The second transition to memory care for my mom has been challenging. This time, the director encouraged family visits from the start. So, with 8 children and many grandchildren, my mom never had a day without a visitor. She was always happy to see us, but not for reasons you would think. In her mind, we were there to take her home and our visits would trigger her to plan her escape. She would lead us to her apartment to pack her belongings or repeatedly ask where the car was so she could leave with us. Redirecting the conversation was difficult, and the longer the visit, the more frustrated she became. As a result, our visits were often short, and in order to avoid upsetting her, we would sneak out without a formal goodbye.
Over the next three months, there were some good moments, but many difficult ones. The nurses would report that my mom’s agitation and anxiety were interfering with her participation in the daily activities. She was easily frustrated, emotionally unstable, and sometimes even aggressive toward staff and other residents. Her constant distress and fixation on “going home” made it impossible for her to acclimate to the community.
We tried several approaches to ease her anxiety. We also worked closely with the team to adjust her medications, but finding the right balance to improve her mood without making her drowsy and unsteady proved to be difficult.
Education: Distressed Behaviors
I have extensive training and expertise in behavior management, especially when it comes to understanding how individuals communicate their needs through behaviors. Often, these behaviors stem from an unmet need—whether it’s a basic one, like pain or fatigue, or a deeper emotional need, such as love, comfort, or security.
In addition to Alzheimer’s Disease, my mom has recently been diagnosed with Adjustment Disorder with Anxiety. This is defined as difficulty functioning in everyday life following a significant change in circumstances. Common symptoms include jitteriness, nervousness, worry, and separation anxiety. I believe that much of my mom’s extreme dependency on her children, as well as her current fear and separation anxiety, is not just related to her having dementia, but also closely linked to past experiences of loss and separation. When she was just 14 years old, her mother went to the hospital for an elective procedure and tragically never returned home. My mom was left to raise her 2-year-old brother without an opportunity to grieve openly. She also endured the heartbreaking experience of delivering a baby who appeared to be very healthy initially but wasn’t in the end. He was taken from my mom’s arms while still in the hospital due to a fatal heart condition that took his life only after 3 days of life. And now, daily asking for my father who passed away a decade ago, her emotions and these unresolved traumas have likely influenced her current distress.
Increased Feelings of Fear, Anxiety, and Agitation
According to Naomi Feil’s Validation Theory, unresolved issues from the past often resurface in individuals with dementia. Because they may no longer have the ability to process these experiences in the way that we would, they often express their unmet needs through behaviors. As a trained Validation Worker, I’ve learned empathetic communication strategies that help comfort and support those experiencing distressed behaviors. ( Feil, N. 2015, V/F Validation The Feil Method, 3rd edition, Edward Feil Productions, LLC.)
Validation is just one of many non-pharmacological interventions we’ve tried. Other approaches we’ve explored include Jin Shin (energy work) music therapy, aromatherapy, physical exercise, activity engagement, and redirection techniques. One key lesson I’ve learned throughout my career is that no single solution works for everyone. Understanding the person behind the disease is critical. Taking a person-centered approach is important—knowing their life story, what matters to them, and what “makes them tick.” Too often, this information is missing, making finding effective solutions difficult.
The same is true when it comes to medication use for behavior management. While non-pharmacological interventions are always the first line of defense, medications may be necessary when those strategies aren’t enough. It’s crucial that a physician closely monitors the individual’s medication and any side effects to find the best combination. Physicians with expertise in dementia, such as neurologists or geriatric psychiatrists, are often best suited to manage these cases.
Below are the most common classes of medications prescribed for stress behaviors.
- Antipsychotics
- Benzodiazepines
- Mood-stabilizers
- Antidepressants
- FDA-approved Alzheimer’s medications
Click here to learn more about their uses, and potential side effects. It’s important to remember that every individual’s chemistry is different—medications that work wonders for one person may worsen symptoms in another. Antipsychotic medications should always be a last resort when treating behaviors, and close monitoring by a qualified physician is essential.
Moving Forward: Finding the Right Approach for Care
This journey with my mom’s transition to memory care has been a complex and emotional experience. From managing her distress and preoccupation with “going home” to navigating her anxiety and agitation, it’s been clear that finding the right approach to care is not always straightforward. What works for one person may not work for another, and this holds true for both non-pharmacological and pharmacological interventions.
Through it all, what I have learned is that my mom’s experiences, history, and emotional needs have shaped her behavioral responses, which is the very reason why it is crucial to take a personalized, compassionate approach to care. Whether it’s through energy work, medication adjustments, or empathetic communication strategies like Validation Therapy, we must remain flexible and patient. Every small step forward is a win.
For anyone going through a similar experience, I encourage you to work closely with a care team, explore various strategies, and most importantly, keep your loved one’s story and needs at the center of every decision. There is no one-size-fits-all solution, but with the right approach, there is hope for creating moments of comfort and peace.
If you have any questions or need guidance on managing these transitions, please reach out. You’re not alone in this journey.