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Dementia and challenging behaviour

By recognising common Behaviours associated with dementia and the factors that may trigger them, you will be better able to address them appropriately.

Neither the individual nor the Behaviour is the problem– the problem is the need or feeling that the individual is trying to communicate with the Behaviour. We now recognise that many Behaviours displayed by people with dementia indicate that they are in some form of distress. The Behaviour is an indication of discomfort, pain, anger, fear and other physical and emotional conditions. The brain damage from dementia often makes it impossible for people to communicate their needs through language, so we must pay close attention to their verbal or physical Behaviours to know how to help them.In dementia, changes in the brain cause changes in how people communicate. The Behaviours associated with dementia are related to damage in the brain, but we now know these Behaviours may be triggered and aggravated by other factors. It was once assumed that the damage to the brain caused the Behavioural symptoms associated with dementia and nothing could be done other than medicating the individual or using restraints. Now we know that there are often physical and emotional causes or “triggers” for Behavioural symptoms of dementia that need to be addressed in much different ways. Medication is a last resort and restraints should be used only in very rare circumstances.They may display a lack of good judgement.

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. 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. They can no longer understand how to change their Behaviour based on the response of others.Generally if someone does something that irritates others or that is unacceptable, people will respond verbally or show looks or Behaviour indicating disapproval. 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. Dementia causes people to no longer be able to understand the reactions of others or to respond by changing their Behaviour. Scolding or showing disapproval of the 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.

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