Dementia is a common condition that affects the brain, memory and behaviour. There is currently no cure, and symptoms progress from mild to advanced. If your loved one has been diagnosed with dementia, you may notice their behaviour changing and becoming increasingly challenging.
Knowing about challenging behaviour in dementia in advance can help loved ones come to terms with the changes, reducing emotional stress and upset. Today, we’ll explore these challenges, why they happen, and how you can act to minimise distress for you and your loved one.
Why Does Dementia Cause Challenging Behaviours?
Dementia is often characterised by seven stages, ranging from early to advanced. Every individual with dementia will progress through these stages, but how long it takes differs from person to person.
Some people won’t reach advanced stages of dementia for 10-20 years after their diagnosis, while others experience rapid decline from the outset.
Many families notice challenging behaviours during the advanced stage of dementia, when damage to the brain is most severe. As neurons are lost in specific brain regions, such as the frontal lobe, individuals lose the ability to plan, control impulses or manage personality changes.
Heightened symptoms, such as memory loss and confusion, can also lead to challenging behaviours as people feel lost or disoriented. This can lead to anxiety, agitation and immense fear.
It’s important to remember that every case of dementia is highly individualised, so anyone at any stage could begin presenting challenging behaviours.
Common Challenging Behaviours Caused by Dementia
People with dementia often present individualised symptoms depending on the type of dementia they have, their current stage, and personal circumstances.
Common Behaviours Caused by Dementia That May Be Challenging
These types of behaviours are common for many people with dementia, no matter what type.
They are most commonly present during advanced stages, but they can also present in other stages:
- Violence towards themselves or others
- Throwing, hitting or damaging objects
- Verbal abuse towards carers, loved ones or strangers
- Shouting and screaming
- Lying, either intentionally or due to confusion and delusions
- Poor personal hygiene or refusal to wash
- Sexually inappropriate behaviour or comments
- Eating inedible objects or refusing food and drink
- Refusing personal care, support or medication
- Following carers or family members constantly
- Wandering or attempting to leave safe environments
- Repetitive questioning or repetitive actions
- Pacing or restlessness
- Sleep disturbances or night time waking
- Paranoia, suspicion or accusing others of stealing
- Hallucinations or responding to things that are not there
- Emotional outbursts or sudden mood changes
- Social withdrawal or loss of interest in activities
- Hoarding or hiding possessions
- Resistance to changes in routine
Challenging Behaviours Caused by Alzheimer’s
Alzheimer’s is one of the most common types of dementia, often affecting memory, confusion and disorientation.
Common behaviours that loved ones may find challenging include:
- Repeatedly asking the same questions
- Forgetting familiar people, places or routines
- Becoming confused about time and location
- Wandering away from home
- Accusing others of stealing misplaced belongings
- Increased anxiety when routines change
- Agitation during washing, dressing or usual routines
- Frustration caused by communication difficulties
- Withdrawing from conversations or activities
- Sleep disruption and night time wandering
- Suspicion, paranoia or mistrust
- Emotional distress or sudden anger
- Refusing help or denying difficulties
- Becoming distressed in unfamiliar environments
- Sundowning, where confusion worsens later in the day
Challenging Behaviours Caused by Lewy Body Dementia
Lewy Body Dementia is another common type of dementia that causes abnormal protein build up in the brain. It’s often associated with fluctuations in awareness, mobility issues and vivid hallucinations.
Challenging behaviours may include:
- Seeing people or objects that are not really there
- Sudden changes in alertness and attention
- Appearing vacant or staring into space
- Delusions or strongly held false beliefs
- Acting out dreams during sleep
- Increased fear, anxiety or panic, often because of the hallucinations
- Aggression triggered by confusion or fear
- Falls linked to mobility and balance problems
- Difficulty understanding visual information
- Extreme daytime sleepiness
- Sensitivity to busy or noisy environments
- Misidentifying people or surroundings
- Resistance to care during periods of confusion
- Fluctuating communication abilities
Challenging Behaviours Caused by Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which damages and kills brain cells, usually because of strokes or mini-strokes.
VD can affect judgement, mood, emotional control and concentration, resulting in challenging behaviours such as:
- Sudden emotional outbursts
- Irritability and impatience
- Depression and low motivation
- Frustration linked to awareness of decline
- Slower thinking and delayed responses
- Difficulty concentrating or following instructions
- Impulsive or unsafe behaviour
- Aggression caused by confusion or frustration
- Withdrawal from social situations
- Problems planning or organising activities
- Wandering due to confusion
- Refusing assistance or support
- Mood changes following stroke-related damage
- Sleep difficulties and tiredness
- Reduced ability to cope with stress
Challenging Behaviours Caused by Frontotemporal Dementia
Frontotemporal dementia is a rarer form of dementia that damages the brain’s frontal and temporal lobes, causing severe changes in personality, behaviour, language and motor function.
Challenging behaviours include:
- Socially inappropriate behaviour
- Loss of empathy or concern for others
- Sexually inappropriate comments or actions
- Impulsive or risky behaviour
- Repetitive or compulsive actions
- Obsessive routines or rituals
- Overeating or unusual food cravings
- Poor financial judgment or reckless spending
- Emotional coldness or indifference
- Inappropriate joking or childish behaviour
- Verbal aggression or tactlessness
- Reduced personal hygiene
- Lack of insight into behaviour changes
- Refusal to follow boundaries or instructions
- Language difficulties causing frustration or anger
How to Manage Challenging Behaviours from Dementia
It can be difficult to manage challenging behaviours on your own, especially when they’re so different from how your loved one used to act. The most important thing to remember is to stay calm and avoid challenging them, as this may make them more distressed.
Other ways to manage challenging behaviour include:
- Communicate clearly: Make sure your loved one can understand you by speaking slowly and repeating yourself when necessary.
- Listen intently: It’s essential that you can listen effectively to your loved one so you can identify the problem at hand.
- Stay positive: While it can be difficult to remain calm when you spot challenging behaviours, staying positive often helps reduce agitation and embarrassment.
- Identify the cause of the problem to stop it: Consider why your loved one is acting out, such as a change in their environment or unmet needs.
- Remember the good times: Try to help your loved one recall something positive from their past to evoke positive memories and calm them down.
- Try complementary therapies: Therapies for dementia, such as doll, art, or music therapy, can help reduce challenging behaviours.
How Trinity Homecare Can Help
At Trinity Homecare, we’re committed to helping individuals and their families through person-centred care. A dementia diagnosis can put an emotional strain on every member of the family, which is where one of our compassionate, fully-trained dementia carers can support you.
Whether you need routine respite from a visiting carer or more comprehensive daily support from a live-in carer, Trinity Homecare can create a personalised care plan to ensure your loved one continues living life the way they want to.
Talk To Us Today
At Trinity Homecare, our ultimate goal is to enrich your lifestyle in the comfort and familiarity of your own home. This allows you to live the independent lifestyle that you love without the daunting thought of moving into a care home. We are here to support you with various forms of live-in care.
Call us now on 0207 183 4884 in confidence for a free, no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.
