Distress Behaviour in Dementia With Coping Strategies (Part Two)
Conditions that cause distress behaviours
“Understand the message and engage with the need that is not being met”
It is widely recognised that most distress behaviours in elderly persons are an attempt at communicating ‘Unmet needs’
The person may be in pain or discomfort, missing their pet, grieving for a deceased loved one.
There are a number of behaviours that are common amongst 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.
Orbiting – this is when an individual starts at one point (such as the nurse’s station) and returns to the same area.
Visiting – some individuals, when wandering, will tend to enter other people’s rooms.
Shadowing – as the name indicates, this is when an individual follows closely behind another individual.
Rummaging & Hoarding- 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 another individual’s possessions. Hoarding is also a problem when perishable food or medications are hoarded.
Repetitive Behaviours are very common in moderate and advanced dementia. These Behaviours can be annoying and frustrating to caregivers. Sometimes the individual with dementia will repeat the same Behaviour over and over, such as continually washing the same dish, tapping their fingers, saying the same phrase. Continual pacing is seen with the individual walking aimlessly back and forth. Fidgeting is also common, with individuals being in seemingly perpetual movement– twisting a piece of clothing, constantly moving in their chairs, moving their feet and so forth.
Some repetitive Behaviours appear to be attempts at “self soothing”. This type of behaviour is seen in other conditions with brain involvement, such as autism, developmental disabilities, and brain injury. If the individual does not appear distressed, other individuals are not adversely affected by the behaviour, and it does not jeopardize anyone’s safety, it may be best at times to tolerate the behaviour.
Can you think of examples of common behaviours that you have observed when caring for an individual?
Points to Consider
Constant repetition of the same word or phrase tends to occur in later stages of dementia. They literally “get stuck” on a word or phrase and can’t seem to move to a different phrase or activity.