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How To Handle Dementia Confusion

Alzheimer’s And Other Causes Of Dementia

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There are several disease processes that can result in dementia. These causes include Alzheimer’s disease, Lewy-body disease, Parkinson’s Disease, Vascular dementia, and head injury to name a few. Alzheimer’s disease is the most common form of dementia, representing approximately 75% of all cases. Alzheimer’s disease is marked by a gradual functional decline, with difficulties with naming, rapid forgetting of newly learned information, and changes in executive functioning. Other forms of dementia have symptoms that overlap with those of Alzheimer’s disease, but the particular pattern of impairment differs for each disease. For example, patients with Lewy-body dementia usually demonstrate fluctuating levels of function and cognition, with relatively preserved naming, spared memory storage but impaired retrieval, and behavioral manifestations such as hallucinations early in the disease process.

The clinical symptoms of dementia fall into two categories: cognitive and neuropsychiatric. Cognitive symptoms include impairments in memory, language, orientation, recognition, and executive functions. In the case above, Mrs. R.’s forgetfulness and inability to use common household items he was previously proficient with are examples of cognitive deficits.

How To Cope With Common Changes In Behaviour

Although changes in behaviour can be difficult to deal with, it can help to work out if there are any triggers.

For example:

  • Do some behaviours happen at a certain time of day?
  • Is the person finding the home too noisy or cluttered?
  • Do these changes happen when a person is being asked to do something they may not want to do?

Keeping a diary for 1 to 2 weeks can help identify these triggers.

If the change in behaviour comes on suddenly, the cause may be a health problem. The person may be in pain or discomfort from constipation or an infection.

Ask a GP for an assessment to rule out or treat any underlying cause.

Keeping an active social life, regular exercise, and continuing activities the person enjoys, or finding new ones, can help to reduce behaviours that are out of character.

Read more about activities for dementia.

Other things that can help include:

  • providing reassurance
  • activities that give pleasure and confidence, like listening to music or dancing
  • therapies, such as animal-assisted therapy, music therapy, and massage

Remember also that it’s not easy being the person supporting or caring for a person with behaviour changes. If you’re finding things difficult, ask for support from a GP.

Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

  • Getting lost easily
  • Noticeably poor performance at work
  • Forgetting the names of family members and close friends
  • Difficulty retaining information read in a book or passage
  • Losing or misplacing important objects
  • Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

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What Are Some Other Typical Dementia Behaviors

In addition to aggression, confusion, sleep problems and wandering, symptoms of dementia can also include delusions, hallucinations, paranoia, depression, apathy and sexual inappropriateness. And, behavioral dementia symptoms tend to occur more frequently as the dementia progresses.

Up to 90% of patients have one or more of these symptoms during the course of their disease, studies show. It is important to discuss all dementia symptoms with your loved ones physician to rule out or treat any medical conditions that could be causing the behavior.

Causes Of Anger And Aggression In People Who Suffer From Dementia

Communication and Dementia

Like with anyone, anger and aggression can surface from an abundance of sources. Our reasons for getting angry or upset may differ greatly from one another, but there are certainly some underlying themes and patterns. In people who suffer from dementia, there are three major triggers or causes of anger and aggression.

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If You’re Looking After Someone With Dementia

Your needs as a carer are as important as the person you’re caring for.

To help care for yourself:

  • join a local carers’ support group or a specialist dementia organisation â for more details, call the Carers Direct helpline on 0300 123 1053 lines are open 8am to 9pm Monday to Friday, and 11am to 4pm at weekends
  • call Dementia UK’s Admiral Nurse Dementia Helpline free on 0800 888 6678 to talk to a registered specialist dementia nurse lines are open 9am to 9pm Monday to Friday, 9am to 5pm at weekends

How To Deal With Dementia Behavior Problems

  • How to Deal with Dementia Behavior Problems: 19 Dos and Donts

Dementia is a disease that affects millions of people across the globe every year. It is often a highly misunderstood condition that is marred by numerous misconceptions, which make the condition difficult to understand and study.

You should know that dementia is not a name for an illness, rather it is a collective term that describes a broad range of symptoms that relate to declining of thinking, memory, and cognitive skills. These symptoms have deteriorating effects that usually affect how a patient acts and engages in the day-to-day activities.

In advanced dementia stages, affected persons may experience symptoms that bring out a decline in rational thought, intellect, social skills, memory, and normal emotional reactivity. It is something that can make them powerless when it comes to living normal, healthy lives.

