The Whitworths of Arizona, bringing science to you in everyday language.

Friday, January 17, 2014

LBD and Stress 2:
Finding the Triggers

Our likes and dislikes vary and so do our stressors. Anything perceived as painful, annoying, threatening, or disrupting will add stress and when continued, will eventually become too much to handle without internalizing it. The problem for the PwLBD is that with a much lower threshold, “too much” comes quickly.

Internalized stress shows up as a variety of illnesses: high blood pressure, headaches, diabetes, cancer and more. The more intense the stress and the longer lasting the greater the risk. Where an illness, such as dementia, is already present, internalized stress makes the symptoms worse.

With dementia, stress often shows up first as agitated behavior or increased acting-out. Find the trigger and you can probably decrease the stress.

Stress is individual. What bothers one person might not bother someone else at all, and vice versa. While everyone reacts differently, the body’s initial physical responses to stress are the same. Physical signs of stress include increased heart rate, feelings of anxiousness and tense muscles.

Stress is caused by something. Become a sleuth and look for the triggers. Each person’s triggers will be different. They can be anything—a certain word or sound or sight, anything. Bill’s was a word:

I always kissed my husband and told him goodbye when I left his nursing home at night. But he’d wake up agitated in a couple of hours. --Barbara

Bill’s trigger was Barbara telling him goodbye—the agitation was his body’s way of communicating the fear that she wouldn’t return.

Look for:
  • Fears like Bill’s and their triggering words, phrases or events.
  • Pain such as infections, aches, illnesses or sores.
  • Irritants such as an uncomfortable sitting position, wet clothes, hunger, frustration.
  • Sensitivities such as bright lights, loud sounds or Lewy-dangerous drugs.
  • Excesses like crowds or too many choices.
  • Hunger, tiredness or illness.
I learned that if I waited until Bill was asleep and sneaked out, he might still wake up but he wasn’t agitated. –Barbara

Barbara removed the trigger and Bill’s stress-related actions stopped. Once you have an idea of the trigger is, your next step is to change or eliminate it as Barbara did. We’ll share more suggestions about stopping stress next week.

A Caregiver's Guide to Lewy Body Dementia is a resource book for all LBD caregivers. Buy it from Amazon through The LBD Book Corner on LBDtools.com and help to support our work.

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