Facing behavioral changes
It is not uncommon for people with dementia to also suffer from behavioral changes. The changes are expressed as psychological symptoms which can be difficult to predict and often incomprehensible to the environment. This can be a great challenge for both relatives and care staff. Not least for close relatives, the changes are often perceived also as a change in the personality of the person with dementia, something that in itself can cause difficult feelings of loss and grief. For healthcare professionals, a large part of the challenge is about trying to see the causes of the symptoms and keeping calm in front of the dementia patient. Below are suggestions on how you as a relative and as a staff can respond to and relate to different symptoms of the disease. (Source: Swedish Dementia Center)
Aggressive behavior can suddenly appear for no apparent reason or can be the result of a frustrating situation. It can be expressed both physically with, for example, pushes and blows and verbally with screams and swearing. Whatever the reason, we should try to understand why a person gets angry or upset.
Is the person tired because he / she has not rested or slept enough?
Is it the side effect of medication that causes aggression?
Can the person not convey if he or she is in pain?
Is the person overstimulated by loud noises, noisy environment or disorder?
Does the person feel lost?
Do you ask too many questions or make too many statements?
Are your instructions simple and easy to understand?
Does the person take in your stress and irritation?
Are you negative and critical?
Try to identify the immediate cause. What happened just before the reaction triggered the behavior? Focus on the feeling, not the facts. Do not focus on specific details but try to look at the person's feelings behind the words.Do not get angry or upset. Do not take an angry behavior personally. The person may not necessarily be angry with you. Be positive, encourage, speak slowly and reassuringly.Examine the surroundings and adapt it to avoid similar situations. Try soothing activities such as music, massage, or gymnastics to reduce the problem. Maybe you can leave the person alone for a while.
A person with dementia can do or say things over and over again. In most cases, he or she seeks security, well-being and closeness.
Look for a reason for the repetitions. Instead of focusing on what the person is doing, think about how he or she feels.From action to meaningful activity. If a person strokes their hand back and forth across the table, take out a cloth and ask for help to wipe the table. You can also ask for help to remove the dust from a garment if a person often strokes his hand over tablecloths, furniture or clothes.Calm the person with a soft voice and light and touch. Give the answer he or she is looking for even if you have to repeat the answer several times. The person may be bored and need something to do. Give structure and engage the person in a pleasant occupation.If the person asks the same things over and over again, make it easier for her or him in everyday life. Makes it easier to remember with notes, clock, calendar and photographs.
A person with dementia may not recognize family members, places or things. The person with dementia may no longer understand how to use a pen or fork. These situations can be difficult to handle and require a lot of patience and understanding.
Try to be calm. Even if you are called by the wrong name or are not recognized, which is a painful attempt not to show that you have been hurt.
Give simple explanations. Do not make a long reasoning but simplify as much as possible. View photographs and other items reminiscent of people and places.
Offer help by asking instead of correcting the person e.g. try and say "I thought it was a knife" or "I think she's your granddaughter". Remember that dementia is the cause of forgetfulness. Your support and encouragement makes everyday life easier.
Memory loss and confusion can cause people to misunderstand things. People with dementia can sometimes become suspicious of those around them and accuse them of theft, infidelity or something else. They may also misinterpret what they see and hear.
Try to think of giving simple answers without long explanations or reasoning. Focus on something else like asking for help with a chore.
Listen to what worries the person and try to understand his / her reality. Make sure the person understands that you care.
Do not argue and do not try to convince. Let the person express their opinions. Confirm his or her opinion
If a person often looks for their wallet or purse, it can be good to have a double set to make everyday life easier.
A person with dementia may feel anxious or upset and may need to walk around to counteract the restlessness. Often the person does not recognize themselves in their own home, but is constantly on the way home. This can make the person feel insecure and constantly follow a staff.
Try to find out what is causing the anxiety. Let the person know that you are there for him or her. Engage the person in something that distracts, such as art, music or walking.
Create a safe environment that is calm and harmonious. Avoid many people and loud noises.