Oftentimes, a person with a form of dementia such as Alzheimer’s cannot express how he or she feels with words and instead communicates through behavior. Successfully dealing with problem behaviors in persons with dementia begins by:
- Identifying the cause of the behavior or “trigger.” Questions to think about are: What happened just before the behavior started? Where did the behavior happen? What happened right after the behavior?
- Reacting calmly and reassuringly.
- And then modifying the environment or caregiving style to reduce potential stressors that can create agitation and disorientation.
Trouble Communicating Clearly
Effect: A person with dementias such as Alzheimer’s may become agitated if he cannot figure out what you are trying to tell him or can’t find the right words to tell you what he wants. What you see are actions that cry out the emotions that person is feeling. Also, the person with Alzheimer’s may use incorrect words for an object or may say repeatedly that he needs to go home, even if he is home. To him, “home” may not really be a place, but represents the feeling of safety.
Response: Respond to the emotion that is being communicated rather than the behavior. When giving instructions, break down what you are asking into one simple step at a time.
Effect: Getting anxious or upset in response to a problem behavior can increase the level of stress or agitation in a person with dementia.
Response: Remember, the person is responding to your tone of voice and body language more than the content of what you’re saying. If you find yourself becoming anxious or losing control, take a time-out to quickly relieve stress.
Effect: Agitation, fear, repetitive behaviors and many other troubling yet typical behaviors associated with dementia can occur when a person is feeling run-down and tired.
Response: Use a quiet tone of voice and encourage some rest time.
Effect: Too many people, too much noise, garish colors in the environment, shadowy rooms or excessive clutter, as well as time of day, can lead to agitation, hallucinations or aggressive behavior.
Response: Stay calm and stay an arm’s length away if safety is a concern. Provide reassurance and encourage the person to go with you to another place where it is well lit, quiet and calming. Be sensitive to the feelings that may be causing the behavior, such as fear or worry.
Effect: Physical discomfort may come about due to illness, medication side effects or other factors, but the person with dementia may not be able to communicate clearly about her discomfort and may try to get the message across through her behavior.
Response: Look for signs of pain, such as a urinary tract infection, constipation, full bladder, redness or tenderness of skin spots or potential pressure ulcers and other physical causes for the change in disposition, mood, etc. Consider whether the person may be hungry or thirsty. Also check to see if his clothes may be too tight or too loose. If medication side effects are the suspected cause of discomfort, contact the physician.
Frustration with Tasks
Effect: When trying to accomplish a task or chore that has multiple steps or seems complicated to the person with Alzheimer’s, strong reactions can occur.
Response: Stay calm and be patient. Repeat instructions one step at a time. Say statements such as, “Do as much as you can and I will help you.” If trouble continues, do not persist in making the person perform the task, but rather move on to a different activity.
Effect: A person may choose repetitive behaviors if he is bored or under-stimulated.
Response: Turn a repetitive action or behavior into an activity. For example, if he is rubbing his hand across the table, give him a cloth and ask him to help with dusting. Other simple, useful tasks are winding a ball of yarn or stacking magazines. Try using art, music or touch to help him relax. Pull out a memory book or treasure box you have made together.
After the Problem Behavior Has Passed
Reflect on how you handled the situation and if anything should be done differently next time. Keep track of your answers each time you see the behavior. These are clues that you can use to help make your caregiving easier. If you can change or prevent the triggers, you may be able to keep the behavior from happening in the same way again.
Endeavor In-Home Care walks hand in hand with families through the progression of their loved one’s disease, offering professional, compassionate in-home care. Contact Endeavor In-Home Care to learn if your clients or loved ones could be a good fit for our specialized in-home Alzheimer’s and dementia care services.
Download a printable version of this resource sheet.
Sources: Alzheimer’s Association: “Living with Alzheimer’s”, Coach Broyle’s Playbook for Alzheimer’s Caregivers, HelpGuide.org