Understanding the Reasons Behind Hiding
Before implementing any strategies, it's essential to understand why a person with dementia might be hiding things. This behavior is not a deliberate act to cause stress but is rooted in the cognitive and emotional changes of the disease. Common triggers include:
- Memory Loss and Forgetfulness: The patient places an item somewhere for safekeeping but then forgets where it is. The hiding serves as a protective mechanism.
- Paranoia and Fear: Feeling insecure or suspicious, the patient may believe that people, even family members, are stealing their belongings. Hiding things is a way to protect them from perceived thieves.
- Anxiety and Boredom: A person feeling anxious, restless, or bored may resort to hiding and rummaging as a way to self-soothe or find purpose.
- A Need for Control: In a world that feels confusing and unpredictable, hiding things can give the patient a sense of control over their environment.
- Overlapping with Hoarding: This behavior can sometimes be related to hoarding, where the person has an inability to discard items and accumulates excessive possessions.
Proactive Strategies to Prevent Hiding
Instead of reacting after an item is lost, proactive measures can significantly reduce the occurrence of hiding behavior and the frustration that comes with it.
Create a Secure and Structured Environment
Maintaining a consistent and organized living space can help minimize confusion and the impulse to hide things. This includes:
- Keeping a Predictable Routine: A regular daily schedule for meals, activities, and rest can provide a sense of security and reduce anxiety, a key driver for hiding behaviors.
- Reducing Clutter: A less cluttered home means fewer places to hide things and less stimulation that can lead to confusion. Organize their space in a way that is easy for them to navigate.
- Using Visual Cues: Place pictures or labels on drawers and cupboards to indicate what belongs inside. This can serve as a helpful reminder and encourage proper organization.
Manage Valuable and Important Items
Protecting essential items is critical to prevent loss, but it must be done with sensitivity to avoid increasing paranoia.
- Secure Valuables: Keep important documents, checkbooks, credit cards, and jewelry in a safe, locked location that the patient cannot access. This is a crucial step to prevent financial or other serious complications.
- Create Duplicates: For items that are frequently misplaced, such as glasses, keys, and remote controls, keep multiple sets on hand. This way, a backup is always available when the primary item goes missing. Some caregivers even use fake duplicates, like old credit cards, to satisfy the patient's need to possess an item without the risk of losing something important.
- Check the Trash: Before emptying trash cans, check them thoroughly. People with dementia can accidentally throw away valuable items, mistaking them for trash.
Redirect and Engage the Patient
Engaging the patient in meaningful, productive activities can help reduce boredom and anxiety, which can trigger hiding behavior.
- Create a Rummage Station: Set up a dedicated drawer, box, or basket filled with harmless objects like old keys, envelopes, or sorting items. This provides a safe outlet for the rummaging and hiding impulse, making the patient feel useful and occupied.
- Involve Them in Simple Tasks: Give the patient simple, repetitive tasks that offer a sense of purpose. This could include folding laundry, sorting silverware, or watering plants.
- Use Distraction: If you notice them beginning to hide something, gently distract them with a different activity or conversation. Redirection is often more effective than confrontation.
Comparison of Proactive and Reactive Hiding Management
| Feature | Proactive Management | Reactive Management |
|---|---|---|
| Timing | Prevents hiding before it happens. | Addresses hiding after an item is missing. |
| Approach | Focused on environmental and behavioral changes. | Focused on locating the lost item and managing immediate distress. |
| Emotional Impact | Reduces patient anxiety and sense of fear. | Can increase patient frustration and paranoia, especially if confronted. |
| Caregiver Stress | Reduces long-term stress by preventing crises. | Heightens immediate stress during the search for a lost item. |
| Key Tactics | Secure valuables, create duplicates, use rummage stations. | Gently search known hiding spots, check trash. |
| Goal | Minimize the opportunity and impulse to hide things. | Find the specific item and de-escalate the situation. |
Reactive Strategies When an Item is Hidden
Sometimes, despite all best efforts, an important item will still go missing. When this happens, a calm and compassionate response is best.
How to Search for Hidden Items
- Know Their Hiding Spots: Most people with dementia use a handful of recurring hiding places. Keep a log of where you've found things in the past. Common spots include: under couch cushions, in shoes, inside appliances, in drawers, or under the bed.
- Search Discreetly: When searching for an item, do so quietly and without drawing attention. If the person with dementia sees you, they may become suspicious or upset.
- Consider Their Logic: Try to think from their perspective. A patient might hide a wallet in the freezer because they think it is a safe place, or they might put keys in a shoe because it's a familiar object.
Managing the Accusation of Stealing
It is common for dementia patients to accuse caregivers of stealing their items. It is crucial not to argue or take it personally. Instead, acknowledge their feelings and offer to help.
- Validate the Feeling: Say something like, "I can see you're upset that you can't find your keys. That sounds frustrating".
- Offer to Help Search: Suggest, "Let's look for them together." Searching with them, rather than denying their claim, is more productive and less confrontational.
- Distract and Redirect: If the search becomes frustrating, suggest a comforting activity, like having a cup of tea or listening to music, and come back to the search later.
Conclusion
Navigating the challenge of a dementia patient hiding things requires patience, empathy, and a strategic approach. By understanding the motivations behind the behavior, implementing proactive measures like creating a secure environment and using decoy items, and responding compassionately when things are lost, caregivers can reduce frustration and create a more peaceful living situation. Focusing on the patient's emotional state and providing reassurance is always more effective than confronting or arguing. Remember, it is the disease causing the behavior, not the person, and your kindness is the most powerful tool.
Understanding Behavioral Changes in Dementia from the Lewy Body Dementia Association offers excellent insights into managing dementia behaviors and is a helpful resource for caregivers.
