Dementia care: Managing changes in behaviour
Coping with changed behaviours is one of the most challenging aspects of caring for someone with dementia.
In this article:
- Behaviour and personality
- Understanding someone’s needs
- Dementia behaviour and triggers
- Dementia behaviour and effective communication
- Dementia behaviour and the physical environment
- Dementia behaviour and getting help
- Dementia behaviour and making a care plan
Each person is an individual. People with dementia have their own personality and character traits. However, some common behaviour emerges during the course of dementia.
Carers need to try not to take the behaviour personally. Remind yourself that the behaviour is a manifestation of the condition. Understanding the meaning behind certain behaviours can help you better manage the situation.
Eventually you will find coping strategies that work well for you, mostly through trial and error.
If a person with dementia can’t verbally communicate their needs, unusual behaviours may be more pronounced. It is helpful to try to comprehend a situation from your family member's perspective.
What unmet need could they be trying to communicate? Some behaviour may be an attempt by the person with dementia to relay discomfort or hunger, the need to go to the toilet or for no real reason at all.
Check with your doctor that the behaviour is not related to infection, pain or a medication side effect. Sometimes the person may simply be hot, cold, tired or bored. Dehydration can cause increased confusion so ensure a person gets adequate fluids.
Most changes in behaviour have triggers. Triggers influence or cause the behaviour. These triggers will be influenced by many factors such as the individual's past experience, culture, previous roles and relationships.
Past memories and associations can trigger behavioural outbursts that can often be misinterpreted as bad behaviour.
Once you have identified the triggers you can begin to think of ways to minimise the exposure to situations that may provoke or influence the behaviour.
Communicating with a person with dementia can be frustrating. Make sure you state your message clearly using a reassuring tone. Repeat the message using simple sentences breaking down tasks into steps.
If the person becomes upset or anxious, distract their attention or change the subject.
Think about how your own feelings and actions may be influencing the behaviour. How are your own actions and feelings contributing to the problem? Are you tired and rushing to get a job done?
Examine all the possible physical factors influencing the behaviour. Avoid over stimulating the person with dementia by minimising noise and distraction. Ensure hearing aids are worn along with appropriate glasses.
An unfamiliar environment or person can cause anxiety and confusion. Try and be consistent with routine, keep tasks simple and know someone's preferences.
You may learn new ways of managing behaviour by talking with other carers in similar circumstances. Some behaviour can be particularly irritating or stressful. Remember to take a break.
Find out what services can help. Organising respite care, a trip to an activity centre or someone to take over for even a day a week will make you feel refreshed.
To establish if behaviour is a one off or a recurring pattern is emerging, it can help to keep a care plan. Start by recording any behaviour. What is happening at the time of the behaviour? What actions do you take to settle the person with dementia? As soon as you come up with an effective care plan, share it with other family members.
Inform any formal carers who help look after the person with dementia. They will want to know all they can about a person with dementia and will appreciate any advice you can give. It will help to be consistent in your approach.
- Ring the National Dementia Helpline on 1800 100 500 to talk to a counsellor at Alzheimer's Australia.
- Contact The Dementia Behaviour Management Advisory Services (DBMAS) on 1800 699 799 24 hours a day. A national telephone line for carers or family concerned about the behaviour of people with dementia.
- Visit Alzheimer's Australia for information about dementia and behaviour changes.
- Coping with dementia and shadowing
- Dementia care: What to do when someone wanders
- Dementia care: Problems with toileting
- Dementia care: Coping with disturbed sleep patterns
- What is delirium?
- Getting help with dementia care
Alzheimer's Society UK