a count of seven. Repeat this five times. Doing this leads to increased focus and a decrease in anxiety and other forms of stress reactivity. Call deep breathing psychological first aid.

Now you can think more rationally

Now, you will be able to think and act more rationally. Deep breathing is not natural to most of us and we need to practice it a couple of times a day anyway. Remember that even if your loved one doesn’t understand the words you are saying or that you are trying to help, they are able to pick up on the feelings you are having and showing.

You have gotten your loved one semi-settled down and they are okay to be on their own for a few minutes. Let’s get rid of some of this stress. Try using the tensing and relaxing of muscles method. It is also known as progressive muscle relaxation. Now it is your turn to find practices that can help you to unwind. 

Tensing and Relaxing Your Muscles

You are going to slowly tense and relax each muscle. Muscles should be tense but not strained. Pay attention to the feeling of the muscle as it is tensed and then relaxed. This only takes 15 minutes.

Find a quiet, comfortable place to sit, take off your shoes, and close your eyes. Let your body go loosey-goosey. Practice belly breathing exercise five times.

Bring your focus to each muscle targeted. For example, take your right hand and make a fist. Squeeze that fist, as hard as you can for 5 seconds. Feel the tension and notice what the muscle feels like. We are not looking for pain. Some discomfort, but not pain.

After holding for 5 seconds, relax the muscle quickly and completely. Notice how that muscle feels and the areas around the muscle too. It may take some practice, but you will get better and better at targeting specific major muscles when it is time.

Relax for 15 seconds before moving on to the next muscle.

Body parts

Foot – curl your toes downward and hold for 5 seconds, then relax

Lower leg and foot – tighten your calf muscles by pulling your toes towards you, hold for 5 seconds, and then relax

Entire leg – squeeze/tense thigh muscles (quadriceps), hold for 5 seconds, and then relax

Do the opposite side next.

Hand – clench your fist, hold for 5 seconds, and then relax

Entire arm – Close your fist and bring your forearm up towards your shoulder (make a muscle), hold for 5 seconds, and then relax

Do the opposite side next.

Buttocks – tighten by pulling your butt cheeks together, hold for 5 seconds, and then relax

Stomach – suck your stomach in (pull belly button towards spine), hold for 5 seconds, and then relax

Chest – tighten by taking a deep breath holding it for 5 seconds and then relaxing

Neck and Shoulders – Shoulder shrugs (shrug your shoulders up towards your ears) hold for 5 seconds and then relax

Mouth – Open your mouth wide enough to stretch the hinges of the jaw hold for 5 seconds and then relax (you may be clenching your jaw and not even know it)

Eyelids – shut your eyes tightly hold them for 5 seconds and then relax

Forehead – raise your eyebrows as high as you can and hold them for 5 seconds then relax

Shorter version

After you become familiar with this routine you can do a shorter version when you are strapped for time.

Feet and Legs at the same time

Stomach and Chest at the same time

Arms, Shoulders, and Neck at the same time

Mouth, Eyelids, and Forehead at the same time

When you are really familiar with the tensing and relaxing techniques, you can learn to find your tense muscles and relax them.

Take micro-breaks

Take a micro-break – 5 minutes every hour

Micro-breaks help you unwind. Micro-breaks are another useful way to manage high levels of stress. You will be much better prepared for crisis situations when you take care of your mental and physical health.

  • Drink a glass of water
  • Close your eyes and deep belly breathe
  • Take a 5-minute walk outside
  • Do a brain dump – journal/write whatever pops into your head for 5 minutes
  • Do some exercises – 10 squats, 10 jumping jacks, 10 lunges, planks, pushups, stretches
  • Watch a short funny video
  • Listen to a favorite song
  • Laugh out loud (yes, you can make yourself laugh…the brain doesn’t know the difference…it just releases the chemicals)
  • Eat a piece of fruit and drink a glass of water.