Where To Get Help
- Your local community health centre
- National Dementia Helpline Dementia Australia Tel. 1800 100 500
- Dementia Behaviour Management Advisory Service Tel. 1800 699 799 for 24-hour telephone advice for carers and care workers
- Cognitive Dementia and Memory Service clinics Tel. 1300 135 090
- Aged Care Assessment Services Tel. 1300 135 090
- My Aged Care Tel. 18000 200 422
- Carers Victoria Tel. 1800 242 636
- Commonwealth Carelink and Respite Centres Tel. 1800 052 222
Tips To Help Manage Dementia Sleep Problems
There are ways to help your loved on get a better nights sleep, Hashmi says.
Avoid things that disrupt sleep.
- Limit caffeine, alcohol, and sugar near bedtime.
- Avoid over-the-counter sleep aids. Instead, Hashmi suggests you talk to a doctor about whether melatonin might help your loved one sleep.
- Remove electronics from the bedroom.
Create a routine that supports sleep.
- Make sure your loved one gets enough daytime light to help with circadian rhythms.
- Change into comfortable clothing, signaling nighttime.
- Consider warm milk, a hot shower, relaxing music or reading before bed.
- Pick a bedtime not too late and stick with it every night.
Not Understanding What Objects Are Used For
Now and again, most people find themselves desperately searching for the right word. In fact, failing to find the word you are thinking of is surprisingly common and not necessarily a sign of dementia, says Rankin. But losing knowledge of objects not just what they are called, but also what they are used for is an early dementia symptom. Oddly enough, people who are losing this knowledge can be very competent in other areas of their lives.
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Behavior Changes May Be First Signs Of Alzheimer’s
Researchers have developed a checklist to help spot those at potential risk
MONDAY, July 25, 2016 — Certain behavior changes may be a harbinger of Alzheimer’s disease, and researchers say they’ve developed a symptom “checklist” that might aid earlier diagnosis.
Experts have long focused on so-called mild cognitive impairment as an early warning sign of Alzheimer’s disease. That refers to problems with memory and thinking that may or may not progress to full-blown dementia.
But now some researchers are zeroing in on a new concept they call “mild behavioral impairment.”
The term is meant to describe persistent changes in an older person’s normal behavior. The changes include problems like social withdrawal, angry outbursts, anxiety and obsessiveness.
“We’re not talking about a blip in someone’s behavior,” said Dr. Zahinoor Ismail, of the University of Calgary’s Hotchkiss Brain Institute, in Canada. “It’s a sustained change from their former ways of functioning.”
And, he said, “that out-of-character behavior can be the first sign of something going wrong in the brain.”
So Ismail and his colleagues have developed a symptom checklist that doctors could potentially use to assess older patients for mild behavioral problems. The tool still needs to be studied further, but the hope is that it will help spot people in the early stages of Alzheimer’s.
“People often think is all about memory loss,” Ismail said. “But it’s not.”
Take Time To Cool Off
If none of these techniques worked while we were home, I just backed off, disappeared to another room, and waited for it to blow over. Thats when the mystery of fluctuating dementia symptoms became shockingly clear, because my father usually had no recollection whatsoever of these cursing episodes. Afterwards, he was adamant that he never said such nasty things to me!
In a way, I must admit these antics were funny at times. When Dad would deny hed had an outburst, suddenly Moms memory would be perfect and shed repeat whatever hed said earlier verbatim! It is so important to remember that when all else fails in dementia care, you just need to let yourself have a good laugh!
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How To Prevent Dementia And Angerits All About Body Language
And finally, because of all this, we need to become very aware of our nonverbal communications. In my article on mean dementia I explained that reading nonverbal communication is one of our intuitive thinking skills, and so it is something not lost to dementia. We begin learning to read our companions expressions, body language, and intonation at an incredibly young agewithin hours of birth. And we keep those skills in dementia.
Dementia will take away our ability to understand language and eventually the meaning of even the first words we learned as toddlers, but people who are experiencing dementia remain very aware of their companions expressions, body language, and intonation. And without memory skills to distract them with memories of the past, or rational thinking skills to distract them with plans or anticipation of the future, people who are experiencing dementia are entirely presentfully alive in the moment and to whats happening around them.
