Behavior Issues

By Family Caregiver Alliance

Individuals with dementia or other conditions may exhibit confusing or challenging behaviors at times. Here are tips and guidance for handling common concerns to help caregivers better understand what their loved ones may be feeling or trying to communicate.

Anxiety and agitation can sometimes be caused by bodily discomfort, such as pain, constipation, hunger, or uncomfortable clothes. Try figuring out what might be wrong. Ask your physician to evaluate for medical problems. Medications and lack of sleep can cause behavioral changes.
Stay calm, as your anxiety will increase their anxiety.
Change in surroundings or routine can be disorienting for someone with dementia. Reassurance is necessary when in a new situation or when things have changed, such as a caregiver, sleeping room, hospitalization, etc. Identify and acknowledge their feelings and let them know they are safe and you are with them.
Many people with dementia become paranoid and feel threatened by everything from a stranger to a piece of mail. If they are having delusions or hallucinations, do not try to talk them out of them, but rather distract or place your hand on theirs to calm them.
Time of day, time of meals, and time of events at home can all trigger behavioral issues. For people who sundown, late afternoon can be a challenge. Some people are better in the mornings, others later in the day. Plan activities around when the person is at his/her best.
Going for a walk outside or a walk around the house will get the person moving, which is both a distraction and also helps to reduce anxiety.
If an activity, such as dressing, is frustrating, help the person to finish the task, using soothing words of reassurance. Then engage him/her in a new activity in which he/she will be successful, for example, folding towels.
Overstimulation, too much noise, the TV, or too many people can all cause agitation. Soothing music or familiar songs can sometimes help. Keep the environment as stress free as possible.
Do not try to physically restrain someone who is upset unless there is an immediate safety concern. Stopping him/her will lead to escalation and puts you and them in danger.
People with sleep disturbances should be evaluated by your neurologist and/or someone with expertise in handling sleep problems. Attend a support group to see what has worked for others. Remember: You need your sleep as well, so solving this problem is essential for your own well-being.
Behavior issues are the way that the person you are caring for is using to try and communicate something to you. Do not take it personally—they are not doing it to get you. Look behind the behavior like a detective and try to figure out what is causing it.