The brain and spinal cord (your central nervous system) are responsible for behaviour and control how you react to various stimuli in your environment. Different parts of your brain control and regulate different aspects of your behaviour.
Dementia gradually damages the brain and affects its function. The type of behaviour this affects and to what degree depends on how severely the brain is damaged and where. Some behaviour problems may get better but others can get worse as the disease progresses, so it's important to be prepared.
There are several different types of challenging behaviour in people with dementia. Here are some common behaviour issues.
- People can be physically aggressive, and hit or kick you, or they may scream and shout.
- Repetitive behaviour is a common issue that is born out in asking questions over and over, or doing the same activity again and again.
- People with dementia can be restless and pace around a lot.
- Dementia can disrupt a person's body clock and they may get up in the night, get dressed or go outside.
Some of these behaviours can be extremely hard to deal with, especially aggression. Although you may feel hurt, it's important to realise that this is a result of their condition and it's not personal. It's vital to stay calm in this type of situation so things don't escalate.
If behaviour like this develops, it’s important to arrange for an assessment with a doctor. There may be many reasons why the person you care for is acting this way and an assessment can help identify these. For example, the person may be in pain or discomfort, have depression or may be experiencing side-effects from their medicines.
The key to coping with difficult behaviour is to try and understand why the person is acting this way. Look at things from their point of view and consider what they are trying to express. Keep the lines of communication open and reassure them as best you can. It may help to step away from the situation and look at their body language to try to understand what they are feeling.
It can be hard to be patient at times, particularly when faced with repetitive behaviour but again, consider why they are doing this. Repetitive behaviour can happen if a person is bored so it may help to give them an activity to do. If they are having trouble remembering things, buy a notebook to record things.
Restlessness can be challenging, particularly if the person wants to walk but has physical difficulties. However, it's important for them to have some physical exercise and work some energy off. Ask your doctor for help with any issues concerning sleep. It may be a side-effect of their medicines, so it's worth having a chat about your options.
It's also a good idea to try to identify any triggers for the person's behaviour, in particular aggression. This can help to prevent such outbursts in the future.
Caring for a person with dementia can be very draining so make sure you make time for yourself too. Speak to your doctor about any local services in your area that can offer you the chance of a break every now and then.
It's also important to realise that you’re not alone. Charities and support groups can offer the opportunity to speak to other people in your situation and share your experiences. See further information for sources of support.
The infographic gives some top tips for dementia caregivers. Click on the image to open a full-size PDF.
- Dementia quality standard. National Institute for Health and Care Excellence (NICE), June 2010. www.nice.org.uk
- Central nervous system anatomy. Medscape. www.emedicine.medscape.com, published 12 August 2013
- Behavioral and psychologic symptoms of dementia. The Merck Manuals. www.merckmanuals.com, published April 2013
- Reducing behaviours of concern. Dementia Behaviour Management Advisory Services. www.dbmas.org.au, published 2012
- The brain and behaviour. Alzheimer's Society. www.alzheimers.org.uk, published November 2010
- Dementia gateway. Social Care Institute for Excellence. www.scie.org.uk, accessed 1 November 2013
- Unusual behaviour. Alzheimer’s Society. www.alzheimers.org.uk, published November 2010
- Dementia. Map of Medicine. www.mapofmedicine.com, published 13 January 2012
- Dealing with aggressive behaviour. Alzheimer’s Society. www.alzheimers.org.uk, published July 2010
- Dementia. National Institute for Health and Care Excellence (NICE), November 2006. www.nice.org.uk
- Behaviour management: a guide to good practice. Dementia Behaviour Management Advisory Services. www.dbmas.org.au, published 2012
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