Lisa continues with her series on ‘Things all dementia caregivers and family members need to know.’  On today’s episode, Lisa focuses on fidgeting behaviors that are so common with dementia, including why fidgeting behaviors occur, what triggers them, the possible hidden meanings behind them, things known to escalate and intensify fidgeting behaviors, what steps caregivers can take to manage fidgeting behaviors, and much, much more.

Don’t miss this very important episode!

About the Host:

Author Lisa Skinner is a behavioral specialist with expertise in Alzheimer’s disease and related dementia. In her 30+year career working with family members and caregivers, Lisa has taught them how to successfully navigate the many challenges that accompany this heartbreaking disease. Lisa is both a Certified Dementia Practitioner and is also a certified dementia care trainer through the Alzheimer’s Association. She also holds a degree in Human Behavior.

Her latest book, “Truth, Lies & Alzheimer’s – Its Secret Faces” continues Lisa’s quest of working with dementia-related illnesses and teaching families and caregivers how to better understand the daunting challenges of brain disease. Her #1 Best-seller book “Not All Who Wander Need Be Lost,” was written at their urging. As someone who has had eight family members diagnosed with dementia, Lisa Skinner has found her calling in helping others through the struggle so they can have a better-quality relationship with their loved ones through education and through her workshops on counter-intuitive solutions and tools to help people effectively manage the symptoms of brain disease. Lisa Skinner has appeared on many national and regional media broadcasts. Lisa helps explain behaviors caused by dementia, encourages those who feel burdened, and gives practical advice for how to respond.

So many people today are heavily impacted by Alzheimer's disease and related dementia. The Alzheimer's Association and the World Health Organization have projected that the number of people who will develop Alzheimer's disease by the year 2050 worldwide will triple if a treatment or cure is not found. Society is not prepared to care for the projected increase of people who will develop this devastating disease. In her 30 years of working with family members and caregivers who suffer from dementia, Lisa has recognized how little people really understand the complexities of what living with this disease is really like. For Lisa, it starts with knowledge, education, and training.

