What is stress?
Stress is something that we all experience in our lives. It can vary from everyday stressors, like running late, traffic or , to more major stressors that happen over our lifetimes. Stress is often described as the body’s reaction to being put under pressure, or situations that may put pressure upon us (Mind, 2017 (1)).
We need stress, it’s primitive, and is linked to the “fight or flight” response which helped our ancestors react quickly to life threatening situations. Nowadays, our fight or flight response is not needed with modern day issues.
Holmes and Rahe (1967 (2)) developed a scale to identify which major life stressors have been shown to impact us the most. The top stressors include death of a family member, retirement, major illness, and marital separation. It’s interesting how some of these top stressors are most likely to occur in later life. These, on top of what happens in our day to day life, can be a lot to take on. This is amplified if you are a carer, or if you are living with dementia.
Stress is very individual, and we all differ in terms of what stresses us out – for me, stress comes when I don’t have control of a situation. I know when I am stressed when, what I describe as “brain fog” happens. I cannot think clearly or logically. This is often paired with changes to my breathing and feeling like I cannot quite catch my breath. Other people react differently, some might experience sweating, heart-racing or negative thoughts.
Stress & Dementia Usually, what brings people to Dementia Support and into Sage House is related to a memory problem. When you dig a little bit deeper and get to know a family, it soon unravels that lots more is going on beneath the surface; difficult family dynamics, grief and loss, and physical health problems – to name just a few.
As Wayfinders, it’s our job to investigate these concerns and see whether there are small changes that can be made to make life a little bit easier. Having a Wayfinder on your side can help identify those things that can be controlled, which can help reduce those feelings of stress – we often talk to carers, whose biggest fears are thinking about the future and the future of their loved one with dementia.
Something we emphasize is that there will be some level of anxiety and stress on top of other issues for the person living with dementia. This can impact the way they behave and the actions they take.
For a person living with dementia, the stress response can come with extra barriers. Research has shown that having dementia results in a lowered stress threshold which gets worse over time. Challenges could be the person is in physical pain but cannot communicate this to their loved one. Some people with dementia may go back in time to a difficult point in their lives, and relive events that bring huge amounts of stress, grief, and loss. Other stress responses can include repeat questioning, continuous walking, or becoming withdrawn and uninterested. It is important to remember some people with dementia are no longer able to make or request changes in their environments to suit their needs. Finding small ways to reduce stress may allow the person to feel more in control of their emotions and allow them to have a “good day”.
“You can’t pour from an empty teapot”
Of course, carers, family and friends of people living with dementia need to be looking out for themselves. Taking some time away from caring for your loved one can feel odd and be linked with feelings of guilt. The quote “you cannot pour from an empty teapot” is key. Taking time to feel you again can act as a refresh and allow you to face the day, as well as build up resilience.
Below are some practical ideas to help reduce stress and anxiety, both for the person with dementia and their carers.
Breathing is talked about a lot. There are so many techniques and methods, but you simply need to focus on your breathing and the here and now. Stop what you are doing, find a quiet space and focus on breathing slow, and deep, breaths from your tummy. This sends a signal to the brain telling us to slow down. Placing your hand on your stomach and feeling the breath can help with focusing.
Mindfulness means focusing on the present moment, not thinking about the past or future. Taking part in a visual mindfulness exercise can allow someone living with dementia to focus on the right now and zone out of any stressful things happening around them. Using all of the senses (touch, smell, taste, sight, sounds) can help to fully engage with the exercise. Make sure the exercises are short and effective so the person with dementia can get the most benefit out of them.
Know your triggers and stressors
Sometimes we experience anxiety and we cannot pinpoint where it has come from. Other times we may know exactly why we feel stressed. Keeping a note of when you are feeling stressed may help identify our triggers. For people living with dementia, they may not be able to identify how they are feeling and may show us warning signs that they are stressed. This can include anger, frustration, withdrawal, signs of depression, lack of concentration, and exhaustion. Being aware of environmental factors like noise and lighting is important, as people with dementia may not be able to make these changes themselves. Also, for some people with dementia, you may find something that never used to be stressful is now a major cause of anxiety for them. As a carer, being patient and understanding is key, and like lots of things this can take practice!
Lastly, sometimes just being there for a person and making them feel heard can make all the difference. Some people forget that there is a person behind the dementia, who has interests and experiences they want to share. Allowing a person with dementia to speak openly and express themselves can act as a distraction from the situation and allow their voice to be heard.