Relatives, caregivers, spouses, siblings, children and anyone close to a person who has dementia need to know how to deal with behavioral problems that surface because of the illness. Examples of dementia problems may include aggressiveness, violence and oppositional behaviors. Find out some of the vital Do and Donts when dealing with a dementia patient.

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Do Not Keep Correcting The Patient

People with dementia do not like it when someone keeps correcting them every time they say something that may not be right. It makes them feel bad about themselves and can make them drift out of the conversation. Discussions should be humorous and light and one should always speak slowly and clearly using simple and short sentences to capture and keep the interest of the dementia patients.

Why Is My Elderly Mother Confused

Top 4 Most Common Challenging Dementia Behaviors (and How to Handle Them)

Contrary to popular opinion, confusion in an elderly adult is not a natural part of healthy aging. Confusion can be caused by many factors, ranging from medication mismanagement to mild strokes to underlying health conditions, which could be as serious as Alzheimers Disease progression or dementia.

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The Challenges And Rewards Of Alzheimers Care

Caring for a person with Alzheimers disease or dementia can often seem to be a series of grief experiences as you watch your loved ones memories disappear and skills erode. The person with dementia will change and behave in different, sometimes disturbing or upsetting ways. For both caregivers and their patients, these changes can produce an emotional wallop of confusion, frustration, and sadness.

As the disease advances through the different stages, your loved ones needs increase, your caregiving and financial responsibilities become more challenging, and the fatigue, stress, and isolation can become overwhelming. At the same time, the ability of your loved one to show appreciation for all your hard work only diminishes. Caregiving can literally seem like a thankless task.

For many, though, a caregivers journey includes not only huge challenges, but also many rich, life-affirming rewards.

Caregiving is a pure expression of love. Caring for a person with Alzheimers or dementia connects you on a deeper level. If you were already close, it can bring you closer. If you werent close before, it can help you resolve differences, find forgiveness, and build new, warmer memories with your family member.

Caregiving can teach younger family members the importance of caring, compassion, and acceptance. Caregiving for someone with dementia is such a selfless act. Despite the stress, demands, and heartache, it can bring out the best in us to serve as role models for our children.

Dont Neglect Your Own Needs

By always focusing so diligently on your loved ones needs throughout the progression of their dementia, its easy to fall into the trap of neglecting your own welfare. If youre not getting the physical and emotional support you need, you wont be able to provide the best level of care, and youre more likely to become overwhelmed and suffer burnout.

Plan for your own care. Visit your doctor for regular checkups and pay attention to the signs and symptoms of excessive stress. Its easy to abandon the people and activities you love when youre mired in caregiving, but you risk your health and peace of mind by doing so. Take time away from caregiving to maintain friendships, social contacts, and professional networks, and pursue the hobbies and interests that bring you joy.

Caregiver support

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Avoid Arguing About Whether They Are Already Home’

For a person with dementia, the term ‘home’ may describe something more than the place they currently live. Often when a person with dementia asks to go home it refers to the sense of home rather than home itself.

Home may represent memories of a time or place that was comfortable and secure and where they felt relaxed and happier. It could also be an indefinable place that may not physically exist.

Its best not to disagree with the person or try to reason with them about wanting to go home.

Ways To Respond When Someone Is Experiencing Dementia Hallucinations

How to Respond When Loved Ones with Dementia are Confused

1. Determine if a response is neededThe first step is to determine whether the hallucination is bothering your older adult.

If its pleasant, you might not want to respond or call attention to it.

Just know and accept that its a dementia symptom and thankfully isnt causing distress.

If the hallucination is upsetting them or causing them to do something unsafe, then its time to quickly step in to provide comfort or redirect to a safe activity.

2. Stay calm and dont argue or try to convince using logicWhen someone is having a dementia hallucination, its important to stay calm and avoid contradicting them.

What theyre seeing is a dementia symptom and is very real to them.

Trying to explain that it isnt real simply wont work because of the damage that dementia has caused in their brain.

In fact, knowing that you dont believe them might make them even more upset and agitated.

If theyre calm enough to explain, it may also help to understand what theyre seeing. Listen carefully and try to pick up clues to what theyre seeing.

But keep in mind that dementia damage in the brain may affect their ability to use the correct words. For example, they could unintentionally say cabbages when they mean green cushions.

3. Validate their feelings and provide reassuranceBe careful not to dismiss your older adults experience.

Brushing off what theyre seeing by saying something like, Dont be silly, theres nothing there, is likely to upset them.

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How To Handle Dementia Behaviors: 6 Things To Try

In most cases, its best to try other approaches before using antipsychotic medications to manage challenging dementia behaviors.

