How to cope with dementia-related behavioural changes

Discover the cause of a loved one’s dementia-related behavioural changes and how to support them with help from The Good Care Group.

Dementia-related behavioural changes are often the most challenging aspect of the condition, both for the person with dementia and their loved ones. To help understand why some of these behaviours are occurring, it can be helpful to uncover the underlying triggers that could be contributing to these behaviours.

Instead of viewing these changes as simply an unavoidable part of dementia, try to see them as signals of unmet needs or sometimes even underlying medical conditions or environmental factors. By discovering more about the causes of your loved one’s behavioural changes and the appropriate recommended responses, you can take steps to improve your loved one’s mood and overall quality of life.

Let’s take a look at why people with dementia are more likely to have significant behavioural changes and what you can do to alleviate distress.

Why do people with dementia have pronounced behavioural changes?

People with dementia are more likely to have rapid behavioural changes for a number of reasons.

The additional cognitive, emotional and physical challenges they face as a result of their condition can be a source of frustration, which can manifest as anger, depression, fear or other emotive states.

It may be that they’re having difficulty communicating their needs, or carrying out a task that was once second nature. However, sometimes the cause of the behavioural change simply cannot be determined.

Tips for living with behavioural changes

Dementia care is complicated, and all people with the condition react differently to their symptoms as their condition progresses. Individuals can even present with different symptoms on a day-to-day basis.

Changes in behaviour usually signify something important your loved one wants to convey or an unmet need they have. Keep a diary of behaviours and look for patterns in what was happening, where you were, the time of day and other relevant details. Make notes on the behaviour and how it was resolved. This may help you reflect on what’s driving the behaviour.

Be positive in your speech and body language, and try using affectionate gestures (like holding hands or hugging) to help calm them.

Your aim is to accommodate rather than control their behaviour. Don’t highlight mistakes or contradict inaccurate statements. Try changing the subject if they become fixated on a particular source of agitation.

Communication

Dementia can make it harder for people to communicate verbally and this can lead to frustration. Try using a dementia communication technique such as the SPECAL method, avoiding asking too many direct questions and never contradict the sense of reality the person is making. Also, look for non-verbal and body language-related cues as to what they’re feeling.

Engagement

Be positive in your own speech and body language, and try using affectionate gestures (like holding hands or hugging) to help calm them.

Your aim is to accommodate, rather than control their behaviour. Don’t highlight mistakes or inaccurate statements. Try changing the subject if they become fixated on a particular source of agitation.

Interpretation

Changes in behaviour usually signify something important your loved one wants to convey, or an unmet need they have. Keep a diary of behaviours and look for patterns in what was happening, where you were, the time of day and other relevant details. Make notes on the behaviour and how it was resolved. This may help you reflect on what’s driving the behaviour.

Entertainment

Boredom or fatigue can often be behind a behavioural change.

Try to keep your loved one stimulated by putting on their favourite album or film. Alternatively, start a conversation about something they’re passionate about.

Why not reminisce about old family memories, or sit with them and go through an old photo album?

Nourishment

Hunger and dehydration can increase the risk of confusion and create a need they might find difficult to communicate.

Think about the last time they ate or drank and offer them some nourishment. Also, don’t forget to factor in the side effects of their medication and conditions such UTIs on their food and drink intake.

Exercise

Agitation might be a sign that they’re trying to burn off excess energy.

If they’ve been sedentary most of the day, ask them to help with a simple task to keep them active and give them a sense of purpose.

A walk might also help balance their emotions by providing both exercise and a welcome change of scenery.

If your loved one remains in distress for a lengthy period of time, you may want to check with a doctor to see whether there are any underlying causes.

Dementia care is complex, and often both emotionally and physically draining without the necessary knowledge and skills. But, by using this advice, you can help make life easier and more enjoyable for your loved one.

Supporting specific behavioural changes

Despite the unpredictable nature of dementia, there are some techniques you can use to try to comfort your loved one.

For more detailed advice, see our guide on managing challenging behaviour in dementia

Confusion

Dementia can make it harder for people to communicate verbally, leading to confusion or frustration. Try to avoid asking too many direct questions and never contradict the person’s reality. Also, look for non-verbal and body language-related cues as to what they’re feeling.

Hunger and dehydration can increase the risk of confusion and create a need they might find difficult to communicate. Consider the last time they ate or drank and offer them some nourishment. Also, remember to factor in the side effects of their medication and conditions, such as UTIs, on their food and drink intake.

Boredom

Boredom or fatigue can often be the source of a behavioural change. Your loved one may feel frustrated but be unable to convey this to you, resulting in feelings of frustration or distress.

Try to keep your loved one stimulated by engaging in dementia-friendly activities, such as playing their favourite album or film. Alternatively, start a conversation about something they’re passionate about. Why not reminisce about old family memories or sit with them and go through an old photo album?

Explore activities that engage multiple senses. Beyond music and films, consider incorporating elements like scents, textures, or tactile objects. In this guide from our dementia care experts, you’ll find plenty of dementia-friendly activities to inspire you.

Aggression

Aggression can be one of the most distressing manifestations of dementia symptoms, and it requires a delicate and understanding approach. Responding with patience and calmness is important, as confrontation will only escalate the situation. Remember not to take the aggressive behaviour personally but rather use it as a warning sign that the individual may be unable to communicate a frustration, need or want.

Identify potential triggers for frustration, such as hunger, thirst, fatigue, confusion or boredom. Attempting to redirect their person’s attention to a calming activity or environment can be helpful. Creating a safe space and promoting positive interactions can contribute to diffusing tense situations and fostering a more peaceful environment.

Sleep problems

Sleep disturbances are a common challenge in dementia care. Establishing a consistent sleep routine is key to ensuring your loved one can enjoy a restful night’s sleep. Try to keep the sleeping environment quiet and comfortable by limiting outside noise and light.

Limiting stimulants like caffeine close to bedtime and encouraging daytime physical activity can contribute to healthy sleep habits. Regular monitoring and adjustments to the sleep routine may be necessary to address any evolving challenges.

Becoming lost

Leaving the home alone may pose a risk to the person’s safety, so it requires proactive measures to ensure the safety of the individual. Creating a secure living space is crucial, and this may involve using visual cues like signs or labels to help with orientation. Door alarms and personal alarms can provide additional safety measures. Engaging in regular physical exercise during the day can help reduce restlessness and provide a sense of routine.

Agitation

Agitation might indicate that the individual needs to burn off excess energy. If they’ve been sedentary most of the day, ask them to help with a simple task to keep them active and give them a sense of purpose. A walk might also help balance their emotions by providing both exercise and a welcome change of scenery.

If your loved one remains in distress for a lengthy period of time, you should check with a doctor to see whether there are any underlying causes.

The Good Care Group has been innovating dementia care for over 10 years. Our qualified carers know how challenging it can be to cope with the behavioural changes brought on by dementia. Each of our carers is highly trained in dementia best practice techniques in line with Dementia UK that focus on the person and their needs. These techniques are proven to provide reassurance, calm behaviours, and reduce the need for antipsychotic drugs.

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