My son, Mark, is an avid fisherman. When he lived at home, he kept his  bait (those big red night crawlers) in the garage fridge, which also happens to be where I keep overflow food and defrosting items.

WARNING: THIS NEXT PART IS REALLY GROSS!!

One Saturday, I opened the garage fridge to retrieve some ground meat I had put in to defrost. There were FRIGGING GINORMOUS NIGHT CRAWLERS EVERYWHERE!! I lost it. Stephen King couldn’t make this stuff up. Apparently, they either were hungry or were seeking an escape route or both. They had squeezed out of the foam container by pushing the plastic lid up (or maybe Mark hadn’t closed it tightly enough). Another fun fact: these critters can scrunch themselves up so that they appear to be an inch long, but can stretch out to NEARLY A FOOT!!  I found this out because all had stretched out to their maximum capacity.  Some were stretched out within the folds of the white accordion gasket that lines the edge of the refrigerator door; others had tunneled through the plastic wrap of the meat and were feasting away. A couple of outliers were channeling their inner Spiderman by hanging on the sides of the fridge. I kid you not, I think there were  20 of these dang things so I’m not sure if they had had a worm orgy, invited friends, or simply engaged in cellular division.

At the time, the fridge was relatively new and in great working order (other than needing to be dewormed), so tossing it out was not an option. After unleashing my volcanic temper and spewing language that could melt titanium, I handed Mark a bucket, rags, and some bleach and put him in charge of Operation Worm Cleanup. I felt bad after the initial eruption of Mount Rita, so I helped. Mother-son bonding time, yay. And then inspiration struck.

These worms are a great metaphor for dementia-related behaviors!!!

The night crawlers did not have a meeting and decide to freak out the red-headed human. They were being worms. Worms move around and eat stuff. I created the situation by allowing the hungry worms to be in the fridge in the first place and then placing food in their vicinity.

The person with dementia does not do things to tick off the caregiver. The individual’s personality and drive and need for a purpose remain. Dementia keeps those pieces boxed inside the person. The person with dementia wants an outlet for that drive and energy but is no longer able to channel these desires into appropriate (for us) venues. If I do not provide an outlet for that energy, drive, or purpose, then I create a problematic situation. If the environment is not a good fit for the person’s personality, you will see behaviors that may not make sense, may be dangerous or may increase the effort of caregiving.

The trick is to provide outlets by providing safe activities that are aligned with the person’s pre-dementia personality, occupation, and favorite hobbies.  That activity may have to be modified a bit to make it safe. For example, I have a neighbor with dementia who was an active gardener. He still loves to mow the lawn. Multiple times a day. No matter how hot outside, he is mowing the lawn. He will not stop until the mower runs out of gas. His wife was terrified of dehydration, heat stroke, or an injury from the mower. When his wife tried to bar him from mowing the lawn, he became extremely angry. So his wife gave up and let him mow the lawn to his heart’s content.

Knowing what I do for a living, my neighbor’s wife asked me for some ideas. I recommended a cordless electric lawn mower with the blades removed. I own two (that’s another story for another day). I know from personal experience that you are lucky if the battery lasts an hour, even less on hot days. Their son took my advice and bought dad a new cordless electric mower for Father’s Day. Son also removed the blades as an added precaution. Now, my neighbor mows for about an hour and the mower stops. He takes it into the garage, where his wife pulls out the battery and puts it on the charger. It takes a couple of hours for the battery to charge, creating a mandatory break. Win-win, everyone is happy.

See the related post about meaningful activities.

And if you have nightcrawlers in your fridge, feed them cornmeal. If we had done that, they probably would have stayed in their container.

Categories: Alzheimer's Disease Dementia FTD Lewy Body Dementia Understanding Behaviors

Dr. Rita Jablonski

Rita Jablonski, PhD, CRNP, FAAN, FGSA is a nurse practitioner, researcher, tenured professor, and former family caregiver. Her research and practice involve all aspects of dementia management; she is best known for non-drug strategies to address dementia-related behaviors.