Common Dementia Behaviors
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Dementia changes one’s behavior.  The Alzheimer’s Association has prepared some helpful information to use when dealing with behavior changes.
Identify and examine the behavior:
  • What was the behavior? Was it harmful to the individual or others?
  • What happened just before the behavior occurred? Did something trigger it?
  • What happened immediately after the behavior occurred? How did you react?
  • Consult a physician to identify any causes related to medications or illness.
Explore potential solutions:
  • What are the needs of the person with dementia? Are they being met?
  • Can adapting the surroundings comfort the person?
  • How can you change your reaction or your approach to the behavior? Are you responding in a calm and supportive way?
Try different responses:
  • Did your new response help?
  • Do you need to explore other potential causes and solutions? If so, what can you do differently?

Aggression
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Aggressive behaviors may be verbal (shouting, name-calling) or physical (hitting, pushing). These behaviors can occur suddenly, with no apparent reason, or can result from a frustrating situation. Whatever the case, it is important to try to understand what is causing the person to become angry or upset.

How to Respond:
  • Try to identify the immediate cause. Think about what happened right before the reaction that may have triggered the behavior.
  • Focus on FEELINGS not facts.  Rather than focusing on specific details, consider the person’s emotions. Look for the feelings behind the words.
  • Don’t get upset. Be positive and reassuring, Speak slowly in a soft tone.
  • Limit distractions. Examine the person’s surroundings, and adapt them to avoid other similar situations.
  • Try a relaxing activity. Use music, massage or exercise to help soothe the person.
  • Shift the focus to another activity. The immediate situation or activity may have unintentionally caused the aggressive response. Try something different.

Anxiety or Agitation
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A person with Alzheimer’s may feel anxious or agitated. He or she may become restless and need to move around or pace. Or, the person may become upset in certain places or focused on specific details.

How to Respond:
  • Listen to the frustration. Find out what may be causing the anxiety, and try to understand.
  • Provide reassurance. Use calming phrases. Let the individual know you’re there.
  • Involve the person in activities. Try using art, music or other activities to help the person relax.
  • Modify the environment. Decrease noise and distractions, or move to another place.
  • Find outlets for energy. The person may be looking for something to do. Take a walk, or go for a car ride.

Confusion
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The person with Alzheimer’s may not recognize familiar people, places or things. He or she may forget relationships, call family members by other names or become confused about where home is. The person may also forget the purpose of common items, such as pen or fork. These situations are difficult for caregivers and require much patience and understanding.

How to respond:
  • Stay calm. Although being called by a different name or not being recognized can be painful, try not to make your hurt apparent.
  • Respond with a brief explanation. Don’t overwhelm the person with lengthy statements and reasons. Instead, clarify with a simple explanation.
  • Show photos and other reminders. Use photographs and other thought-provoking items to remind the person of important relationships and places.
  • Offer corrections as suggestions. Avoid explanations that sound like scolding. Try “I thought it was a fork,” or “I think he is your grandson Peter.”
  • Try not to take it personally. Remember, Alzheimer’s disease causes your loved one to forget, but your support and understanding will continue to be appreciated.

Repetition
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A person with Alzheimer’s may do or say something over and over again—like repeating a word, question or activity. In most cases, he or she is probably looking for comfort, security and familiarity. The person may also pace or undo what has just been finished. These actions are rarely harmful to the person with Alzheimer’s but can be stressful for the caregiver.

How to respond:
  • Look for a reason behind the repetition. Try to find out if there is a specific cause to trigger for the behavior.
  • Focus on the emotion, not the behavior. Rather than reacting to what the person is doing, think about how he or she is feeling.
  • Turn the action or behavior into an activity. If the person is rubbing his or her hand across the table, provide a cloth and ask for help dusting.
  • Stay calm, and be patient. Reassure the person with a calm voice and gentle touch.
  • Provide an answer. Give the person the answer that he of she is looking for, even if you have to repeat it several times.
  • Engage the person in an activity. The individual may simply be bored and need something to do. Provide structure and engage the person in a pleasant activity.
  • Use memory aids. If the person asks the same questions over and over again, offer reminders by using notes, clocks, calendars or photographs, if these items are still meaningful to the individual.
  • Accept the behavior, and work with it. If it isn’t harmful, don’t worry about it. Find ways to work with it.

Suspicion
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Memory loss and confusion may cause the person with Alzheimer’s to perceive things in new, unusual ways. Individuals may become suspicious of those around them. Even accusing others of theft, infidelity or other improper behavior. Sometimes the person may also misinterpret what he or she sees and hears.

How to Respond:
  • Don’t take offense. Listen to what is troubling the person, and try to understand that reality. Then be reassuring, and let the person know you care.
  • Don’t argue of try to convince. Allow the individual to express ideas. Acknowledge his or her opinions.
  • Offer a simple answer. Share your thoughts with the individual, but keep it simple. Don’t overwhelm the person with lengthy explanations or reasons.
  • Switch the focus to another activity. Engage the individual in an activity, or ask for help with a chore.
  • Duplicate any lost items. If the person is often searching for a specific item, have several available. For example, if the individual is always looking for his or her wallet purchase, two of the same kind.

Wandering
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It’s common for a person with dementia to wander and become lost. In fact, more that 60 percent of individuals with Alzheimer’s will wander at some point. They may try to go home when already there or may be attempting to recreate a familiar routine, such as going to school or work.

How to Respond:
  • Encourage activity. Keeping the person with Alzheimer’s active and engaged will discourage wandering behavior by reducing anxiety and restlessness. Involve the person in daily activities such as doing dishes, folding laundry or preparing dinner.
  • Inform others. Make sure friends, family and neighbors know that the person has Alzheimer’s and that wandering may occur.
  • Make the home safe. Install deadbolt or slide-bolt locks on exterior doors, and limit access to potentially dangerous areas. Never lock the person with dementia in a home without supervision.

Trouble Sleeping
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People with dementia often can have problems sleeping or may experience changes in their sleep schedules. Scientists don’t completely understand why these sleep disturbances occur. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain.

How to Respond:
  • Make a comfortable environment. The person’s sleeping area should be at an appropriate temperature. If helpful, provide nightlights or other security objects. Discourage watching television during periods of wakefulness at night.
  • Maintain a schedule. As much as possible, encourage the person with dementia to adhere to a regular routine of meals, waking up and going to bed. This will allow him or her to sleep more restfully at night.

For more information, please contact Castle Rock Services at (208) 409-4857 or visit the Alzheimer’s Association website.
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