What is separation anxiety in individuals with Alzheimer's or dementia and some tips and strategies in managing it?
Reluctance and fear from being separated from the individual's primary caregiver, or separation anxiety, is a normal, healthy response and occurs regularly in those individuals with Alzheimer's disease or dementia.
Many factors contribute to separation anxiety including changes in a caregiver or household routine, illness, or from just being tired and/or over stimulated.
For the individual affected by Alzheimer's or dementia, the separation anxiety is magnified as the individual already feels personally "lost,鈥 and losing, or being separated from, a familiar caregiver can make him/her very unsettled and agitated. The thought of being alone, or even abandoned, greatly affects the individual and can be a challenging circumstance for the primary caregiver.
Some caregivers are very challenged when their loved ones "shadow them," meaning they are constantly under their feet, so to speak. The affected individual is not shadowing, or wanting to be with the caregiver all the time, purposely. The effects of the disease make the affected individual react in such a way that he/she trusts and needs that familiar person and thus, that person becomes the center of his/her world. It's a form of reassurance and validity; a connection the affected individual relies upon for his/her security and quality of life. Without it, the affected individual soon becomes paranoid and afraid, and his/her anxiety can produce behavioral outbursts or expressions.
Affected individuals need to build trust in others, caregivers other than their primary caregiver so that the primary caregiver can have some space, or respite, from his/her loved one. The affected individual eventually grows to trust and rely upon these new caregivers in their lives. These new, trusted caregivers can be family members or close friends or even a consistent professional paid caregiver. Once trust is established, it will be easier for the caregiver to get away when needed and not be shadowed so much by his/her loved one.
Always redirecting the individual suffering from Alzheimer's or dementia is another way to reduce separation anxiety. Validate the affected individual's expressions of fear and anxiety and use a comforting and soothing tone of voice for reassurance. Find something that the loved one enjoys doing, like taking a walk outside, working on a puzzle, gardening, painting, looking at photographs, listening to favorite music, etc. Pay attention to routine, as the more structure in the day the affected individual enjoys, the less chance that anxiety will rise. Offer them plenty of understanding and acceptance and never scold or ridicule the individual for the way he/she is feeling or acting.
The environment can also cause anxiety to escalate if the surroundings for the affected individual become unknown or are frequently changed, so changing care settings frequently can disorient the affected individual and cause strain. Additionally, affected individuals oftentimes mirror their caregiver, and they can sense emotions of the familiar caregiver. These emotions can be transferable, so it is important for caregivers to maintain control over their own anxieties when dealing with their loved ones. If the affected individual senses his/her caregiver's frustration or distress as the caregiver is leaving, then that might signal to the individual that something is wrong, and it will escalate the situation and the anxiety.