How to understand challenging behaviour in Dementia

The term "distress behaviour" has been used to refer to the "difficult" or "problem" behaviours which may be shown by individuals. Such behaviours include aggression (e.g, hitting, kicking, biting), destruction (e.g, ripping clothes, breaking windows, throwing objects), self-injury (e.g, head banging, self-biting, skin picking), tantrums and many other behaviours

How to assess the behaviour in Dementia

Before you can effectively respond to a Behaviour, it is important to determine what may be causing the Behaviour. REMEMBER- each individual Behaviour should be assessed and your findings documented. The first point to make is that there is no simple answer to this question. However it is helpful to remember, that most people without dementia display lots of distress behaviour as the disease progresses.

How to recognise common behaviours in dementia

There are a number of Challenging Behaviours that are common among individuals with dementia. Memory problems and subtle Behaviour changes are evident in early dementia, while many of the more overt Behaviours occur in individuals with moderate to severe cognitive impairment.

What makes you angry and someone with Dementia

Before we can understand what challenging behaviour is for someone with dementia, we need to understand what gets us angry. When we understand what makes us angry, we can then look to why people with dementia display challenging behaviour. Behaviours are often triggered by physical needs of the individual – e.g., hunger, need to urinate, and fatigue.

How to understanding noise making in Dementia

Verbal Behaviours - The verbal Behaviours can take many forms. Those listed are among the common non-aggressive verbal expressions. Repeating questions and comments often occurs because the individual does not remember what they just said. It can become annoying for caregivers when they are asked “What time is it?” several times within a minute, but it does no good to become impatient or scold the individual. It will not help them to remember better.

How to recognise lack of good judgement in someone with Dementia

The ability to make good decisions is often affected by dementia. This can result in people saying and doing things that are out of character causing challenging behaviour. It can also place them in danger, such as walking into traffic, going into extreme cold without a coat or protection, or becoming the victim of a scam artist.

How to recognise lack of good judgement in someone with Dementia

No longer understand how to change their Challenging Behaviour based on the response of others. Normally people can “read” the responses of others, such as a frown or look of anger, and are able to modify their Behaviour if they chose. Scolding or showing disapproval of the Challenging Behaviour of an individual with dementia will generally not change the Behaviour. In fact, confronting or distress them may lead to an escalation of the unwanted Behaviour.

How people are no longer able to interpret and communicate with dementia

Normally we can understand and respond when our body tells us we are hungry, thirsty, need to urinate, are cold or are experiencing fatigue. Dementia damages the part of the brain that helps us understand the signals we are receiving from our body. The individual with dementia will be uncomfortable, but may not be able to understand the cause of the discomfort and respond appropriately displaying challenging behaviour.

Why people are likely to do things that irritate, offend, or embarrass others

As the part of the brain that controls Behaviour becomes damaged by dementia, it is not uncommon for people with dementia to say and do things that are considered socially inappropriate. They lose the ability to understand the difference between Challenging Behaviours that are socially OK and those that aren’t. They have lost the ability for their brain to tell them what not to do.

How to recognise rummaging & Hoarding in dementia

Some individuals with dementia have a tendency to rummage through drawers and closets as if looking for something. Others tend to gather up all sorts of items as if they were collectors. These Behaviours are particularly a problem if they are rummaging through or hoarding other individual’s possessions. Hoarding is also a problem when perishable food or medications are hoarded.

How to respond to repetitive behaviour in dementia

The best way to manage Behaviours is to prevent them. The way you communicate can keep a individual calm or can make the difference between calming a distressed individual or causing an escalation of the Behaviour. Communicating with a individual who has dementia requires extra time and patience. Calling the individual by name and being at eye level will be less threatening and show caring and respect. Studies have shown that individuals are more likely to respond negatively when spoken to in “Elderspeak”.

How to manage inappropriate behaviours in dementia

Inappropriate Behaviours - Inappropriate Behaviours are those Behaviours that tend to make others uncomfortable. They include such Challenging Behaviours as disrobing or urinating in public, touching another individual or oneself in an inappropriate area of the body, getting in bed with another individual without mutual consent, and masturbating in public