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Dementia care – dealing with behavioural changes
Dementia in its mid-to-late stages and Alzheimer’s can present a whole spectrum of behavioural changes. In this article, we outline a few strategies to cope with these changes.
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Understanding behavioural problems caused by dementia
As dementia progresses, it can make people feel lost, confused, anxious and frustrated, which can sometimes result in physical manifestations of these feelings, as well as angry outbursts and suspicious behaviour.
Learning and understanding strategies to deal effectively with dementia behaviour is essential if you are a caregiver or provide live-in care. Dementia care staff will be trained to deal with these behavioural problems, but learning how you can manage better when faced with a loved one’s aggressive, oppositional or sometimes violent actions or speech will help you both. The way you communicate with them can make a significant difference.
While each person with the disease will handle their feelings in their own way, certain behaviours are common among people with dementia. These include:
– Suspicion of others
– Aggression, including screaming and shouting
– Pacing back and forth
– Repetitively carrying out an action or repeating questions over and over again
These actions are an attempt to communicate, and it is important to remember that your loved one is not choosing to be difficult. Try and stay calm and establish why they’re expressing themselves in this way. By trying to understand, you are closer to being able to calm them down. If you spot early warning signs that your loved one is about to have an outburst, you may be able to prevent it. Distraction techniques can be effective in refocusing a person’s energy elsewhere, preventing the challenging behaviour from being displayed.
Becoming suspicious of others
A common problem for people with dementia is that they become suspicious of others. This can be caused by memory loss, general confusion and lack of recognition of friendly faces.
You may find they accuse you or their live-in carer of taking their possessions. If they lose something, they may panic and think they’ve been burgled. They may believe that everyone is watching them or planning something against them. This behaviour may appear paranoid and delusional, but you must remember that these feelings are very real for your loved one. Listen to their concerns, do your best to calm them down, and change the subject as best you can.
This is a common symptom of dementia and can be especially upsetting and scary when it is totally out of character. Witnessing your loved one’s personality changing can be distressing, and is often the hardest part for a carer or family member to deal with.
Aggression caused by dementia most commonly manifests itself in using offensive language, shouting, repetitively yelling the same thing, or prolonged screaming. The causes for this behaviour include depression, frustration with a situation, humiliation or fear, loss of judgement, loss of self-control and inhibitions and no other way to express feelings.
Try and identify any triggers that set off this behaviour to avoid them in future. Don’t argue or become aggressive yourself, as your loved one may become violent. If you find this hard, remove yourself from the room. Always remember, even if it seems very personal, it is the condition causing the behaviour. When your loved one has calmed down, act normal once again to move forward.
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It is very common for people with dementia or Alzheimer’s to repeat themselves constantly or carry out actions time and time again. This can be due to boredom, memory loss, side effects of their medication or anxiety. Try to establish why they are repeating their behaviour, so you can help break the cycle.
If you think they’re bored, attempt to engage them in an activity that they enjoy, such as watching TV or listening to music.
Anxiety is common in dementia and reassuring your loved ones that you love them and will support them can help to alleviate these feelings. If they have 24/7 dementia care, they will already have the reassurance of having someone who cares for them on hand at any time of the day, and in-home care will allow them to stay in the comfort and familiar surroundings of their own home. For people with dementia or Alzheimer’s care in their own home can provide some much-needed stability and consistency in day to day routines.
If you suspect the medication your loved one is taking is to blame for their behaviour, contact their GP for advice.
Pacing back and forth is common, as is taking long walks. This appears to be a short-lived stage of dementia. If your loved one has private live-in care, ask their caregiver to take them out daily for long walks, if you are not able to do so yourself. Dementia care is most effective if it is home care. The familiarity of a home environment is comforting and reassuring for those with dementia.
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Dealing with dementia behaviour problems
Remember that difficult behaviours do not define your loved one, but are merely the product of the condition. They are not choosing to act in this way. Try to be patient and forgiving and don’t hold a grudge over something that has been said or done. This is an effective strategy in all areas of elderly care. Physically abusive behaviour from your loved one is not ok. Speak with the healthcare provider or GP immediately, to protect their safety as well as your own and that of other family members.
Finally, remember that you don’t have to deal with a loved one with dementia on your own. Care at home is the best way to support and look after loved ones with dementia or Alzheimer’s, and private care staff will give you and your loved ones the reassurance and support to allow them to maintain their independent living.
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