Ways To Reduce And Manage Mean Dementia Behavior
1. Calm the situation downThe first thing to do is reduce the tension in the room.
Start by limiting the distractions in the room, like turning off the TV or asking others to leave.
And if you stay calm, theyre also more likely to calm down.
It might help you to count to 10 or even leave the room for a short time to cool down. Repeat to yourself its the disease as a reminder that theyre not intentionally doing this.
If the current activity seemed to cause the agitation, try shifting to a more pleasant, calming activity. Or, try soft music or a gentle massage.
2. Comfort and reassure while checking for causes of discomfort or fearTake a deep breath, dont argue, and use a calm, soothing voice to reassure and comfort your older adult.
It also helps to speak slowly and use short, direct sentences.
Then, check for possible causes of agitation or fear, like:
- Feeling disturbed by strange surroundings
- Being overwhelmed by complicated tasks
- Frustration because of the inability to communicate
It also helps to focus on their emotions rather than their specific words or actions. Look for the feelings behind what theyre doing as a way to identify the cause.
3. Keep track of and avoid possible triggersWhenever difficult behavior comes up, write down what happened, the time, and the date in a dedicated notebook.
Also think about what was going on just before the behavior started and write that down as a possible trigger.
Taking some time away can help both of you.
How To Handle Alzheimers Aggression
One of the biggest challenges for people taking care of elderly parents with Alzheimers disease or other types of dementia is dealing with outbursts of agitation and aggression.
Techniques for managing AD aggression, such as redirecting their attention or medication, can certainly help. However, Cindy Steele, RN, nurse scholar for Copper Ridge, a residential care community located in Utah, says the key to handling anger and aggression is finding out what is causing the outburst.
Dismissing aggression as a normal behavior associated with Alzheimers doesnt enable the caregiver to fix whatever is causing the outburst, explains Steele. Why do they seem to get upset? What causes it?
Steele focuses on behavior management for Alzheimers and dementia patients and says agitation and aggression are typically caused by one or more of the following five factors.
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Aggressive Behaviour In Dementia
In the later stages of dementia, some people with dementia will develop what’s 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.
It’s 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 you’re 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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What Are False Beliefs And Delusions
Beliefs:A persons beliefs are the basis for how they view the world. We start forming what we believe as children and continue to build upon it throughout our lives. Examples could include someones religious or political beliefs. But there are life lessons that people can pick up that can have a negative influence on their lives, for instance, beliefs such as: Dont trust people theyll always let you down.
Our beliefs are personal to us, and as such, its possible that all of us might have thoughts and beliefs at some time that are false. Someone might believe that their neighbour doesnt like them when theres no evidence to support this. But people with normal cognitive function have some control over how their beliefs affect them and dont usually allow them to become a negative influence in their life.
When someone has dementia, they may lose the ability to moderate their thoughts or keep them in check, and this is when false beliefs can become a problem.
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.
- 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.
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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.
Personality Change May Be Early Sign Of Dementia Experts Say
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By Pam Belluck
Has the person become agitated, aggressive, irritable, or temperamental? the questionnaire asks. Does she/he have unrealistic beliefs about her/his power, wealth or skills?
Or maybe another kind of personality change has happened: Does she/he no longer care about anything?
If the answer is yes to one of these questions or others on a new checklist and the personality or behavior change has lasted for months, it could indicate a very early stage of dementia, according to a group of neuropsychiatrists and Alzheimers experts.
They are proposing the creation of a new diagnosis: mild behavioral impairment. The idea is to recognize and measure something that some experts say is often overlooked: Sharp changes in mood and behavior may precede the memory and thinking problems of dementia.
The group made the proposal on Sunday at the Alzheimers Association International Conference in Toronto, and presented a 34-question checklist that may one day be used to identify people at greater risk for Alzheimers.
I think we do need something like this, said Nina Silverberg, the director of the Alzheimers Disease Centers program at the National Institute on Aging, who was not involved in creating the checklist or the proposed new diagnosis.
Others are more enthusiastic.
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Do Make Sure That The Dementia Patient Gets Enough Rest Food And Water
Fatigue, hunger and thirst may cause combativeness. Ensure that the person with dementia is well fed, hydrates enough, and gets adequate sleep and rest. In line with this, they should also have enough bathroom breaks. Research also shows that it may help to reduce loud noises as well as clutter in the space where the patient spends most of his/her time, as both loud noises and clutter tend to over-stimulate people with dementia.
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How To Help Soothe Paranoia In Dementia
We can provide reassurance and support so those experiencing paranoia feel safe and loved. Do not fall into the trap of detailed explanations or logical arguments. Try these behavioral techniques to calm someone living with dementia, who is experiencing paranoia.
What we call paranoia in dementia feels very real for the person living with it. It is their reality. Susan London, LMSW, Director of Social Work at Shore View Nursing and Rehabilitation says that, There is often no evidence that will convince them otherwise. Try the following in response to your loved one:
Do Keep Eye Contact When Speaking
Communicating with a dementia patient requires a lot of patience, especially during later stages of dementia. It is vital to ensure that you talk in a place that has good lighting, a place that is quiet and without too many distractions. Do not try and stand over the person you are talking to, but rather try to be at their level and keep eye contact at all times. Take care to make sure that body language is relaxed and open. Prepare to spend quality time with the person so that they do not feel rushed or like they are a bother.
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Types Of Medication For Difficult Behaviors In Dementia
Most medications used to treat difficult behaviors fall into one of the following categories:
1.Antipsychotics. These are medications originally developed to treat schizophrenia and other illnesses featuring psychosis symptoms.