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Welcome, welcome. Welcome to another brand new episode of the Truth Lies and Alzheimer show. I'm Lisa Skinner, your host, and today I'll be continuing with our series called things all Dementia Caregivers should know and need to know. As caregivers, I feel very strongly that you need to know that seniors with dementia absolutely need activities that will set them up for a successful experience. Everyday activities can become too difficult for older adults with Alzheimer's disease or dementia, as we all know, but like the rest of us with healthy brains, people who live with dementia still have the need to feel successful. It's the way we're wired. It's a basic human need. So that's precisely why providing failure free activities for people with dementia is so important. It will ensure that they can always be successful no matter what, because if they fail at something, they feel very bad about themselves, and they feel very frustrated because they're losing control of their independence. And most people who live with dementia know they have it, and they just see everything diminishing in their abilities to function on a day to day basis, but being happily engaged in A satisfying activity we know actually reduces agitation, anxiety, depression and anger, it may even reduce challenging behaviors like sundowning or reduce the need for medication. The one of the things that we see on a regular basis in people living with dementia is fidgeting. It's a it's a common behavioral expression among individuals with dementia. Various studies and observations indicate that many people with dementia exhibit fidgeting behaviors, which can manifest in different ways, such as repetitive movements, pacing and or manipulating objects. I don't know if you all remember this, but I've told this story several times. It's a chapter in my book. My mother in law, Mary Ann, was a fidgeter. And the thing that she did, like all day long, was she took napkins and she folded them into force, and then she took the square that she had folded the napkins into and put it in her purse, close the purse, and shortly after that, she opened the purse, took the napkin out, and started all over again. And she would do this all day long, and it just kept her occupied. Here are some of the reasons why fidgeting is prevalent in dementia, because they have cognitive impairment, and then as the dementia progresses, their cognitive function declines, and that leads to confusion and more confusion and more confusion, and also restlessness, which can trigger fidgeting. They very commonly feel anxious and uncomfortable. Many individuals with dementia experience anxiety or discomfort due to their condition, resulting in fidgeting as a coping mechanism. Their need for stimulation, fidgeting can serve as a way to seek sensory or physical stimulation, especially when other forms of engagement become so limited for them, and of course, losing a routine that we become accustomed To in our everyday lives and changes in environment or routine can increase feelings of unease, and that can lead to increased fidgeting behavior. So when fidgeting is common, the intensity and frequency can widely. Area among individuals with dementia and our caregivers, you and me and our family members can actually help manage this behavior by providing appropriate activities and creating a calming environment for those we care for and our loved ones now, fidgeting can also be triggered by various factors, including, again and anxiety and stress, because high levels of anxiety or stress can lead to fidgeting, and this is a way for them to relieve tension. They could simply be bored. Lack of stimulation or engagement can cause individuals to fidget as a way to occupy themselves. Restlessness is common physical discomfort, such as being in an uncomfortable position or experience pain. These things can all contribute and trigger fidgeting, cognitive overload. Might not have thought of that one. When a person is faced with too much information or is trying to process complex tasks. They made fidget as another coping mechanism. And cognitive overload is really easy. It happens very quickly and easily. When you live with dementia, they can only process so much information at a time you stack too much on them, and you've got cognitive overload. Fatigue can trigger fidgeting. Tiredness can lead to restlessness, prompting fidgeting as a way to stay alert or combat drowsiness. And then we have social situations which not everybody who lives with dementia is comfortable anymore. In so in social situations, fidgeting can be a response to nervousness, shyness, or the pressure to conform routine changes, changes in environment or routine can create a sense of unease that also triggers fidgeting behavior and the neurological conditions that we see with dementia can lead to increased fidgeting as part of the actual disorders symptoms, therefore identifying specific triggers can help in managing fidgeting behavior more effectively. People with dementia may fidget for other reasons too, such as motor activity. Some forms of dementia affect motor control and coordination, and this can lead to involuntary movements or fidgeting, as the brain struggles to manage their physical actions, habitual behavior over time, fidgeting can become a habitual response for some adults, offering a sense of comfort or normalcy. And I believe that's exactly what it was for my mother in law, Mary Ann, it became so habitual that it's like she couldn't stop folding her napkins and tucking them into her purse, but it made her happy, so it was a good thing. And then, in terms of social interaction, fidgeting may also be a way for individuals to engage with their surroundings or communicate non verbally, especially if their verbal communication becomes challenging, which it often does with Dementia. Now this is important to know, digiting can escalate easily under certain conditions.

