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Dementia & Behavior

Tips for managing behaviors

People with dementia are often confused, disoriented, and frightened. As a result, they may lash out at their caregivers. Understanding the underlying causes of these behaviors makes it easier to handle them with compassion and even a sense of humor.

Check with a doctor to ensure that behaviors are not the result of an underlying medical issue or adverse side effects from medication.

If your loved one is having emotional or behavioral issues as a result of the dementia, there are several strategies that can help calm things down and keep behaviors from escalating.

The behavior could be the result of an inability to express thirst, hunger, discomfort, or pain. When basic needs are met, difficult behaviors may be eased.

Do not take outbursts or inappropriate behavior personally. Your loved one may be feeling confused or fearful, which is driving the behavior. People with dementia experience loss of control over their thought processes, and any stimulus that exacerbates feelings of instability can set off panic or aggression. It is important to understand what triggers the behavior and to try a different approach or change the environment.

Use creativity, flexibility, patience, and compassion. Do not argue or try to reason with your loved one. Rather than attempt to exert control, always consider what need may be manifesting itself and try to accommodate the need in order to ease the behavior.

According to Angela Lunde, health education outreach coordinator at the Mayo Clinic, caregivers should respond to people with dementia in a way that offers them a sense of control, or even the illusion of control, by “validating their feelings, joining their agenda, and lastly redirecting.”

If your loved one is having a delusion or hallucination that is making him agitated, try redirection. For example, if he thinks he may be running late for work and that makes him frustrated, reminding him that he doesn’t work anymore may make the situation worse. Instead, divert his attention by offering to fix breakfast so he won’t be late. Chances are the delusion will pass before breakfast is over.  Creativity and humor are some of the best tools to employ in situations like these. Be gentle with both your voice and your body language.

Later in the day may be a more difficult time for your loved one. “Sundowning” is caused by overexertion and often results in agitation and increased confusion. Anticipate the triggers and create a consistent schedule to follow daily. Get your loved one involved in a chore that provides a familiar activity and a sense of purpose. Later in the day, switch to low-energy activities to avoid overstimulation. Use soothing music and soft lighting, and speak in gentle tones to provide a calming environment.

Imagine yourself in your loved one’s place to understand how memory loss affects his daily life. Keep your communications clear, calm, and easy to understand. Your own irritability or asking too many questions or making too many statements could cause confusion or fear.

With compassion, understanding, and a sense of humor, you can create an evolving relationship that has incredible value and meaning.

When things get difficult, ask for help. Contact us at CarDon, or visit your local Area Agency on Aging or Alzheimer’s Association chapter.