Commonly used drugs: Antipsychotics often used in older adults include:
- For a longer list of antipsychotics drugs, see this NIH page.
Usual effects: Most antipsychotics are sedating, and will calm agitation or aggression through these sedating effects. Antipsychotics may also reduce true psychosis symptoms, such as delusions, hallucinations, or paranoid beliefs, but its rare for them to completely correct these in people with dementia.
Risks of use: The risks of antipsychotics are related to how high the dose is, and include:
- Increased risk of falls
- Increased risk of stroke and of death this has been estimated as an increased absolute risk of 1-4%
- A risk of side-effects known as extrapyramidal symptoms, which include stiffness and tremor similar to Parkinsons disease, as well as a variety of other muscle coordination problems
- People with Lewy-body dementia or a history of Parkinsonism may be especially sensitive to antipsychotic side-effects in such people, quetiapine is considered the safest choice
2. Benzodiazepines. This is a category of medication that relaxes people fairly quickly. So these drugs are used for anxiety, for panic attacks, for sedation, and to treat insomnia. They can easily become habit-forming.
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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Falling More Frequently Than You Used To
Constantly tripping over your own two feet? Everyone falls now and again but frequent falling could be an early signal of Alzheimers disease, according to research. A study published in July 2013 in the journal Neurology found that presumptive preclinical Alzheimers disease is a risk factor for falls in older adults. People will come into our office concerned because they forgot what was on their grocery list last week, but when their spouse says theyve fallen four times in the past year, thats a sign of a problem, says Rankin. Frequent falls may also be a symptom of other brain disorders, including progressive supranuclear palsy.
Talking With A Doctor
After considering the persons symptoms and ordering screening tests, the doctor may offer a preliminary diagnosis or refer the person to a Cognitive Dementia and Memory Service clinic, neurologist, geriatrician or psychiatrist.Some people may be resistant to the idea of visiting a doctor. In some cases, people do not realise, or else they deny, that there is anything wrong with them. This can be due to the brain changes of dementia that interfere with the ability to recognise or appreciate the changes occurring. Others have an insight of the changes, but may be afraid of having their fears confirmed.One of the most effective ways to overcome this problem is to find another reason for a visit to the doctor. Perhaps suggest a check-up for a symptom that the person is willing to acknowledge, such as blood pressure, or suggest a review of a long-term condition or medication.Another way is to suggest that it is time for both of you to have a physical check-up. Any expressed anxiety by the person is an excellent opportunity to suggest a visit to the doctor. Be sure to provide a lot of reassurance. A calm, caring attitude at this time can help overcome the person’s very real worries and fears.Sometimes, your friend or family member may refuse to visit the doctor to ask about their symptoms. You can take a number of actions to get support including:
- talking with other carers who may have had to deal with similar situations
- contacting your local Aged Care Assessment Team
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Early And Middle Stages Of Vascular Dementia
Some symptoms may be similar to those of other types of dementia. Memory loss is common in the early stages of Alzheimer’s, but is not usually the main early symptom of vascular dementia.
The most common cognitive symptoms in the early stages of vascular dementia are:
- problems with planning or organising, making decisions or solving problems
- difficulties following a series of steps
- slower speed of thought
- problems concentrating, including short periods of sudden confusion.
A person in the early stages of vascular dementia may also have difficulties with:
- memory – problems recalling recent events
- language – eg speech may become less fluent
- visuospatial skills – problems perceiving objects in three dimensions.
As well as these cognitive symptoms, it is common for someone with early vascular dementia to experience mood changes, such as apathy, depression or anxiety. Depression is common, partly because people with vascular dementia may be aware of the difficulties the condition is causing. A person with vascular dementia may also become generally more emotional. They may be prone to rapid mood swings and being unusually tearful or happy.
Need advice on managing behaviour changes?
Read our top tips for managing and reducing out of character behaviour.
Coping With Suspicions And Delusions In Someone With Dementia
It can be very distressing to see a loved one experiencing delusions, suspicions, and paranoia, but they are fairly common symptoms of dementia. Here are a few ideas to help you cope
People with dementia find it harder to remember things and stay anchored in the present moment. This can lead to suspicions, delusions, and paranoia. If the person you care about is in the grips of a delusion, it can take every ounce of energy and love to manage.
Did you know? Around 40 per cent of people living with dementia experience delusions.
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Our Most Frustrating Rational Thinking Losses
If Im experiencing dementia and you ask me to do something I cant do, Ill feel embarrassed, angry, hurt, or all three at once. Its essential that you understand what someone experiencing dementia is no longer able to comprehend for you to avoid getting combative, aggressive, and mean reactions.
Rational Thinking Loss #1Becoming unable to understand why.
Rational thinking skills are for understanding how, why, when, who and whatthe ability to perceive relationships between facts. Dementia takes that away. So if you try to explain to your loved one why they need to do something, or what went wrong, or how to do something, they will not be able to follow you and will end up embarrassed or concluding that youre making fun of them. Anger or hurt feelings will result. Whenever you catch yourself explaining why, stop. Youre asking them to do something they can no longer do. Youll have pleasanter interactions once you build new conversational habits and turn your focus away from why to talking about things that are pleasant.
Rational Thinking Loss #2Becoming unable to see cause and effect.
Rational Thinking Loss #3Becoming unable to follow sequences.
Rational Thinking Loss #4Becoming unable to prioritize.