Understanding behaviours
All behaviours have meaning, so it is important to try to understand why the person with dementia is behaving in a particular way. Like any person, people with dementia will have their good days and bad days. Family members and caregivers play an important role in providing support and understanding, and can try to elucidate what may be triggering the behaviour. It may be easier to figure out ways to prevent the behaviour from happening again than to resolve it when it happens.
Possible triggers
• Fatigue
• Hunger or thirst
• Sleep deprivation
• Physical discomfort such as pain, fever
• Illness
• Needing to urinate or open their bowels/urinary retention or constipation
• Trying to express their emotions
• Too much noise such as TV, radio or too many people talking at the same time
• Impaired vision or hearing causing the person to misinterpret sight and sounds
• Boredom
Tips to prevent triggers
• Encourage short periods of rest in the course of the day to minimise fatigue
• Be vigilant to watch for non-verbal cues of pain and discomfort such as frowning or grimacing
• Regular toileting
• Changing or checking diapers regularly to promote comfort
• Monitor bowel habits to ensure regular evacuation
• Serve snacks and fluids in between meals
• Lower the volume of the TV or radio to minimise noise which can trigger agitation
• Too many people talking to them at the same time can be confusing
• Do not force the person to do something that he or she does not like such as bathing. The caregiver can use the soft approach by coming back to the person when he or she has forgotten about the initial event
• Reduce clutter to allow them space to move around
• Speak slowly and in short sentences especially to those with hearing impairment
Changes in personality
It is not uncommon to notice changes in the personality of a person with dementia. This is because the disease causes changes in the brain. Often, families find it difficult to accept the personality change in their loved ones. The person they once used to know may seem to have become a different person.
It is crucial for families and caregivers to understand that it is the disease that causes the changes in their loved ones and not the persons themselves.
Personality changes you may see:
• Getting upset more easily
• Suspicion towards others including family members
• Loss of interest in activities they used to enjoy
• More unkempt or pay less attention to their appearance / grooming
• Buying the same things repeatedly
• Wandering away from home
• Inappropriate social behaviour such as spitting in public
• Imagining things that are non-existent
• Physical aggression
Tips to cope with personality changes:
• Be genuine and sincere when you approach them
• Reassure them that they are safe
• Keep things simple. Say one thing at a time
• Have a daily routine and provide structured activities
• Do not argue or try to reason with your loved ones
• Step back when you are angry. If you show the person that you are angry or frustrated, they will mirror your emotions
• Try using music, songs or other activities the person used to enjoy to soothe and comfort them when they are upset
• Hold and comfort them when they appear anxious or afraid
• Try not to retort even if you are blamed or accused wrongly
• A gentle touch or hug to show the person that you really care usually helps
Next Chapter: UNDERSTANDING AND CARING WELL FOR THE PERSON WITH DEMENTIA
