As dementia progresses, it’s not uncommon for people to begin displaying strange and uncharacteristic behaviours. These may be considered ‘challenging’ to people who don’t understand them or the reason behind such a sudden change.
Challenging behaviour in dementia can put the individual or their primary carer in danger. They can also affect their independence and dignity, which, in turn, can affect self-esteem. Today, we’ll explore potential challenging behaviours that people with dementia might exhibit, and how to handle them.
Why Can Dementia Cause Challenging Behaviours?
Challenging behaviours often present themselves in people with advanced dementia, whose symptoms have been progressing for a while. They are also more common when dementia affects the frontal lobe, which is the part of the brain responsible for impulse control, personality and certain behaviours.
However, it’s worth noting that dementia symptoms are highly individual, so anyone affected by the disease could begin displaying challenging behaviours.
Strange behaviours occur because, as a person’s dementia progresses, the brain function becomes inhibited. This can prevent them from controlling what they do or say. The challenging behaviours are often a way to communicate their feelings, as they don’t know how else to react.
This often means that, while you may find the behaviour challenging and difficult to deal with, there may be a reason behind it. They may be in pain or emotional distress, and the behaviour may not resolve until their needs are met.
Potential Challenging Behaviours in Dementia
Behaviours often seen exhibited by individuals with dementia, that may be considered ‘challenging’, include:
- Violence and aggressive outbursts: A person with dementia may suddenly become aggressive towards loved ones or strangers, which can frighten people who aren’t aware of their condition.
- Hurting themselves: Dementia may cause the individual to intentionally or unintentionally harm themselves, due to confusion, frustration or an inability to recognise danger.
- Throwing objects: A person with dementia may throw objects when feeling overwhelmed or unable to communicate their needs.
- Verbal abuse: An individual with dementia may use offensive or hurtful language, often without realising the impact of their words.
- Shouting or screaming: The person with dementia might shout or scream to express themselves, especially if they can’t find another way to communicate their needs.
- Lying to loved ones: Individuals may lie to loved ones, though they often believe they’re telling the truth and may experience confusion, false memories or delusions due to their condition.
- Poor personal hygiene: A person with dementia may neglect their hygiene due to forgetfulness, lack of awareness or difficulty completing tasks.
- Inappropriate sexual behaviours: The individual may display behaviours that seem sexually inappropriate due to changes in impulse control and judgement.
- Strange eating habits: The person may develop unusual eating patterns, such as overeating, refusing food altogether, or eating inedible things.
- Refusing care or medication: The person may resist help from loved ones, carers or healthcare professionals, leading to a rapid decline in health and cognition.
- Following loved ones around: A person with dementia may start shadowing a loved one, especially if they’re feeling insecure, anxious or unsafe.
How to Manage Behaviour that Challenges in Dementia
Managing challenging behaviour can be overwhelming for loved ones, especially when they’ve appeared suddenly.
Below are several steps to take to manage your loved one’s behaviours calmly and effectively:
1. Look For a Problem
Consider:
- Are you concerned about the behaviour?
- Is the problem the behaviour itself, or the reactions and attitudes of other people?
- How is your loved one living? Could their environment be causing the problem?
- Are they trying to communicate a need to you?
2. Consider the Situation
It can be helpful to look at each behaviour individually.
- When and where does the behaviour show?
- Is the behaviour linked to the same place or under the same circumstances?
- Are there any other people involved?
- Have you noticed any patterns of behaviour or common themes? Any possible triggers?
3. How Are They Feeling?
Respond to your loved one as they’re exhibiting challenging behaviour.
Notice if they’re:
- Tired, overstimulated, scared or anxious?
- Embarrassed, misunderstood or frustrated?
- Depressed or experiencing delusions or hallucinations?
- Bored or lacking socialisation?
- In an uncomfortable environment?
4. Identify Anything They Could Be Reacting To
Now you know a little more about the situation, consider whether your loved one is reacting to:
- The understanding that they can no longer do something they used to enjoy
- Something unpleasant, scary or something they don’t like
- Change, such as a new living environment or carer
- A memory
- Being provoked
5. Create a Strategy
Talk to your loved one and the people closest to them, such as their carers and friends. Devise a plan together that involves slightly changing their routine, such as going to sleep earlier or spending more time with loved ones, to see if this changes their behaviour.
You could also consider changing their environment. Remember that small changes can make a big difference, so don’t try to change too much at once. This can leave them feeling more confused and anxious, exacerbating challenging behaviours.
Being consistent is essential. Make sure everyone close to them understands and uses the strategy, so you can truly make a difference in the behaviours.
Physical and Mental Causes of Challenging Behaviours
Sudden changes in behaviour are often a result of pain or discomfort from a physical health issue, such as constipation. If you notice challenging behaviours, we recommend that you consult your loved one’s GP for a health check. This can rule out physical causes and medication side effects.
If the GP rules out health problems as the cause of their behaviour, they may be referred to a mental health team. Mental health conditions, such as depression, can often contribute to changes in behaviour. Treatments can often manage and reduce the behaviour.
In some cases, the behaviours are not caused by physical or mental pain. In these cases, you can manage behaviour with empathy and patience.
Responding with Empathy and Patience
It can be difficult to manage your loved one’s behaviour, especially when you and their GP can’t determine a clear reason behind it. It may help to see things from their point of view, with a clear understanding of dementia.
People experiencing dementia symptoms can often find it difficult to understand the world around them. This can be confusing and anxiety-provoking for them, often causing them to act out. They may be reacting in a way to capture your attention so you’ll help them feel better.
Consider what you know about the person and how they used to act before their condition progressed. This might give you an idea of why they’re exhibiting strange behaviour. For example, if your loved one used to work night shifts, that might explain why they now want to stay awake all night and sleep during the day.
Try not to argue with your loved one, even if you become frustrated with the challenges. Be mindful of what they believe to be true and empathise if they’re confused or experiencing delusions.
For example, if they believe that they have to go meet their parents for lunch, don’t argue or say they’re wrong. Instead, ask them to tell you more about your parents, or distract them with another activity.
To learn more about talking to your loved one, read our guide to 20 things not to say to someone with dementia.
How Trinity Homecare Can Help
At Trinity Homecare, we understand how difficult it is for families to witness their loved one’s behaviour change as a result of dementia. Our live-in or visiting carers can help you devise a plan to manage these changes and offer emotional support to the entire family.
When working with Trinity Homecare, you can expect:
- One-to-one support at home
- Completely bespoke care that has been tailored to you
- Specialist care for a number of different circumstances
- Home carers carefully matched to your needs
- CQC rated ‘Outstanding’ live-in care services
Our carers are available for your loved one whenever these behaviours become apparent. Through round-the-clock assistance and live-in dementia care, we prioritise safety, independence and dignity.
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.
