How to Deal with Dementia Behavior
When your parent or loved one is diagnosed with Dementia, it poses challenges for you as the caregiver especially as the disease progresses. Some dementia sufferers show very minor signs of bizarre behavior but others may exhibit behaviors that can be embarrassing, frustrating and exhausting.
My mom would take off her shirt and expose herself when she was staying at the group homes as well as the assisted living facility and nursing home. Since then, she has not exhibited that behavior as often and she’ll only do it once in a blue moon. But it’s ok because she’s in her own home now and no one else can see her but us. Nevertheless, there are ways to deal with common behavior problems in dementia sufferers.
Communication
- Get rid of distractions such as the TV or Radio in order to maintain eye contact with the confused person. When there’s not so much going on in the room, the person may be able to focus a little better.
- Use short and simple sentences and give only one direction at a time. This one could be a little difficult, because you have to change the way you speak and sometimes you forget that the confused person may not understand what you are saying.
- Try to make an effort to be very expressive in communicating. For example, use alot of hand gestures or pictures when trying to communicate to the person. My mom understands us without having to do all this, but whatever you think will help or you see helps, you should definitely give it a shot.
- Sometimes, and we are all guilty of this from time to time, we tend to talk down to seniors as if they are children. I don’t know how that came to be, perhaps because of negative cultural stereotypes, but it’s a No-No. Seniors deserve dignity and upmost respect even when they are no longer able to comprehend what’s happening to them. Therefore, when talking to your loved one, speak to them normally but just repeat yourself if they do not understand.
- Try not to bring up subject matter that your loved one can no longer remember. Usually, these are things that are in the short-term. My mom remembers a lot of things that happened 20-30 years ago. It’s funny how that works, but we always talk to her about my brother-in-law (who passed away in 1994) and things we did, trips we made, etc. She remembers all of it!
Wandering
This is a scary one. Sometimes it can have tragic consequences. Fortunately for us, it was the first and last time it would ever happen again. (She is monitored closely and unfortunately she no longer walks.) My mom wandered off last year and was gone for a few hours before my father even noticed. Both my sister and I received a call from the police when one of their neighbors discovered her by their car. Luckily, my mom only made it to the parking lot directly in front of their apartment. (This is a huge complex.) My father only discovered her missing when the police knocked at their door. He thought that she was in her room the whole time. With his disability, he wouldn’t have been able to search for her without assistance. My mom was a little dehydrated and confused, but otherwise healthy.
- My mom and dad’s old apartment did not have special locks, just the normal ones you see. My mom wandered off, despite our hand-written signs telling her not to leave. So you may want to consider either changing the locks or if you can’t do that, install one of those door bell alarms that signal that the door is opening or closing.
- You can try a sign, though I would suggest buying one that looks like a stop sign or “do not enter” to see if that works. As I stated above, our handwritten signs didn’t work.
- Try child-proofing doors. You can find doorknob covers at Walmart or other store that sells child-proof supplies.
- Put away items that would remind your loved one of leaving, such as: their coat, keys, glasses, etc.
- Have your loved one wear some kind of identification. We bought our mom one of those gold necklaces that had our phone numbers on it. This is how the police were able to locate us. She also carried an identification card that I made with her medical information (doctor, medicines, her condition), our phone numbers and her age.
- Alert the neighbors that your loved one is a wanderer and give them your contact information.
- It may or may not help, but if you allow your loved one to have regular exercise, it may decrease the need to want to get up and wander.
Incontinence
I think this is one of the worst aspects of it all besides agitation/anger. This is the most stressful thing, in my opinion, more than the bizarre behavior. Unfortunately for my mom, she suffers from both fecal and urinary incontinence. She started having accidents about a little over 2 years ago.. We cautioned her not to eat too much fatty and lactose laced foods. While that was a partial reason for the incontinence, the dementia also plays a major role.
- Establish a routine. I would try to bring them or encourage them (if they are able) to use the bathroom every 2 hours. You may want to set an alarm as a reminder.
- Try to avoid drinks that would cause them to go the bathroom a lot, such as: coffee, soda, beer, etc. Avoid foods that would cause them to get an upset stomach. Limit intake of fluids before bed.
- Purchase a commode and place it next to their bed so they don’t have to walk very far to use the bathroom
- Use adult diapers or pads, whichever is appropriate. Our mom has to use full diapers, pull-ups and straps.
- Use adaptive clothing, if your parent likes to fidget with things. (Our mom would remove her diaper all the time, and accidents occurred, we bought her an outfit that zips down the back instead of the front, so she couldn’t take her clothes off.)
Angry/Agitated Behavior
For us, this is the worst part of it, besides the memory loss. Here is your loved one, they were in control all of their lives, all of a sudden, they are not. They can’t control themselves emotionally, mentally, physically. It’s heart-wrenching to see them go through this. It is because of this reason that we had to move our mom back home. The nursing home couldn’t handle her outbursts, the dementia-ward at the assisted living center could not control her endless pacing, yelling, crying, etc.
- Take your loved one to the doctor to rule out any medical causes. Sometimes it could be something simple such as a bladder infection and because your loved one is confused, they may not realize it. Unfortunately, we tried everything as listed on this guide and nothing worked. My mom is now on anti-psychotic drugs to calm her mind, but on the flip side, she’s very groggy. This was the last resort and it was something that was started at her stay in the nursing home shortly before moving her back home. Drugs are the last resort and if you can use other methods, you should.
- Reduce outside noise, and other distractions in the room. Familiar objects and/or photograph
s may help them feel more comfortable and may facilitate some pleasant memories. - Soothing music, gentle touch, reading or a peaceful walk may help with the agitation. Do not try to restrain your loved one if they are behaving irrationally, it only makes things worse. Instead, try the methods mentioned to try and calm them down.
- Typically, agitation dementia sufferers will start to become more agitated in the twilight hours before and after the sun sets. This is called “Sundowning”. The reason is not known, but it is believed that increased shadows might cause some confusion.
- Keep requests short and simple. Instead of asking, “What would you like for dinner?”, say, “Here is what we are having for dinner.”
- Let your loved one know that you understand why they are frustrated.
Repetitive Speech/Actions
- If your loved one asks the same question over and over, try not to remind them that they already asked the question. Instead ,either ignore it (which works sometimes) , or try to distract them after you reassure them that you acknowledged what they asked.
- Make sure the loved one is not in pain or suffering from any medication side effects.
- Your loved one may fidget at times. This is something that my mom does from time to time. She’ll try to “sew” or she’ll pull on her buttons or something to keep her hands busy. This is all part of the effects of dementia. I would just give them something safe that they can hold, like a ball of yarn or just allow them to be.
Traveling
- Do not try to negotiate with your loved one about traveling. Instead of asking things like, “Are you ready to leave?”, say something along the lines of “Here is your coat and purse.”
- Just like you would your own children, reassure them that everything will be OK. New and difference surroundings can make them anxious.
- If you take a vacation or go on a weekend trip and take your loved one, make sure you take someone else to help you out.
- If you have to wait somewhere, bring things to occupy your loved one such as: cards, snacks,etc.
Miscellaneous
- Bathing: If bathing is a problem, you can skip a day unless they have soiled themselves heavily. There are products including sprays and wipes that you can purchase at your local drug store to help clean and deodorize your loved one. Adjust the temperature accordingly.
*credit- SCRC
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