Assessment Of Psychological And Behavioral Symptoms
The symptoms of dementia can be conceptualized in several ways.18 The most popular dichotomic concept, broadly distinguishes cognitive and noncognitive symptoms.20 Other concepts differentiate between cognitive dysfunctions and behavioral or psychiatric disturbances. However, all of these concepts have limitations with respect to the complex interactions between cognitive deficits, psychological symptoms, and behavioral abnormalities. Recent, studies indicate that several noncognitive symptoms are related to the level of cognitive dysfunction among patients with AD.21,22 Most notably, aggression appears to increase with greater cognitive impairment.22 Less consistent are data on the association of mood disorders, psychosis, and severity of cognitive dysfunctions. To date, the relationship of cognitive and functional status with disturbed/disturbing behaviors among dementia patients remains an understudied area.21 Alois Alzheimer stated in the case description of Auguste D. in 1906 that behavioral disturbances like screaming, paranoid ideations, hallucinations, and sexual disinhibition were prominent features of this dementia type.23
The basis of the diagnosis of behavioral and psychological symptoms of dementia comprises a clinical interview, direct observation of the patient with dementia, and/or a proxy report, from a carer or other observers.24
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Why Aggressive Behavior Happens
Aggressive behavior is almost always triggered by something. Figure out what that something is and youll both be much happier. If your loved one seems angry and is acting aggressively, check for pain first. Someone with dementia may not know how to express discomfort or pain. To identify the cause of aggression, look for these signs: Stroking or pulling on a particular part of the body. Facial contortions like clenched teeth or inverted eyebrows. Body language, like rocking or pulling away. Appetite change An existing condition like arthritis Dental problems like a toothache Nails that are too long Constipation
Is it a reaction to other people? Is something wrong in the environment? Does the aggressive behavior happen at the same time every day, or in the same place? Maybe a particular person coming to visit will cause your loved one to get upset.
Finding a pattern will help explain, and ultimately manage, your loved ones aggression. One good idea to help is keeping a caregiver diary that lists what was happening when your loved one became angry. Details like time of day, what activities were going on previously or were anticipated, and how exactly the lashing out occurred can be useful in identifying the problem. If you need to see a doctor to address behavior issues, having notes will be helpful for forming a medical opinion. Was the person tired? Uncomfortable? Embarrassed about something?
Aggressive Behaviour In Dementia
In the later stages of dementia, some people with dementia will develop whats known as behavioural and psychological symptoms of dementia .
The symptoms of BPSD can include:
- increased agitation
These types of behaviours are very distressing for the carer and for the person with dementia.
Its very important to ask your doctor to rule out or treat any underlying causes, such as:
- uncontrolled pain
- infection, such as a urinary tract infection
- side effects of medicines
If the person youre caring for behaves in an aggressive way, try to stay calm and avoid confrontation. You may have to leave the room for a while.
If none of the coping strategies works, an antipsychotic medicine can be prescribed as a short-term treatment. This should be prescribed by a consultant psychiatrist.
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Managing Anger And Irritability In Parkinsons As A Caregiver
Informal caregivers particularly family members often play a significant role in helping and caring for loved ones with Parkinsons. Research has shown that caregivers are especially affected by caring for someone dealing with cognitive and mental dysfunctions from Parkinsons. These caregivers report higher caregiver burden and lower overall well-being and quality of life than caregivers of people with PD without significant cognitive impairment. Many caretakers of people with Parkinsons experience anxiety and depression.
The stress of caregiving is a common topic of conversation on MyParkinsonsTeam. One member wrote, My wife has Parkinsons. It is hard to deal with all her ups and downs. We are both exhausted.
Another member wrote about her husband with Parkinsons: His dementia is hard. He is emotional at times, angry at times, and is not aware where he is at times. One member said, My husband has Parkinsons, dementia, diabetes, and a bad heart. It is getting more and more difficult to give him his medications, as he gets very angry and does not take them.
Its important to remember that anger and irritability in people with Parkinsons is often a part of the disease. It is not your fault.
Changed Sexual Behaviours In Dementia
It is important to remember that any strange or uncharacteristic behaviour is part of the illness and not directed in a personal way. The person with dementia may no longer know what to do with their sexual desire, or when or where to appropriately express their desire.
Some of the changes in sexual behaviours in people with dementia can include:
- increased sexual demands can result in unreasonable and exhausting demands, often at odd times or in inappropriate places, and aggression if those needs are not met
- loss of sexual inhibitions can result in sexual advances towards others, undressing or fondling themselves in public, or mistaking another person for their partner
- diminished sexual interest can result in the person becoming withdrawn or they might accept physical contact from others, but not initiate affection.
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Understanding The Causes And Finding Ways To Cope
While some people living with Alzheimer’s disease or other types of dementia remain pleasant and easy-going throughout their lives, others develop intense feelings of anger and aggression.
When someone with dementia lashes out at you for seemingly no reason, it’s normal to feel surprised, discouraged, hurt, irritated, and even angry at them. Learning what causes anger in dementia, and how best to respond, can help you cope.
Common Causes Of Sleep Problems In Dementia Patients
Troubled sleep is thought to be a dementia risk factor as well as a behavioral symptom. Here are some factors that may contribute to your loved ones sleep problems:
- Brain changes. Dementia patients have steeper changes in their brains sleep architecture and their circadian rhythms, causing sleep disturbances.
