Understanding why a person with dementia may display distress behaviours. Part 3
Updated: Oct 25, 2020
The need to be social
Everyone wants and needs social contact.
From the simple question, Can you tell me the time? To a full conversation about a subject of mutual interest. Yet often isolation becomes the norm for the older person, especially someone with dementia. “Persons – can be considered not only as individual autonomous agents, but also as mutual dependent and connected by relationships.” Hughes and Baldwin (2006) As the short term memory goes and the long term memory increases it becomes too familiar that the person becomes isolated.
There by producing a meaningless conversation and often walking away rather than taking the time to listen and understand. People need to feel a sense of belonging and to know who they are.
Providing a supportive social environment: recognising that all human life is grounded in relationships and that people with Dementia need an enriched social environment which both compensates for their impairment and fosters opportunities for personal growth. Brooker (2007).
Being placed in an unfamiliar place will increase the need to know in the individual. Their need to know, who said what, what is going to happen next, will increase confusion caused by their dementia and disorientation to the surroundings.
The persons need to know will increase their anxieties and may exhibit behaviours that have not been seen before, collecting items, eating off the floor or following the carer. Yet carers will carry on with ignoring this.
Expecting the person to settle in time or stop the person doing new habits causing more frustration and confusion. When all we need to do is offer an explanation, give meaning to them and show comfort.
Talking and explaining what is about to happen will reduce the feelings of no control, fear and anxieties. Simply taking the time and not rushing the person will give feelings of confidence, understanding and a sense of cooperation.
Family and carers can easily help the person overcome isolation of with simple processes. Engaging in an activity for a few minutes will reinforce the friendship that is slowly being built, not showing that our concerns and fears because we have become risk adverse and letting the person explore their environment, meet other people within the environment and do the tasks they were doing before coming into the home, such tasks with guidance as making a cup of tea, polish the furniture or hold a screw driver and taking apart an engine in the shed. All of the tasks that the person had done before and can still complete will give them a sense of wellbeing, belonging and most important a feeling of being useful again.
The need to be loved
The feelings of intimacy and sexual expression with the capacity to enjoy sex are not lost in old age.
It may be experienced less frequently, but for many it still remains a pleasurable activity. There is no age at which sexual activity abruptly ends. Yet the cultural expectation is for these needs to become unacceptable within the care home. NICE Guidelines (2006) states “Health and social care staff, especially in residential settings, should identify and, wherever possible, accommodate the preferences of people with dementia including their sexuality.”
When confused people express sexual needs our approach may be prejudiced by our own values and beliefs. Sexual behaviours are a relatively infrequent problem but may have a disproportionate impact on family and carers.” The sexual interests and attitudes of a person with dementia may change “(Hanks, 1992).
Too often family and carers will do all that they can to stop sexual expression from a person rather than look to help. Taking time to explore the needs of the person and finding ways that are appropriate and acceptable sexual behaviour.
A cuddle is often seen as a sexual need just because the person sees someone as their husband or wife, yet it may be that all that is needed is comfort, reassurance and the need to be loved.
The body may be old but we need to remember that the mind is telling the person different. Guiding the service user to their room so that the personal act of satisfying their needs is the easiest of tasks, yet family and staff still show prejudice.
In all that we need in life it has been the foundation of who we are. It is the needs in life that build our character, our emotions and a sense of being. It creates our past, our present and our future. But for those persons with dementia, their needs, their future is in the hands of others.
Professional care givers, family and friends all hold the key to ensure that the service user will continue to receive excellent quality care by providing and meeting the unmet needs.