1. Get a thorough physical exam and medication reviewHaving their doctor give a thorough exam and full medication review is a good first step to figuring out the root cause of difficult behavior.

Because people with dementia cant communicate discomfort or needs, these behaviors may have a physical cause like constipation, infection, chronic pain, vision or hearing problems, or sleep problems.

Plus, many common medication side effects and combinations of medicines can cause added confusion and agitation in older adults. That could lead to challenging behaviors.

2. Stick to a regular daily routineIf your older adult is losing their cognitive abilities, their world gets filled with more and more unknowns.

If their days arent structured, life can become even more stressful because they may not know what to expect next.

Having a regular daily routine can reduce difficult behaviors, improve sleep, and reduce sundowning symptoms.

3. Help them exercise regularlyRegular exercise has many physical and mental benefits for all people, but can be especially helpful for older adults with dementia.

Exercise can slow cognitive decline, boost mood, burn off nervous energy, and improve sleep.

Theres even a home exercise routine that improves dementia symptoms. Get more exercise suggestions here.

Additional dementia communication tips:

How To Respond To A Confused Senior

Even if you do everything within your power to provide a comfortable, safe environment for your loved one, the nature of the disease makes confusion and agitation inevitable. Know that you are not responsible and that help is available for you both.

Follow these 4 Steps to Responding to a Confused Senior with Dementia or Alzheimers Disease:

  • Listen to frustrations Validate their emotions and sympathize with their situation.
  • Provide reassurance Although you may not understand, provide comfort and reassurance. Trying to reason with a confused senior may not be affective because their brain simply doesnt process information the way a healthy brain would. Make sure they know they are safe and that you support them.
  • Modify the situation If they seem agitated by loud sounds, try moving to a quiet area. In overwhelming situations filled with new faces or places, distraction can be helpful. Give your loved on a task to focus on, something simple like folding towels, buttoning a sweater, or completing a puzzle. Occupying their mind with something other than confusion can ease behavioral symptoms.
  • Speaking with your loved one medical professional or assisted living care providers is essential. These specialists will be able to alter medications or therapy plans and provide advice on how to respond in the future.
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    More Tips For Handling A Request To Speak To Someone Whos Deceased

    First and foremost, dont try to change their mind or correct them. Their reality is much different then ours. Redirect the conversation or use some interventions to direct their mind somewhere else. When your loved one asks for someone who is no longer alive, explain they are at work, wentRead More

    Know Where To Find Help

    Dementia and Sundowning: Tips to help you manage sundowning

    As your loved ones disease progresses, you may need additional support and help providing adequate memory care. Preparing for this reality in advance is beneficial to both you and your senior loved one. Trained assisted living professionals are able to meet the unique needs of Alzheimers and dementia patients.

    To learn more about memory care and how specialized care can help, please call ComfortCare Home of Wichita at 444-0532.

    Additional Resources

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    What Is Delirium

    Itâs when confusion gets worse suddenly and comes and goes over several hours or days. It happens when a new health problem puts too much stress on the brain, and it can be a sign of a serious illness.

    Your loved one may have delirium if they:

    • Are more easily distracted than usual
    • Find it harder than usual to remember things
    • Talk about something totally different, or are harder to understand than usual
    • Are more or less energetic than is normal for them
    • See things that arenât there
    • Show unusual emotions, such as fear or depression
    • Have a change in personality that comes on in a few hours or days
    • Have changes in behavior that quickly switch between alertness and confusion or sleepiness

    Each of these signs on its own can be caused by other problems, but when they happen together, itâs likely delirium.

    In older people who have dementia, delirium is usually caused by medications, anesthesia and drugs for pain after surgery, and medical conditions like infections or long-term diseases that get worse.

    Why Not Try This

    Challenging dementia behaviors can be super-stressful. This basic approach can help stretch your patience and move you both toward a more peaceful quality of life.

    Best of all, you can start using the Why-This, Try-This approach right away, even if youve been responding differently before.

    To make these steps simple to refer to, Ive compiled a free downloadable PDF, 7 Steps to Managing Difficult Dementia Behaviors Without Medication, A Surviving Alzheimers Cheatsheet.

    Get Your Free Managing Dementia Behaviors Cheatsheet.

    Questions, suggestions, or try tips that work well for you? Please post them below!

    Paula Spencer Scott is the author of Surviving Alzheimers: Practical Tips and Soul-Saving Wisdom for Caregivers . You can learn more at

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    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.
    • Listen.
    • 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


  • Regular exercise may be another outlet for nervous energy.
  • Apathy


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