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Dementia

Dementia Symptoms: How to Handle Personality and Mood Changes

Medical nurse supporting patient

Dementia affects people in different ways, but changes in mood, personality, and behavior are very common dementia symptoms. The disease can result in a range of unpredictable behaviors, including poor judgment, aggression, mood swings, or repeated questioning. If your loved one has dementia, dealing with these changes can be emotionally daunting and can place enormous stress on you and other family members—even if you know your loved one’s dementia behaviors are symptoms of a disease and not intentional. Learning more about typical dementia behaviors and how to handle them can help you face challenging situations in the future.

Dementia can change your loved one’s personality and behavior. They may act very differently than they used to and may say or do things that they would not have normally done. The cause of these changes is still not fully understood.

What Are Common Changes In Behavior And How To Handle Them?

Repetitive Behavior

People with dementia may say, do, or make the same requests over and over. They may also become very clingy and shadow you or follow you around.

What to do:

  • Provide plenty of reassurance and comfort, both in words and in touch.
  • Communicate with simple and direct language.
  • Don’t remind the person that they’ve already asked a certain question. Help them find the answer. For instance, if they keep asking the time, buy an easy-to-read clock.
  • Repetitive movements may be reduced by giving the person something else to do with their hands, such as clothes to fold.

Restlessness, Pacing Up And Down, Wandering, And Fidgeting

People with dementia often develop restless behaviors, such as pacing up and down, wandering out of the home, and agitated fidgeting.

What to do:

  • Have a daily routine, including daily walks and easy exercise.
  • If your loved one wanders, consider installing new locks that require a key. Put away their essential items such as their coat, purse, or glasses – some individuals won’t go out without certain objects of theirs.
  • If your loved one fidgets a lot, try to give them something to occupy their hands with, such as worry beads or simple tasks to help you with.
  • Distraction sometimes works. A walk, food, or favorite activity might be helpful.
  • Consider some type of tracking device that can be used if your loved one happens to get out of the house unnoticed.

Night-time Waking And Sleep Disturbance

Dementia can cause problems with the person’s body clock, or sleep-wake cycle. A person with dementia may get up repeatedly during the night, unaware that it’s night-time.

What to do:

  • Create a soothing environment at night: make sure your loved one’s room is comfortable and is set up to promote good sleep. The room should be dark, quiet, and cool.
  • Avoid stimulants like caffeine, alcohol, and nicotine late in the day as these may disrupt sleep.
  • Increase daytime activities, particularly physical exercise, and discourage inactivity and napping during the day.
  • Establish a consistent schedule: maintain regular times for eating, waking up, and going to bed.

Aggressive Behavior

This can be physical, such as hitting, or verbal such as using abusive language. Aggressive behavior is usually an expression of anger, fear, undiagnosed pain or frustration.

What to do:

  • Consult with a doctor to rule out or treat underlying causes, such as uncontrolled pain, untreated depression, infection, or side effects of medicine.
  • Stay calm and try to avoid confrontation.
  • Don’t ignore or talk over the person. Instead, involve them in what’s happening and explain the situation.
  • Think about whether the environment could be causing the person distress or not meeting their needs. For instance, they may not be able to find the toilet, or bad lighting may be causing confusing shadows.

Hoarding

People with dementia may often appear driven to search for something that they believe is missing, and to hoard things for safekeeping. Hoarding behaviors may be caused by isolation, memories of the past, or fear.

What to do:

  • Learn the person’s usual hiding places and check there first for missing items.
  • Provide a drawer full of odds and ends for the person to sort out as this can satisfy their need to be busy.
  • Make sure the person can find their way around, as an inability to recognize the environment may be adding to the problem of hoarding.

Some General Advice

Consult with a doctor

Behavioral problems may have an underlying medical reason: perhaps the person is in pain or experiencing an adverse side effect from medications. In some cases, like incontinence or hallucinations, there may be some medication or treatment that can assist in managing the problem.

Try to keep the environment familiar

People with dementia can become upset if they find themselves in a strange situation or among a group of unfamiliar people where they feel confused and unable to cope. A well-established routine can also help.

Their behavior has a purpose

People with dementia often cannot express what they want or need. Always consider what needs the person might be trying to meet with their behavior and, when possible, try to accommodate them.

Remember behavior is triggered

It’s important to understand that behavior is triggered so do your best to figure out what that trigger might be. You are in a sense a detective assessing various possibilities.. It might be something a person did or said that triggered a behavior, or it could be a change in the physical environment or various other possible reasons.

Foster an attitude of acceptance

The behavioral changes are due to real issues and are not because the person is deliberately trying to be difficult. Try not to take it personally, not to use a raised voice, and avoid expressing dissatisfaction or other means of disapproval.

Talk to other caregivers

Consider a support group where you might learn about helpful strategies that other caregivers have used.

When taking care of a loved one with dementia, it can be difficult to decide what you can manage yourself and when external help is needed. Our Home Care Quiz assesses 6 key areas, from eating habits to behavior, to help you decide if it’s time to start thinking about in-home care for your loved one.

If you would like to speak directly with an expert, we encourage you to schedule a free 30-min session with our Expert on Memory Care.

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