Behaviour changes in dementia

Behaviour changes in dementia

I spend a lot of time helping people to understand that in dementia most of the time a person is just themselves – maybe a bit slower or more easily confused and forgetful, but otherwise the same.?

The dramatic images of dementia in the public imagination are difficult to shake off, and sometimes people think it can’t be dementia unless the person is behaving in wild, noisy, and difficult ways all the time. ??

In this blog I’m going to dive in and look at some of the most difficult behaviour changes that might be presented to family carers and professional caregivers.? It’s as well to know about them in case they suddenly crop up, but there are many people with dementia who never have these problems.

Difficult symptoms could include the following eight problems described here, but there may be a lot of variation.?

When someone with dementia does anything that makes you feel uncomfortable or distressed yourself, they are communicating with you.? In a way they are communicating their own distress and discomfort.?

Working out what is causing their problem is the first step, but you have to accept that sometimes it is impossible to say what the problem is, and you need to get help, and remove yourself from the situation until you feel well enough to try again.? The most general point about reducing the behaviours that are symptoms of distress is that reducing stress almost always helps, and as a family carer, you may be in a good position to say what it is that is causing the upset.

  • Agitation – the person is restless and pacing, unable to sit or eat, or stop long enough to interact with you.? They might resist strongly or fight you if you try to use touch to slow them down or get their attention.
  • Anxiety – the person show signs of terror, and can’t rest, desperately trying to get somewhere else, such as home, or even to a place that doesn’t exist anymore or is irrelevant like their work place or their child’s nursery when the child is now an adult.?
  • Aggression – where their distress is leading to a storm of flight or fight reactions, and they misperceive you as a threatening stranger, or they know who you are but accuse you of trying to hurt them and they hit back at you.
  • Emotional distress – when the person is inconsolable, and suffering a wave of grief or loss that you can’t touch, and which you can’t explain.
  • Delusions – this is the word used when there is a fixed, false belief that cannot be shaken by explanation or logic, and which is causing harm and distress to the person.
  • Hallucinations – this is like a delusion in that it has no connection with reality, but it is where the person sees, or hears something that is not there.? The worst is if it is something frightening or distressing.
  • Sleeplessness – for people at home sleeplessness in the person with dementia causes sleeplessness in the caregiver, who may be exhausted but still need to get up for work the next day.? It even affects you if the person is in another place as they may make repeated telephone calls throughout the night.
  • Calling out and shouting – repetitive vocalisation can include the same question over and over, or chanting of distressing words that sound like a continuous call for help, even when there is no help that can be offered, giving the impression to others that the carer is ignoring or neglecting the person affected. There is no peace for anyone.


Read the full post on my site by tapping the link –https://juneandrews.net/blog/5/12/2023/behaviour-changes-in-dementia

Steven J. Orfield

President at Orfield Laboratories, Inc.

11 个月

Amen, June

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Ian H G J.

Consultant Clinical Psychologist & Clinical Neuropsychologist & Counselling Psychologist; Director & Consultant Clinical Neuropsychologist at Specialist Neuropsychology & Psychology Services (SPANS) Limited;

11 个月

Hi. It’s good to talk about this kind of aspect of dementia. So it’s a positive. You could let people know you don’t have to know what’s going on inside the person with dementia to help them. Nor do you have to understand dementia. So often the person is blamed or seen at fault. Most professionals work on changing the person. I try to change mindsets of carers/professionals & encourage a different approach. As a behaviourist & person-centred, I see behaviour as a response to the environment, which can be events or people or speech. To keep it simple, something has gone on which the person with dementia could not cope with & the unwanted behaviour is a distress communication. Thus, helping families & carers & professionals to see we can change the environment & the behaviour goes away. Had a patient 3 decades ago where they were angry a lot & threw objects, in their house. I noticed the spouse wanted to explain to them, & mentioned a lot, about their memory. I simply advised to stop using the word & discussing memory: the behaviour went away. It’s a case of listening to what’s wanted by the person with dementia. Hope this helps. Happy to explain further. It’s the crux of what Tom Kitwood was trying to say, in my view.

Kate Gallagher

Strategic Account Director @ CIRTEC Group | Account Management

11 个月

Hi June, an inspiring post. Please can you send me a message, thanks

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