So one of those conditions is increasing anxiety or stress. If the underlying cause of fidgeting, such as anxiety or stress, intensifies, the fidgeting behavior may become more pronounced or frequent, so you want to kind of keep a watchful eye on that environmental factors can easily escalate fidgeting behaviors, and that means that disruptive or chaotic environments can. Can exacerbate feelings of discomfort, leading to more intense or aggressive fidgeting social pressure. In social situations where a person feels judged or uncomfortable, fidgeting may increase as a coping mechanism, potentially drawing more attention and escalating the behavior. These are all signs that they're trying to tell you that they are not comfortable in the situation that's going on at that time, lack of sleep or exhaustion can heighten irritability and restlessness, leading to increased fidgeting over simulation. Being in environments with too much sensory input can overwhelm individuals living with dementia, triggering more fidgeting as they try to manage their discomfort cognitive load. When faced with complex tasks or information overload, fidgeting can escalate as to response to frustration or confusion. So fidgeting, as you can see based on what I've talked about so far, are major tell signs that something is not right with them, and then there's physical discomfort. If a person is experiencing pain or discomfort, their fidgeting may become more intense as they seek relief understanding the context, and these triggers of fidgeting can be so helpful in managing and potentially reducing its escalation, if you know, if you recognize that the fidgeting behaviors, if it does intensify, is due to something not being right with them. But the good news is, caregivers can take several steps to manage fidgeting behaviors in individuals with dementia. So number one, identify the triggers, observe and note what circumstances or environments increased their fidgeting, understanding triggers can help in creating a more supportive atmosphere, then you can provide comfort, ensure the individual is physically comfortable, adjust their seating, their clothing or other environmental factors to minimize that discomfort, offer them stimulating activities. So engage your person with activities that can occupy their hands and their minds, such as puzzles, coloring books, sensory toys that are actually designed for fidgeting, you need to somehow create a calm environment for them, and you can do this by reducing noise and distractions in The environment, which will help ease anxiety and their restlessness, encourage movement, allow for physical activity or movement breaks, which can help release pent up energy and reduce fidgeting. Practice mindful techniques you can introduce to the person that you're caring for, or your family member, to relaxation techniques such as deep breathing or gentle stretching to help calm anxiety and reduce fidgeting or give them A really relaxing, soothing hand massage that works wonders. You can use these fidgeting tools that are available, like stress balls, textured fabrics or other sensory items that can be soothing and engaging, communicate with them, encourage open communication, ask the individual how they are feeling, and if there's anything specific bothering them, and see how they respond. Always monitor their health. Keep an eye on any signs of discomfort or health issues that may be causing increased fidgeting, and consult health care professionals if necessary. If you remember in couple of the other episodes what every caregiver needs to know and should know, we've talked about other behavioral expressions that where they're trying to tell you that something's not right. Well, fidgeting. Is just another one of those. So keep your your eye on fidgeting behaviors. And I know it's hard sometimes, but try to be patient and understanding. Recognize that fidgeting could very well be a coping mechanism for that individual so approach the behavior with empathy and patience rather than frustration. By implementing these strategies, you can help manage fidgeting behavior in a very supportive and constructive manner. Seniors with Alzheimer's or dementia, obviously, one of the repercussions of cognitive decline is they very often become anxious or nervous when they don't have something to do with their hands. So there are, as I mentioned, a lot of things that you can offer them that keep their hands busy and keep their mind focused on something other than what may be bothering them. So the end of the day, ways that we can provide for our loved ones and the people we care for that have calming and comforting effects are to keep the restless hands occupied. That helps to relax them. It stimulates their brain activity. It helps with several conditions, including memory loss, anxiety and more, and it helps them practice their motor skills and keep those in check. It's like working our muscles through exercise and a lot of these things that are available for them to use and keep their hands occupied are suitable for different levels of dementia, because you can look for something that fits their level of difficulty. If they're in an earlier stage, it can be a more difficult activity. If they're further along with the dementia, you want to simplify it, and it can also be a fun and engaging activity for them to do with you or just by themselves. That said, I wanted to just kind of share with you some of the comments that people who have used some of the fidgeting products that are available out there. This one woman said she gave her mom a fidget apparatus she had dementia and fidgeted with all the various gadgets that were on this one particular thing that she gave her, and she just swears by it, she said it just relaxed her and kept her occupied. And you know, when I saw my mother in law and what that you know, full tuck and repeat behavior did for her. I've seen it happen myself. One woman says she bought it for her grandma, who has Alzheimer's disease and dementia, and she found it to be a wonderful distraction for her, just for her to keep her hands busy and have something else to focus on. And one person commented that they use theirs at bedtime to keep their mom's restless hands away from pulling her bedtime catheter out. That's brilliant. I think that's a great use of a fidget product. Lastly, keep in mind that no two seniors living with Alzheimer's disease and related dementia are alike,

and symptoms will differ from one person to another. So a fidget toy or prop another caregiver has recommended to you might not work for your loved one, so it's important to try a variety of items and see what your loved one responds to so uh, folding towels is a great activity, and some of the people living with dementia today who are baby boomers or even depression era, a lot of that age group. Uh, we're homemakers, and they're used to folding towels, so that could be part of reminiscence therapy for them and familiarization. So you can really be creative with this. So that is will conclude today's episode in which we are continuing with the series, things all Dementia Caregivers should know and need to know to make your lives a lot less stressful in your caregiving experience so much more pleasurable, and don't forget to go to our website minding dementia.com for all our latest updates. We post there regularly. So I want to thank you all for being here with me today. And of course, as always, I'll be back next week with another brand new episode of the truth, lies and Alzheimer show. I'm Lisa Skinner, your host, and I hope you all have a wonderful week, and I'll see you back here next to next Wednesday. Thanks so much for being here. Appreciate your time. Bye for now.