Some helpful tips for dealing with Dementia related behaviours

Agitation/Anxiety People with dementia will eventually become restless, anxious, or sadly even upset. Therefore, it can be extremely helpful to listen intently to the person living with dementia as they express their frustrations. As it is likely that you will get some clues about what it is that is upsetting them e.g. pain, discomfort, too hot, too cold, hungry, or simply just needing the toilet. Frustration and over-stimulation are common triggers of being agitated. So always ensure you try and reassure the person who has dementia, that you are there to provide help, support and assistance when and where needed. Sometimes, just changing the subject or persuading them to participate in an enjoyable activity can help them.

Aggression Aggressive behaviour amongst those living with dementia can happen rather suddenly and without little warning. Therefore, try to find out what has triggered or started their aggressive behaviour, so that steps can be taken to avoid what instigated or triggered the situation. Always react in a measured and calm way and reduce environmental distractions/potential causes, such as loud noises or potentially frightening shadows or movements. Again, persuading an aggressive person to participate in an enjoyable activity or simply moving onto another subject can be extremely effective in resolving the situation.

Repetition People who have dementia can often repeat a word, question, phrase or action over and over again (For example, saying "Where are we going today?" repeatedly). This behaviour is somewhat harmless, but it can be both disconcerting and sometimes even a little annoying given time for those who are caring for the person who has dementia. Repetitive behaviour can be a sign of emotional stress, since people who have dementia are often looking for something comfortable and familiar - for which they have a level of degree of control over. For you to address this repetition, always try and find a reason for it as well as their emotion behind it. This can help you reduce your chances of responding impatiently to the person. If the repetition is an action, try turning it into an activity or play session that makes the person with dementia feel useful. For example, if the person is constantly fidgeting with their hands, try giving them something to sort out.

Hallucinations The most common hallucinations for someone with dementia are visual, (1) seeing something that is not really there and (2) auditory, hearing something that is not really there. However, hallucinations can also occur with their taste, smell, and even touch. Hallucinations are very much real to those who have dementia. So do not try to convince the person that they are simply just imagining things as you may make the situation far worse. Instead, reassure the person who is experiencing the hallucinations, that you are there to help. And again instead of dwelling on it encourage them to participate in one of their favourite activities. Also consider if the hallucination is problematic. Or if it is a "nice" hallucination, such as seeing an old water features that was once outside in their garden that is not really there. If the case, there may be no real benefit in you trying to discourage this behaviour.

Suspicion Memory loss and also disorientation can cause individuals with dementia to perceive situations incorrectly and inaccurately. They may indeed become suspicious of others around them - even those most closest to them. And accuse them of theft, being unfaithful, or various other offences. Although these are often hurtful, do try and not be offended by it or take it seriously or personally. Remember, their behaviour is caused by their dementia. Do not bicker, quarrel or argue with the person or try to convince them of your innocence. Instead, say, "I am sorry that you are upset that you have lost your purse/wallet; I will do my best to try and find it for you,". So avoid giving them long and complicated explanations. Once again, encouraging them to participate in one of their favourite activities can be effective in these situations. Another suggestion or good idea is to store "back-ups" of the commonly misplaced items (e.g., hats, wallets). For example, I have 3 copies of the same family photo album, which my Mum sometimes misplaces.

Confusion Dementia often causes confusion about people, places, and time. The person who has dementia may still know who he or she is, but the person may not recognise others and/or their current location, time, date, or even year. An individual with dementia may also become confused by everyday objects such as knives, forks, spoons and pens. As frustrating as this can be for their carers, the best way to respond is to stay calm and provide simple, clear, positive answers when the person asks for their help. For example, if the person seems somewhat confused about the purpose of a fork or spoon, simply reply by saying, "Here is your spoon for eating your soup." You could also calmly show the person how to use the kitchen utensil (For example, by saying "watch me"). Never lecture the person or talk to them in a sarcastic, belittling way for becoming confused. It isn't their fault that they have dementia.

Wandering When a person who has dementia wanders, their wandering may be for good reason. For example, the person who has dementia may think that they are going to an old job they had or are going "home" to a home that they used to live in as a child. Or sadly the person who has dementia may simply wander aimlessly and for no reason whatsoever. To help reduce the frequency of the wandering, try and ensure that the person has plenty of supervised activity and things to do to help channel their energy. People with dementia may also wander because of their emotional stress or physical discomfort. So try and find out what may be triggering and instigating this type of behaviour by finding out if the person is upset, worried or in fact even in pain.

Apathy Apathy can be defined as a lack of interest in or motivation to engage in activities. It is not healthy for someone with dementia to sit around passively in an accepting manner, without active response or resistance. So try and find out what may be triggering the apathy e.g. being ignored or becoming overwhelmed with a task. It is important to keep the person who has dementia moving and as physically active as possible in order to maintain their physical health and to prevent depression. Therefore, try and simplify the activities that they used to enjoy doing, so that they can participate at a level they are comfortable with and not too overwhelmed. Even a small amount of physical activity is better than doing none at all.

Sundowning Sundowning is a term used to describe behaviours that intensify or worsen (e.g. confusion and agitation) in the late afternoon and early evening. And it is most common with Alzheimer's disease. There are various theories about why sundowning happens, such as their increased fatigue or increasing confusion due to darkness and shadows. Therefore, the best way to approach and deal with sundowning is to make late afternoons and early evenings as simple and relaxing as possible. So reduce distractions and keep all rooms well-lit until bedtime.

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