How to prevent making bad decisions
When someone with dementia starts making poor decisions, it can lead to risky situations. Family members can help guide them through this phase with understanding and support. Here are some tips, actions, and recommendations:
1. Set Clear Boundaries
Establish limits on decisions: Encourage them to make simple, everyday choices, like what to eat for breakfast, while setting boundaries around more complex decisions, such as finances or driving.
Limit access to risky activities: If they make unsafe decisions regarding money, driving, or appliances, you may need to limit their access to bank accounts, car keys, or potentially dangerous household items like stoves.
2. Simplify Choices
Offer limited options: Instead of asking open-ended questions like “What do you want for lunch?” give two simple choices, like “Would you like soup or a sandwich?” This reduces the cognitive load and prevents decision paralysis or poor choices.
Break down decisions: When they need to make decisions, break them into smaller, manageable steps to help guide their thought process.
3. Involve Them in Safe Decisions
Encourage participation in safe choices: Involve them in decisions that won’t cause harm, like picking out clothes or choosing what show to watch. This helps maintain their sense of independence without risking bad outcomes.
Validate their input: When they offer their thoughts on a decision, even if it’s off track, acknowledge their opinion before gently steering the decision toward a safer or more reasonable choice.
4. Monitor Finances and Legal Matters
Assign financial power of attorney: To avoid risky financial decisions, consider assigning a trusted family member as the financial power of attorney. This ensures that important financial decisions are handled responsibly.
Set up automatic bill payments: Automate payments for utilities and other essentials to avoid missed bills or unnecessary spending.
Review investments and large purchases: Regularly review their financial transactions to prevent impulsive or inappropriate spending.
5. Provide Gentle Guidance
Guide, don’t control: Avoid taking complete control over every decision right away, as this can cause frustration. Instead, gently steer them toward better choices by offering suggestions.
Use reminders and cues: Subtle reminders about previously discussed decisions can help reinforce good judgment. For example, place notes around the house about when certain tasks should be done or leave reminders in visible places about medications.
6. Limit Impulsive Behavior
Reduce temptations: If impulsive spending or poor dietary choices become an issue, consider reducing access to credit cards, limiting cash at hand, or adjusting the household pantry to include healthier options.
Set up spending limits: For those who might make poor financial decisions, you can set up limits on credit cards or use prepaid cards with fixed amounts to prevent large, impulsive purchases.
7. Address Safety Concerns
Focus on safety: If their decisions could lead to physical harm, such as leaving the stove on or wandering outside at night, take preventative actions like using appliance timers, installing GPS trackers, or setting up locks on doors.
Create a safer environment: Rearrange the home to minimize risks. For example, remove trip hazards, lock up cleaning supplies, and ensure that emergency contact numbers are easily accessible.
8. Use Distraction or Redirection
Gently redirect them: If they’re about to make a poor decision, try distracting them with a new activity or steering the conversation toward something positive to avoid confrontation or escalating frustration.
Introduce calming activities: Offer activities that can calm their mind, such as going for a walk, listening to music, or doing a puzzle, to redirect their focus from decision-making that could lead to mistakes.
9. Consult Professionals
Involve healthcare providers: Talk to their doctor about their decision-making issues, as there may be medical or therapeutic interventions to help. Cognitive training or medications may be available to improve decision-making skills.
Work with legal and financial advisors: Professionals can help set up safety nets like power of attorney or trust funds to prevent poor financial decisions while still honoring their independence.
10. Provide Emotional Support
Stay calm and patient: When they make poor decisions, remain patient and avoid blaming them, as frustration can worsen the situation. Use a gentle tone to help guide them without making them feel embarrassed or incapable.
Validate their feelings: Acknowledge their emotions and offer reassurance, even if their decisions don’t make sense. For example, saying, “I understand this seems like a good idea, but how about we try this instead?” can help them feel heard without reinforcing bad decisions.
11. Involve Them in Future Planning
Discuss future wishes early: Have conversations about their future preferences when it comes to healthcare, finances, and living arrangements before their decision-making deteriorates further. Involving them in these discussions ensures that their wishes are respected while allowing you to step in when needed.
These tips can help family members strike a balance between protecting their loved ones and maintaining their dignity and independence during the decision-making process.
Source: Alzheimer Society of Canada
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