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Dementia

How Does Dementia Affect Behavior And How Can I Deal With These Changes?

Caring for a loved one with dementia can be draining not only physically but also emotionally. This is especially the case when their behavior changes and they show signs of stubbornness, defiance, or aggression. As a person’s dementia progresses, they may begin to behave in ways that other people find difficult to understand and cope with. While this can be one of the most difficult aspects of dementia, you’re not powerless. Having a better understanding of these behaviors and a number of strategies on hand to deploy whenever you need them gives you the means to better handle difficult situations in the future.

Why does behavior change in people with dementia?

There are many reasons why a person’s behavior may change. Dementia is a result of physical changes in the brain, and these can affect the person’s memory, mood, and behavior. People with dementia lose neurons (cells) in parts of the brain, and behavior changes often depend on which part of the brain is losing cells. While sometimes behavior may be related to these changes, other times, it may be triggered by changes in the person’s environment, health, or medication.

The most common behavioral changes and how to deal with them

Stubbornness

Resisting care and general stubbornness are two hallmarks of dementia. Stubbornness often manifests itself in saying ‘’no” to your or the caregiver’s ideas, refusing to eat, to bathe, or to change clothes, and generally refusing to cooperate.

What can you do?

  • Don’t overwhelm your loved one with too many questions. When you ask a lot of questions, your loved one could become confused and agitated, and may refuse to answer. Instead, offer a couple of options to choose from. For instance, instead of asking what they’d like to drink, ask if they prefer water or tea.
  • Learn to compromise. Remaining flexible can help you avoid arguments and enhance your relationship. As long as your loved one’s safety and well-being is not in jeopardy, you can allow them to choose what to do in terms of diet or exercise.
  • Provide purposeful tasks. People with dementia often become stubborn because they’re losing their independence. Giving them purposeful tasks and activities to do could make them feel useful and in charge. Some duties you can give them include organizing clothing, doing laundry, or helping with dinner preparations.
  • Avoid power struggles. If you give ultimatums or try to force your loved one to do something, they may just become even more stubborn. They also may be more inclined to mimic negative behavior, such as screaming, or yelling. They will respond better when you’re empathetic, respectful, and kind.

Read more on How to Handle Defiant Behavior in Aging Parents with Dementia here.

Aggressive Behavior

When your loved one becomes aggressive, it can be frightening and distressing. You may also feel hurt and rejected. However, it’s important to keep in mind that such behavior is unlikely to be a deliberate act of aggression and more likely to suggest fear or desperation. When aggression appears, the most likely reason is that the person is reacting to a distressing situation.

What can you do?

  • Consult with a doctor to rule out or treat underlying causes, such as uncontrolled pain, untreated depression, infection, or side effects of medicine.
  • Try to identify the immediate cause or trigger. Think about what happened just before the aggressive outburst started. Something like fear, frustration, or pain might have triggered it.
  • Use a gentle tone and reassuring touch. When your older adult gets upset, take a deep breath and stay as calm as possible. Staying calm and breathing slowly helps to reduce everyone’s anger and agitation. Speak slowly and keep your voice soft, reassuring, and positive.
  • Calm the environment. A noisy or busy environment could also trigger aggressive dementia behavior. Turn down music volume, turn off the TV, and ask other people to leave the room.

Read more about Dealing with the Aggressive Side of Dementia here.

Restlessness

Fidgeting, pacing up and down, and trying to leave the home are common behaviors in people living with dementia. They may also become clingy and follow you around the house.

What can you do?

  • Introduce a daily routine that includes daily walks and some easy exercise.
  • Try to engage them in activities that provide enjoyment and a sense of purpose, like walking, gardening, crafts or puzzles.
  • Give them something comforting to hold, like a cuddly toy or a soft blanket.
  • Distraction sometimes works. A walk, food, or favorite activity might be helpful.

Hoarding

There are a number of reasons why your loved one may hoard things. It may make them feel more secure, it may be a way to deal with losing memories, they may think that someone is trying to steal their things, they may be worried about not having enough food for later, or they may forget where they put things.

What can you do?

  • Provide a drawer full of odds and ends for the person to sort out as this can satisfy their need to be busy.
  • Create a memory box, a designated place to keep the “special things” a person with dementia likes to collect. Pick out and decorate the box together and store it in the same place all the time.
  • Unfortunately, when a loved one hoards items indiscriminately, important belongings are bound to get misplaced, sometimes temporarily, and in some cases permanently. To complicate matters further, hoarding behaviors may also be coupled with the tendency to hide things. Lock away anything of value, such as money, credit cards, jewelry, or heirlooms.
  • Find your loved one’s favorite hiding places. These might include drawers, underneath cushions and furniture, and in pockets or closets.

Sleep disturbance

Dementia can cause problems with the person’s body clock, or sleep-wake cycle. They may get up repeatedly during the night unaware that it’s night time and they should be sleeping.

What can you 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.
  • Increasing daytime activities, particularly physical exercise and walks can help promote better sleep at night.
  • Avoid stimulants like caffeine, alcohol, and nicotine late in the day as these may disrupt sleep.
  • Limit daytime sleep and discourage afternoon napping.

Confusion

Memory loss can lead to confusion, which means that your loved one may keep asking the same questions over and over, doesn’t recognize formerly familiar people or places, or becomes disoriented.

What can you do?

  • Help them find answers themselves. For instance, if they keep asking the time, buy a big, easy-to-read clock.
  • Label drawers and cabinets. This is especially helpful if confusion about where to find things is a common trigger.
  • Use tools such as alarms, calendars, and to-do lists to help them remember tasks.
  • Keep familiar objects around to help reorient your loved one.

Wandering

Wandering is very common in people living with dementia. As their memory declines, they might leave a confusing situation or suddenly try to find someone and become disoriented and lost. Such wandering can be dangerous, even life-threatening, yet family members and caregivers often feel guilty about putting in place measures that will keep their loved one safe.

What can you do?

  • Secure all doors. Be especially vigilant about doors that lead outside and consider installing new locks that require a key.
  • Use technology. Tracking devices and surveillance systems are widely available and affordable.
  • Enlist a team. Neighborhood watch groups and local police are often happy to help keep an eye out for your loved one.
  • Put away their essential items such as their coat, purse, or glasses – some individuals won’t go out without certain objects of theirs.

Read more on How to Handle Personality and Mood Changes here, while you can also find great communication techniques for challenging situations in this article.

How to find joy in caring for a loved one with dementia

While it may sound difficult at first, despite all the challenges the illness presents, there are still ways to find happiness and joy in your caregiving journey and make the most of the time you can still spend with your loved one. Firstly, it’s important to understand that your loved one’s behavioral changes are not deliberate and they’re not trying to be difficult and aggressive with you on purpose. They simply may not be consciously aware that they’ve changed, which is part of the condition. People with dementia reflect their view of the world, which means they might get angry about little things, like cold coffee or being told they can’t do something.

To add more meaning to a regular day, try to find exciting activities you think your loved one would enjoy. Take inventory of their past and current interests and hobbies and find something you can do together, so you can create new meaningful memories. Examples might include gardening, cooking, playing or watching sports, reading together, fishing, photography, movies, crafting, or listening to or playing music.

If you think you need help caring for your loved one, cooperating with an in-home caregiver can be hugely beneficial. As a first step, you can schedule a free in-home meeting to clarify your loved one’s specific needs and how an in-home caregiver could help. Schedule an in-home meeting now!

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