3.6 Managing anxiety about memory and thinking difficulties

The worry about losing or forgetting important things, and feeling unsure of what is happening or even who people are can spill over into enormous anxiety for the person with dementia. Anxiety can manifest as constantly asking the same question, following you around (sometimes called ‘shadowing’), becoming upset or increasing confusion.

Strategies that reduce anxiety for people with dementia:

• A calm environment. In dementia, the brain does not cope well with competing distractions, such as trying to have a conversation with the TV on. Reducing noise is important to enable the brain, and the person, to function at their best. Marie created a ‘calm space’ where her husband Andy could retreat to when things threatened to overwhelm him in their noisy extended family home.
• Monitoring and responsiveness. Don’t push the point of checking calendars or placing items in the correct spot if the person is tired, hungry, feeling unwell or flustered. People with dementia will become more tired as their brain has to work much harder to process information. Often they are at their best in the morning. Try to program more challenging activities when they are feeling rested.
• Get active outdoors. Walking, cycling and being in nature can reduce distress and anxiety. Regular exercise can positively influence mood and helps get a better night’s sleep.
• Provide reassurance. Give a soothing activity to do, like walking the dog, having a cup of tea or listening to music. Massage can be helpful, and there is some evidence that aromatherapy with lavender or lemon balm is calming. You can try drops of a good quality oil in moisturiser for massage or try a thermostatically controlled electric diffuser.
• Keep information simple, short and to the point. Try not to get exasperated and keep your voice calm. Anxiety is contagious. Sometimes you may need to leave the situation for a while and return when you feel calmer.
• Identify with the feeling. Marie would become increasingly anxious and worked up about forgetting appointments. Sarah her daughter, found that simply identifying with Marie’s feeling of frustration about her forgetfulness from dementia helped reduce her mother’s anxiety.