Dementia-Related Behaviors: What is Your Loved One Trying to Tell You?

Home Care Services, Suffolk County, NY

In the United States, a new case of Alzheimer’s develops every 68 seconds.  According to the Alzheimer’s Association more than five million people are living with Alzheimer’s.  By 2050, that number is expected to almost triple to fourteen million.  It is the sixth leading cause of death in the U.S. and kills more than breast cancer and prostate cancer combined.

While very prevalent, there are many facets about Alzheimer’s disease that are still a mystery to scientists and doctors in the field.  The symptoms of the disease are never the same experience for any individual.  Another enigma is that the disease progresses at a different rate for each person without any rhyme or reason.  According to the Alzheimer’s Association, the top ten early signs and symptoms of Alzheimer’s disease are the following.

  1. Memory loss that disrupts daily life
  2. Challenges in problem solving
  3. Difficulty completing familiar tasks
  4. Confusion with time or place
  5. Trouble understanding visual images and spatial relationships
  6. New problems with words and speaking
  7. Misplacing things and losing the ability to retrace steps
  8. Decreased or poor judgment
  9. Withdrawal from work and activities
  10. Changes in mood and personality

Over half of those living with Alzheimer’s experience behavior disturbances.  These dementia-related behaviors include sleep disruptions, agitation, delusions, hallucinations, pacing and restlessness, and emotional outbursts.   One factor that contributes to an increase in behavioral symptoms with dementia is diminishing language skills as a result of the disease.  In fact, those living with dementia having difficulty finding the right words, difficulty concentrating and following conversations, lose their train of thought while speaking, and increasingly rely on non-verbal communication (i.e. gestures, facial expressions, etc) to get their message across.  It can be a source of tremendous frustration for the person living with dementia and often leads to withdrawal from social interactions.

For family members that provide care to the person living with dementia, these behavior disturbances can appear to be brought on without warning or cause.  However, research has show that there is always an underlying reason for dementia-related behaviors ranging from fatigue and hunger to physical discomfort and pain.  Below is a list of the contributing underlying factors that cause dementia-related behaviors.

  • Pain
  • Drug interactions or side effects
  • Change either in the environment or in the daily routine
  • Misperceived threats
  • Fear
  • Fatigue
  • Sensory loss
  • Hospitalization
  • Discomfort with bathing
  • Sensory overload

Family members must often play the role of a detective to understand what the behaviors mean and find ways to soothe the person in the “heat of the moment” when they are experiencing a behavioral disturbance.  Below are some tips for quelling severe dementia-related behaviors.

  1. Speak in a soft, consoling voice
  2. Ask the person for the facts. For example, “what’s wrong?”, “what can I do to help?”, or “does something hurt?”
  3. Repeat and/or rephrase. “It sounds like you’re worried because you cannot find your wallet”, “I can see that you’re very upset and are concerned about this”, or “so, you’re worried that you forgot to do something, is that right?”
  4. “I’m going to do my very best to help you find your wallet.  Let’s go”, “I want you to know that I love you and only do what’s best for you”, or “let’s check the calendar and call the doctor to make sure you didn’t miss your appointment”
  5. “While I was looking for your wallet, I found this photo album.  These photos bring back so many memories”, “do you remember that time when I was a kid and I fell and got hurt and you made me laugh”, or “I was checking the calendar and saw that we have a visit coming up with your friend this week.  How do you think she’s doing?”
  6. Go along for the ride. Sometimes no matter what you may try, the person is still in distress and is unable to change their behavior.  Take a walk with the person, let him/her go through the behavior while staying back and watching for his/her safety.  There are times when the emotion or feeling just needs to go through its natural course and the best we can do is ensure the person’s safety while it’s happening.

People living with dementia require a lot of oversight and assistance with many aspects of life and the daily routine.  When dementia-related behaviors become so severe that family members are unable to provide care and assistance to the person, it may be time to talk to a doctor and have a medical evaluation.  There may be medications or other interventions available to calm the behaviors so that family members can provide assistance to the person living with dementia.