Oliver: When life requires being part Sherlock Holmes, part scientist

Caregivers often must play a variety of roles, assuming ones they didn’t have before or expanding the ones they already had. For those of us who care for people with Alzheimer’s disease, it’s safe to say we might have to add two more: investigator and scientist.

My role as an investigator often resembles solving mysteries Sherlock Holmes could appreciate. My husband, who was diagnosed with early onset dementia in 2015, no longer speaks.

It’s not that he cannot utter words, because when he’s angry he’s capable of uttering mild profanities. At a recent gathering with friends, one of our friends was teasing another. Tony saw this and as clear as a bell said, “What are you doing?” It was the first full sentence I’ve heard him say in months.

Since Tony can’t tell me what’s going on, I’m left to my best guess. Sometimes, it’s obvious what needs to be done. Tony has some well-established routines that must be followed, making my job easier.

What’s difficult is when he starts to become aggressive or irritated. The cause isn’t always apparent. Worse yet, it’s easy to ascribe a meaning to the behavior that could be completely wrong.

Lately, Tony hasn’t been particularly happy with a lot of things. I know this because I’m on the receiving end of his unhappiness, and I have a few bruises to show for it.

When I was caring for mother, who also had dementia, her ability to speak and interact with me made it easier to know what was going on. A lot of her irritation came from the vivid imaginary world that she lived in. If the “little people” that only she could see were trying to steal her stuff, she’d get mad. My job was to assure her that I wasn’t going to let them get anything.

As far as I can tell, Tony is not responding to hallucinations that only he can see. Occasionally, I might get the sense that maybe he sees something that’s not there, but more often he’s here in the present.

A program put on by the Alzheimer’s Association that I’ve now taken twice offers some insight into what might be triggering challenging behavior. This program was helpful when I took it years ago. Senior Services of McHenry County offered it again recently, and I recognized it a few minutes in.

Still, the advice I received helped me reevaluate what might be going on with my dear Tony.

Challenging behaviors often come from physical discomfort, environmental concerns or poor communication.

For instance, is the person in pain? Are they tired because they haven’t had enough sleep? Are they hungry or thirsty? All these things can cause someone to be “cranky.”

Is the room too loud? Does the person feel lost? Is there too much clutter, causing overstimulation? Is it a time of day the person has problems with? All these things can cause confusion or frustration.

Lastly, are your instructions clear and easy to understand? Are you asking too many questions or not allowing the person enough time to process? Is the person picking up on your own stress and irritation?

Here’s where the Sherlock Holmes role comes in. With Tony’s inability to tell me, I’m left to look for “clues” as to the behavior. Most of the unpleasantness of every day comes at two distinct times, one of which is after just about every meal. The other is shower time, which apparently is a “normal” trigger point for a lot of people with dementia.

I’ve figured out that something in Tony’s diet does not agree with him, making him quite uncomfortable after eating. That pain often would result in him taking swings at me, even as I was trying to get him to the bathroom.

That’s when the scientist role took over. Now I had a hypothesis to test. What food or foods are causing him discomfort?

Of course, the thought that we would have to shift our diet again wasn’t something that made me particularly happy. We went down that road when I was learning to control my own acid reflux.

However, I’ll do what I must to make him comfortable and happy. That also will mean that I’m less likely to be the one bears the brunt of his unhappiness.

Happy husband, happy life. Or at least a less bruised one.

• Joan Oliver is the former Northwest Herald assistant news editor. She has been associated with the Northwest Herald since 1990. She can be reached at jolivercolumn@gmail.com.