Q: My dad has pretty advanced dementia. Since my mom died two years ago, he has gotten worse. They had been living in a very nice apartment in (an assisted living facility) near our home. My dad still has the same apartment, but he may not be able to stay there much longer. He can still manage basic things and does not need that much assistance. The issue is his behavior.
My dad wants to hug and embrace everyone all the time. Sometimes it is funny, but often it is not. Even when in our house, he will attempt to kiss us many times.
The problem is that we are not enjoying this at all. We love my dad but we are not a particularly touchy-feely family. We have tried to politely let him know it is not OK, but he just gets sad and starts crying.
My mom and dad were a very close couple, married for over 55 years. They came together from Europe and were best friends. They held hands and kissed even when we thought it was too much. I know that he misses her. We tried medication for depression and anxiety, but no pill has made the difference.
Is there anything you can think about to help us? Any advice, even a small suggestion, will be greatly appreciated.
Nancy and family
A: What you have described is tough. You and your family obviously worry about your dad. You love him and you want him to stay in the place he has been calling home now for many years. The behaviors you have described make this very challenging.
Let's go back to the basics of behavioral problems with dementia. Many people suffering with dementia have these challenges.
Pacing, oppositional behavior, arguing, and even screaming can all happen. Then there is the behavior you describe -- not understanding social boundaries. That happens more often than you think.
You see, behavior that we call inappropriate is nothing more than expression of unmet need. For wanderers, it is the need to move, to be active. Oppositional and aggressive behavior often stems from an inability to cope with negative emotions and experiences. Constant screaming and crying is associated with loneliness and the need for attention.
How about your dad's behavior? What kind of need is he trying to express?
I think your dad is craving a human touch and affection. I suspect that he got plenty of it when your mom was alive. It sounds like they had a great marriage and genuinely loved each other.
We do not realize how little our aging parents and friends get touched. We do not live in a particularly embracing society. As a result of our restraint, lonely seniors often do not get enough physical displays of love and caring. They often only get touched when care is delivered to them by their aides. That touch is business-like and typically does not convey emotion.
We all need affection. Non-sexual affection helps people feel needed and accepted. If your parents were born in Europe, they might have been brought up in a culture where touching -- even of strangers -- was very important and normal. Now your dad is seeking comfort through his hugging and kissing -- the same comfort he experienced with your mom.
I do not want for your family to change. I know that you have tried to accommodate your dad's needs. To help him, I would propose two unorthodox things.
The first one is massage -- and I mean for both your dad and you. Regular massage has numerous benefits for seniors. It has been shown to reduce stress and anxiety. It is great for osteoarthritis and back pain. It works for chronic headaches. Some studies claim it reduces blood pressure, lowers inflammation and boosts our immune system. Although not all of these claims have been truly proven, research has been quite impressive and encouraging.
Massage has actually been studied in patients with dementia. Together with music therapy it is considered a promising alternative to the usage of medications. It also has very few, if any, side effects and, considering how expensive medications get, it can be quite cost effective.
There are many types of massage. Swedish massage is the most popular. It consists of gentle strokes and moves and can be quite soothing. There is sports massage and hot stone massage. We have reflexology centered on certain crucial points identified in our body.
My suggestion would be to start by visiting a local massage salon. An experienced therapist will know what to do. If the response is what we hope for, then massage may become a weekly ritual.
If cost is an issue, then maybe a family member or the hired aide could become a massage expert. There are many ways to do this. You can get books, videos and such quite cheap.
What about the second unorthodox thing? You may consider reconciling with your parent's heritage and moving more towards the touchy-feely world. Not much -- just a little bit. I know many of you reading this may be frowning, but just give me a moment.
When comparing Nancy's aging dad with Nancy and her family, it is probably the later that would be easier to change and adjust. A little more hugging, a little closer embrace, one more kiss and saying "I love you dad" twice as much may prove exceptionally therapeutic.
Who knows? You may discover it has helped you as well.