- Over-the-counter medications. Some over-the-counter medications labeled PM can disrupt sleep by making patients sleep for a bit but then making them more confused or sleepy at the wrong time, Hashmi says.
- Diet. Caffeine, excess sugar , and alcohol can disrupt sleep patterns, Hashmi says.
- Electronic screens. The blue light from a computer, portable electronic devices, and television screens can delay sleep and disturb sleep patterns, Hashmi says.
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What Can I Do During An Anger Outburst
- Remain calm – avoid confrontation, which may mean leaving the room for a while. Be positive and reassuring, speaking in a slow, soft tone.
- Determine whether theres any pain or discomfort – book an appointment with their GP if you are uncertain as undiagnosed pain, untreated depression or an infection can lead to anger, or can be a side effect of medication they are on.
- Think about other possible causes – what happened just before the outburst? You may also want to keep a diary to work out any regular triggers. Do the anger outbursts happen at certain times of the day, in certain places or around certain people? Is it when they are asked to do a particular task that they struggle? If so, what can be done to alleviate these responses?
- Validate their emotions and try a relaxing activity – let them know that you understand why they are feeling like this, so that they dont feel isolated or misunderstood. Then use music, exercise or another activity they enjoy to help them relax.
Take Care Of Yourself Too
Itâs not easy to care for a person with Alzheimerâs disease, especially when they lash out at you. Itâs completely normal to feel overwhelmed, isolated, or sad.
If you are a caregiver, do yourself and the person you care for a favor. Let someone know if you start to feel depressed, anxious, exhausted, or irritable. If you take good care of yourself, you can take better care of others.
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Inappropriate Behavior And Loss Of Empathy
If someone who is usually sweet, considerate, and polite starts to say insulting or inappropriate things and shows no awareness of their inappropriateness or concern or regret about what theyve said they could be exhibiting an early sign of dementia. In the early stages of some types of dementia, symptoms can include losing the ability to read social cues and, therefore, the ability to understand why its not acceptable to say hurtful things.
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Tips For Handling A Seniors Aggression
Most importantly, try not to take the aggressive behavior personally, Hashmi says.
The classic line I always use is that this is the disease talking. It is not the person, Hashmi says. There is a lack of awareness in that moment. Its not your mom or dad or spouse saying that. Its the disease.
When you are faced with a loved ones aggression, Hashmi suggests employing these 4 Rs:
When theyre feeling calmer, Hashmi says, you can try asking yes/no questions to help determine whether an unmet need is causing the behavior. Ask: Are you hungry? Are you thirsty? Are you in pain? Are you tired?
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Common Early Symptoms Of Dementia
Different types of dementia can affect people differently, and everyone will experience symptoms in their own way.
However, there are some common early symptoms that may appear some time before a diagnosis of dementia. These include:
- memory loss
- difficulty concentrating
- finding it hard to carry out familiar daily tasks, such as getting confused over the correct change when shopping
- struggling to follow a conversation or find the right word
- being confused about time and place
- mood changes
These symptoms are often mild and may get worse only very gradually. Its often termed mild cognitive impairment as the symptoms are not severe enough to be diagnosed as dementia.
You might not notice these symptoms if you have them, and family and friends may not notice or take them seriously for some time. In some people, these symptoms will remain the same and not worsen. But some people with MCI will go on to develop dementia.
Dementia is not a natural part of ageing. This is why its important to talk to a GP sooner rather than later if youre worried about memory problems or other symptoms.
Tips For Common Behavior And Mood Changes
Aggressive & Threatening Behavior
Sometimes things can get out of control and feel very scary. These are tips and strategies for dealing with especially challenging behaviors. If you think that you or others may be in immediate danger, call 911.
The person with dementia is threatening you or acting physically violent, such as hitting, pushing, or kicking you
- Give the person space and time to calm down.
- Stay out of arms reach and position yourself near the exit.
- Avoid small spaces like kitchens, bathrooms and cars.
- Remove or secure objects that could be used as weapons.
- Reduce background noise .
- Keep a phone with you in case you need to call for help.
- Go outside, to a neighbors house, or public place if needed to stay safe.
- Take a deep breath and try to stay calm.
- Empathize/apologize: I am sorry this is so frustrating.
- Offer reassurance: I know this is difficult. It is going to be okay, or I am here to help.
- Give yourself a break take time to care for your own needs.
- Get help .
- Tell the dispatcher your name and location and that your family member has dementia. Tell the dispatcher if a weapon is involved.
The person with dementia is angry and accusing you of something that is not true, such as stealing from or cheating on them
The person with dementia is throwing fits or having emotional outbursts, such as yelling, screaming, or banging on things
Anxiety Related to Dementia
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