No reaction: Why are they withdrawing from me?

Does a loved one with dementia seem to look straight through you? Do they remain silent no matter how much you talk to them? Here’s why this upsetting and worrying behaviour can happen – and what you can do about it

It’s heart-breaking to watch a loved one with dementia slowly withdraw. How can you bring them back? How can you forge a connection? Can they even hear you?

The simple answer is yes, you can usually bring them back and make a connection. Most of the time they can hear and understand you too, but they might be struggling to demonstrate this in the normal way.

Signs that they’re withdrawn

- They are quiet and don’t make much conversation
- They seem unaware of you or other people in the room
- They stare back without a response, or seem to look through you
- They struggle to start an activity they used to enjoy, such as a jigsaw or a game

Why does someone with dementia become withdrawn?

People with dementia become closed-in and unresponsive for many reasons, including:

Loss of ability
Dementia can affect areas of the brain associated with the ability to plan, initiate or carry through a task. Damage to the frontal lobe area of the brain in particular can take away the ‘spark’ needed to help decide what you want to do, act or react appropriately and see the activity through to the end.

What’s more, as the person with dementia becomes aware that they’re losing this ability, it can affect their self-esteem and confidence, which, in turn, can cause them to withdraw even more, creating a damaging, downward spiral.

A way of dealing with difficult emotions
Coping with a dementia diagnosis can cause a range of complex emotions, from fear to anger, sadness to embarrassment. Your loved one may prefer to retreat within themselves whilst they try to cope with these emotions. Dementia can also trigger depression, which is another reason why they might become more withdrawn.

Boredom or isolation
It’s easy for a person with dementia to feel isolated and bored because their loved ones, often with the best intentions, are doing too much for them. It’s important not to assume that someone with dementia is unable to carry out tasks they used to. If you do this, you risk making them feel left out and cut off from the world. The trick is to find tasks and activities that will help them to engage, but which are also suitable for their level of ability, and this is easy once you know what to look for.

Illness or medication
Sometimes apathy and unresponsiveness are actually a symptom of illness, particularly if they affect energy or concentration levels. The illness may make them sleepier, and when they wake up they could find it hard to engage with the conversation, causing them to become even more withdrawn.

Did you know? Some medications can also cause a person to withdraw, particularly sedatives and antipsychotics. The latter should not be a long-term treatment for people with dementia, and the use of prescribed antipsychotics should be reviewed on a regular basis by the care team.

8 ways to re-connect with a person who has dementia

Pick the right activities
If your loved one seems to have no interest in activities, reassess what you’re offering. If you’ve suggested they do a jigsaw, but it has a complicated pattern and lots of pieces, it could be that they’re embarrassed to admit they can’t do it, and so show no interest. However, there is now an enormous range of jigsaws that are designed especially for people with dementia, they have less pieces making them easier to manage but have appropriate images and themes for older generation adults.

Help them get started
Your loved one may seem keen to start an activity, whether it’s craftwork, painting or doing an odd job around the home. But when you hand them the tools to get started, they don’t do anything. If this sounds familiar you could try starting them off on the activity yourself. For example, grab the dishcloth, run a basin of water and wash a plate if you want them do washing up. Once they see what you’re doing, they can copy you and continue the task. You could also break things down into manageable chunks. Rather than suggesting that they clean the living room, start small by saying they could help to dust the bookshelves, and go from there.

Use gentle touch
The use of therapeutic touch to calm and support people with dementia is well-established. A 2009 study found it could help reduce restlessness and agitation in nursing home residents. Touch also acts as a bridge to the present day. When you’re holding the hand of someone with dementia, you’re bringing them back to the present. If you let go of their hand, particularly if you’re walking or guiding them somewhere, you may notice that they stop, become distracted or unsure of what to do or where to go. The touch of your hand on their arm will guide them back to the here and now.

Play music
Music and sound memories are some of the first to be laid down (babies can hear inside the womb from 16 weeks of pregnancy) and last to be lost. When cognitive and speech abilities have declined, listening to music could still help you make a connection with a loved one with Alzheimer’s or other form of dementia. If you’ve ever watched the famous scene from dementia documentary Alive Inside, of the gentleman with dementia whose whole behaviour changes when he hears a familiar piece of music, you’ll understand the power of music.

Look out for the subtle signs
The days of long and winding conversations may have passed, but they could still be engaged and listening. Look out for less obvious signs that they’re following what you say. For example, perhaps their eyes follow you round the room, maybe they squeeze your hand, or they may smile but not speak. These are all positive signs of engagement.

Practice ‘active listening’
This includes using strong and clear eye contact, trying not to interrupt them, giving them your full attention, minimising distractions and repeating back what you’ve just heard them say so they have a chance to check that it’s accurate.

Stay positive
It can be so difficult seeing a previously vivacious, gregarious and happy person seemingly locked inside their own little world. However, don’t forget that while they may not be able to respond to you, that doesn’t mean they can’t hear or understand you. So don’t have a conversation with someone else whilst they’re in the room, and never talk about them with someone else whilst they’re in the room. Remember, they can sense your emotions, so if you become angry, upset or frustrated, it’s possible they will do the same.

Sit quietly
Don’t be afraid to sit quietly with a loved one if necessary. Putting too much pressure on them to interact and chat could make them feel stressed and agitated. Simply being with them in comfortable, easy silence might be all you can do – but it might also be enough.

Do you have any tips on making a connection with someone with dementia who is unresponsive or withdrawn? Share them in the comments box below or send us an email.