THIS is why your loved one with dementia challenges you but is fine around others

Welcome back Careblazer. I am so excited for today’s video. I’m going to share with you why your loved one may seem to have a negative reaction toward you and not to other people AND begin to introduce you to the idea that your loved one CAN learn new things in a way that can help improve their behavior. Now I’ve taught on this concept before in previous blog posts and videos on my YouTube channel, but I want to teach it a bit differently here. 

This is what you are going to get from this post: 

#1. Why just because your loved one has dementia, doesn’t mean they can’t learn new things.

#2. How this ability to learn new things is creating strain and tension in your relationship.

#3. How you can begin to help you apply this information to your personal situation so you can see some positive results.

This is going to be so important for your future as a Careblazer, I hope you enjoy it and don’t miss my bonus tip at the end. 

Before we dive in, just a quick reminder, I have a free dementia Careblazer survival guide for you. You can grab your free copy by clicking this link. 

If you would rather watch a video on this topic, click here.

Okay, so for the topic today. 

In the past, I’ve talked about how just because your loved one may have a bad memory, it doesn’t mean they don’t “remember” or that they can’t learn new things. I’ve used the classic example of the pin prick “experiment.” This is the story of a doctor who  was working with a person with severe memory loss was working with this patient every day, yet the patient would never remember him and stick her hand out to introduce herself each time she saw the doctor. One day, the doctor stuck a pin in the palm of his hand and shen she reached out her hand to shake his hand, her hand got pricked, she pulled it away quickly. The very next day, although she had no memory of the doctor, of the appointments, she would not stick out her hand to shake this doctor’s hand. Although her memory when tested and just based on observation in daily life was severely impaired, and she insisted she had never met this doctor before. She couldn’t explain why she didn’t stick her hand out, she just wouldn’t. 

In psychology there is something called "classical conditioning" and what it means is that when two things are paired together consistently, they become associated with one another. Sometimes the pairing happens quickly, especially if it evokes pain as in the pin prick experiment or if it evokes great pleasure. Other times, the pairing takes longer to make the connection. 

Classical conditioning happens naturally all the time so it’s easy to miss it and not realize that this is actually a type of learning. 

The psychologist who first studied classical conditioning studied it in dogs. He discovered that dogs salivate when they have food. And then he started ringing a bell before giving the dog food. After enough pairings, the dog started salivating at the sound of the bell BEFORE the food was even introduced. So the sound of a bell doesn’t produce salivating. If I rang a bell right now, my dog Niko wouldn’t salivate. BUT, if I fed him right after I rang that bell, he would eventually begin to salivate because he’s made an association. 

Associations are being made all the time. Including with your loved one who has dementia. They may not be able to verbalize it. They may not be able to explain it. So it’s not easy for us to realize that learning IS actually happening. 

Here are some examples of how this can be happening with someone who has dementia. 

• You put on your shoes before you leave the house to go to work. When you leave the house, your loved one often becomes anxious. Eventually, the sight of you putting on your shoes provokes anxiety. 
• Let’s say your loved one doesn’t like to shower. Everytime the home health aide comes to the house, they try to get your loved one to take a bath by taking off their clothes, washing their body etc. Whenever it’s bath time, your loved one resists. Eventually, the sight of the home health aide arriving to the home will be paired with negative emotion. 
• A family member that visits weekly always brings a treat and watches a funny show with your loved one. Every time this family member comes to visit, your loved one smiles, is pleasant, and seems to do better than on days when they are just with you. 

Notice how classical conditioning involves the pairing of two things consistently over time to the point that they become associated with each other? Furthermore, a pairing can occur with a positive OR negative emotion.

If you are the person that is constantly reminding your loved one of their disease, or that they need help, or that they can’t do something, or that they need to do something they don’t want, then YOU eventually become paired with a negative emotion. This is often why you’ll see people with dementia having more of a struggle with the primary caregiver and do better with people who aren’t around as much. It’s because that pairing hasn’t happened with the person who doesn’t come around as much. 

This is so very important to understand. It means the day to day interactions you are having with your loved one are incredibly important. Of course this doesn’t mean that you should never intervene or provide the safety and structure needed. BUT, it does mean it would be a really great idea to start to question and think about whether there have been any unintentional negative pairings and if there are some ways to pair some positive emotions into your day. 

None of this information is ever to discourage you or be used to beat yourself up. You can only move forward from what you know now. And the good news about classical conditioning is that if you notice perhaps you have been  unintentionally pairing some negative emotions with a task or activity, you can reverse that. For example, in the classic example of a dog with food, if I continued to ring a bell but stopped giving my dog food, eventually my dog would stop salivating at the sound of the bell. It may take some time, there is no set number of how many times things have to be paired together for it to “stick,” but it can be done. It’s possible for you and your loved one. 

Now I invite you Careblazers to apply this to your own caregiving experience. What is it that you’d like to pair? Is there a positive behavior you’d like your loved one to engage in more often? Is there a challenging behavior you’d like them to engage in less? Think of how classical conditioning can be applied to those situations.

A BONUS TIP would be to compliment, praise, and give attention to the things your loved one does or says that you want to foster more of, and ignore the things/behaviors that you’d like to see less of.

This is just one tool in an entire tool chest of approaches to be used when it comes to dementia behavior. I’ll link a playlist to a bunch of other behavior videos here. If you are a Care Course member with Q & A access, bring your ideas and questions of how to apply this concept to your specific situation to one of our upcoming Q & A sessions so we can work through this together. 

Careblazer, I hope this gives you some food for thought. Let me know if you plan to try this approach with your loved one in the comments below. 

I’ll be back next week with a new post. In the meantime, keep up the great work!