Caring for someone with dementia can be a challenge, whether you are caring for them at home or have the help of a senior living community. If your loved one has Alzheimer’s disease or another form of dementia, they may display common challenging behaviors as the disease progresses. These behaviors can pose safety risks and be challenging for family members to handle. Here, we’ll explain some of the common dementia behaviors and go over some tips to help manage them.
Agitation or aggression
It can be very distressing when the personality of someone you may have known your entire life changes in dramatic and disturbing ways. It is not unusual for someone who has always been calm and appropriate to become agitated or even aggressive with the progression of dementia. It can sometimes seem as if you are dealing with a different person.
Tips for managing this dementia behavior
- •Monitor your emotions. The situation can worsen if you get frustrated or angry in response to your loved one’s agitation. Stay calm, take deep breaths, and move on to effective interventions.
- •Try to find the cause. Agitation and aggression often result from unmet needs such as hunger, thirst, pain, discomfort, or boredom. Try to find the cause and solve that problem.
- •Keep the person engaged. Structured activity can solve a host of problems. Physical activity is especially helpful. Try walking, gentle stretching, or folding laundry. Listening to music, watching movies, and looking at photographs can keep your loved one calm and mentally engaged. There are many activities people with dementia can do independently while at various stages of the disease.
- •Maintain a routine. Disruption in daily routine can lead to increased agitation. A routine provides a comforting and calming structure. Try to stick to a schedule that works best for your loved one.
Wandering
People with dementia may wander due to searching for something, getting disoriented in familiar surroundings, or trying to leave their environment out of fear or discomfort. It poses a significant safety risk. Adults with wandering behavior sometimes go outdoors in freezing weather without appropriate clothing. Wandering increases the risk of falls, weather-related injury, and even death.
Tips for managing this dementia behavior
- •Lock doors and windows. Secure all possible exits, and consider using locks to keep your loved one in a certain area of the home. If the wandering behavior includes repetitive attempts to leave, try disguising doors to look like the walls.
- •Use alarms and motion-sensing devices. Bed alarms and other motion-sensing devices can cover a room or area of the house so you can be aware of and monitor your loved one’s movements.
- •Provide supervision. Consider hiring a caregiver to supervise your loved one if you can’t always be around. Caregivers can also relieve you of your duties during the week so you can take care of personal responsibilities and find time to recharge.
- •Plan activities. Someone who is physically and mentally engaged is less likely to wander. Doing activities, like going for walks, listening to music, and looking through family photos can help keep your loved one engaged.
Sleep problems
Unfortunately, sleep problems affect 25 to 50% of people with dementia. As nightfall approaches, people with dementia can become agitated or anxious, wander, have an increase in delusions and hallucinations, and experience a surge in energy. This phenomenon is known as sundowning. Most sleep problems associated with dementia fall under this term.
Tips for managing this dementia behavior
- •Minimize daytime sleeping. Without causing fatigue, try to limit napping during the day so they can rest more easily at nighttime.
- •Turn on interior lights before the sun sets. Having the lights on will minimize shadows, which can confuse and disorient some people with dementia.
- •Maximize the bedroom environment. Ensure the bedroom is calm, clear of clutter, and cool and dark at night to promote a peaceful environment and improve sleep.
- •Adhere to a schedule. A change in routine can easily disrupt a person with dementia. Try to keep meal, activity, and sleep times consistent.
Changes in appetite
Decreased appetite and refusal to eat can have several causes in older adults and those with dementia, including fatigue, pain, difficulty communicating, constipation, depression, diminished smell, difficulty swallowing, and lack of physical exercise. This behavior is challenging because maintaining a healthy diet is critical for older adults. Taking in fewer calories can cause muscle loss and a decline in strength and endurance, which can lead to balance and safety concerns.
Tips for managing this dementia behavior
- •Use smaller portions. Smaller portions may be more appealing and easier to eat.
- •Minimize distractions. The eating environment should be calm and simple, with no TV or electronics.
- •Consider tableware specifically for people with dementia. Tableware for people with dementia is breakproof and easy to grip. It is also often red, providing a high contrast between the food’s color and the plate’s color, which has been shown to stimulate appetite.
- •Be flexible with eating times. For people who struggle with their appetite, be prepared to offer them food whenever they are hungry.
- •Consider spices and salt. As people age, their taste buds dull. Added salt and spices can make food more flavorful and appealing and encourage an increase in food intake.
Hallucinations and delusions
Seeing things that aren’t there and having strong beliefs with no basis in reality is a behavior a person with dementia may experience. The experience can be highly stressful and disturbing. Often, delusions can take the form of believing that family members mean harm or that someone is stealing things.
Tips for managing this dementia behavior
- •Offer reassurance. Stay calm and supportive. Don’t confirm the hallucination or delusion, but don’t be demeaning or disrespectful.
- •Distract. Try distraction activities: Engage the person in a game, music, simple tasks, or walking.
- •Consider a medical appointment. If you have tried several strategies to minimize hallucinations and delusions with little effect, consider an appointment with your loved one’s physician. Sometimes, medication is necessary to manage troubling behaviors.
Memory loss
Memory loss is a defining characteristic of dementia. It can take several forms and worsen over time due to brain cell damage. Examples of memory loss are difficulty retrieving information, forgetting events, getting lost in familiar places, difficulty finding words, forgetting the names of objects, and inability to store recent memories. Memory loss is distressing for the person living with dementia and their caregiver and can cause frustration, anger, and confusion.
Tips for managing this dementia behavior
- •Avoid correcting. Correcting someone with memory loss will likely lead to more distress.
- •Be patient. Having patience can be challenging when someone repeats the same question over and over. Try changing the subject or distracting them with a different activity. Don’t get angry; be accepting and nonjudgmental.
- •Write things down and keep it simple. Writing down the names of objects and instructions on using technology and appliances can be helpful, especially in the early phase of dementia. Keep instructions simple and clear.
Confusion
People with dementia can feel lost, disoriented, and unable to carry out simple tasks like bathing, dressing, or cooking. This confusion can lead to frustration and agitation. We can’t know exactly what a person with dementia is feeling, but when you focus on their emotions, it is easier to intervene successfully.
Tips
- •Don’t leave your loved one alone. Be sure to be near your loved one or to arrange for supervision. While it may be impossible to supervise your loved one at all times, if you must leave them alone briefly, make sure they have a task or some other activity, such as listening to music, to occupy them.
- •Calm the environment. Overstimulation in the form of too many people or lots of noise can lead to or increase confusion. If necessary, move the person to a quieter area.
- •Keep it simple (again!). Try to keep instructions simple and to the point. When offering options for things such as food or clothing, don’t give too many choices, which can provoke anxiety.
Managing difficult dementia behaviors
Navigating the challenging and sometimes heartbreaking journey of dementia requires patience and flexibility. Dementia and Alzheimer’s are progressive diseases, and when you find a strategy that works, you may eventually need to try something else. There are many options, such as in-home memory care or memory care senior living communities, that can help meet your loved one’s needs. Take care of yourself and call upon the support of friends, family, and community resources to sustain you. These tips can help you successfully and effectively care for your loved one.
