Dementia Behaviors, How To Recognize Them, And What To Do About Them
What can you do when dementia behaviors appear? You can help by recognizing the behavior, finding its underlying cause, and responding to the need behind it.
Fear, anger, and sadness are common among dementia patients. But, a person with dementia may have an impaired ability to reason and manage emotions. As a result, they may express feelings through inappropriate or troubling behavior, which can be a drastic change in a person's personality.
Depression
People with dementia may also experience depression but not verbalize it.
You may attribute an eating or sleep disturbance to the disease process of dementia itself. However, these and other difficult behaviors sometimes indicate that depression has developed.
Recognizing depression
The Cornell Scale for Depression in Dementia is a tool used by professionals to assess depression in a person with dementia. Healthcare providers interview close family members or caregivers, asking questions about certain behaviors the person with dementia engages in. Signs of depression in dementia include:
Restlessness and fidgeting
Hand wringing
Pulling own hair
Agitation
Moving or reacting more slowly than usual
Complaining about many physical ailments
Loss of interest in things
Loss of appetite
Weight loss
Lack of energy
Trouble sleeping
Talking about suicide
Self-blame
Pessimism
Delusional beliefs
Social withdrawal
Trouble concentrating
Responding to depression
When you recognize that the person you're caring for shows consistent signs of depression, talk to their doctor. In the meantime, you can take some steps to alleviate the situation.
Help them find a mental health counselor.
Help them stay active.
Acknowledge their feelings.
Talk with them about what they enjoy and do those things together.
Celebrate special occasions.
Give them a chance to contribute in a volunteer setting or at home.
Let them know you love and appreciate them.
Offer them their favorite foods.
Play their favorite music for them.
Make their daily routine predictable.
Confusion
People with dementia can become confused about major events or even about where they are and what they've been doing.
Recognizing confusion
Confusion can appear as demanding questions or indignant statements. People with dementia may ask the same question over and over, or they may tell you that they are somewhere they are not.
On the other hand, some people with dementia show confusion in their facial expressions or in their hesitancy to trust. Their confusion may result from not realizing they're in a safe place.
Responding to confusion
You can't solve dementia confusion by pointing out that they're saying incorrect things. Explaining and arguing don't work because they may be unable to process what you tell them.
Instead, it's better to redirect someone with dementia to another activity when they act confused. Tell them what they need to feel safe. If that means not telling them the exact truth, it's okay.
Fear, anger, and aggression
Fear and anger can lead to aggression in some people with dementia. This brain disorder can result from biological changes to the brain or from feeling highly frustrated by not understanding the current situation.
When fear is the emotion behind aggressive behavior, the person with dementia is trying to deal with people, places, and objects that seem less familiar than they once did. They may also sense they have less control, and aggression might help them feel safe or in control.
Recognizing anger
People with dementia may become belligerent, call someone hurtful names, or use profanity even if they never have before. They may even act out physically by hitting, kicking, tripping, or biting you or someone else. Sometimes, they might throw objects or destroy someone's personal belongings.
Responding to anger
If someone you care for has dementia and anger becomes a problem, first deal with aggressive acts and words. Perhaps more than any other dementia behavior, you need to figure out the cause of the aggression and the need it represents. Don't argue or tell them no. Don't restrain them unless you need to for safety purposes.
Talk to them kindly without touching them or hovering over them. Walk away for a moment to give them space and time to work it out for themselves. Then, talk to them more to find out how they would like you to help. Stay calm. Even if you can't do what they ask of you, listen and acknowledge their needs.
There are some things you can do to try to help stop angry outbursts before they start. Using visual cues may help avoid anger outbursts. For example, you can use visual cues, like photos or simple written instructions, to guide them through their daily routine and prevent them from getting frustrated. You can also give them a simple job to do, like folding laundry, that can help them feel useful. The repetitive nature and soft touch of the fabric in an activity like folding towels can give them something to stay focused on and possibly diffuse some of their tension. Also, avoid asking open-ended questions that require them to weigh multiple options and formulate a response, as this can cause stress for someone with dementia. For example, instead of asking, “What do you want for breakfast?” ask, “Do you want oatmeal or eggs for breakfast?”
Sleep changes
Sleep issues can be challenging to resolve. A person with dementia may struggle with sleep because of changes in their brain. Multiple factors, like physical pain, health problems, or a need to use the bathroom more frequently, can also interrupt sleep as a person ages.
Developing RBD
People with dementia can also develop REM sleep behavior disorder (RBD). RBD may cause them to act out their dreams as they sleep.
Also, a dementia patient might wake up in the middle of the night and not know the time, then go about their day as if it were morning. They may also have trouble falling asleep or may wander at night, making safety an issue.
Risks of these sleep patterns
If a person with dementia is wandering at night, ensure they're safe. Sometimes, people living with someone with dementia install an alarm system so they know immediately if the person leaves the house.
If a person with dementia is more active during the day, they may sleep better at night. If they wake up at night thinking it's morning, show them the time and gently encourage them to get back in bed. Adjusting the lighting to minimize shadows, which can confuse people with dementia, may also help diminish confusion at night, which may help them fall and stay asleep.
Hallucinations
Dementia hallucinations usually happen in the later stages of the condition. A dementia hallucination is a false sensory perception caused by brain degeneration. People may start seeing or hearing things that aren’t really there.
Recognizing hallucinations
It can be challenging to recognize when someone is hallucinating. You might be able to find out by simply asking them. If they don't or can't answer you, some signs to watch for are:
- Watching an empty part of the room intently, as if something interesting or alarming is happening there
- Speaking as if in conversation, even though no one is there
- Holding a listening posture or facial expression as if something else has the person's attention
- Moving the eyes as if watching something when nothing is moving in the environment
Responding to hallucinations
First, assess whether the hallucination is a problem for them. If it makes you feel uncomfortable but doesn't seem to negatively impact them, it might not need to be dealt with. However, if a hallucination is causing a problem or making them feel fearful, you can help them.
Talk clearly and speak slowly. Don't pretend the hallucination is real. Acknowledge their feelings, but don't pretend to feel the same way. If you do, they might lose their grasp on the difference between what their senses are telling them and what they know to be true. For example, if the hallucination is that there is someone else in the person’s room that is scaring them, you can tell them you know they are feeling scared, but do not pretend that you are afraid of the person in the room.
Paranoia and false beliefs
Sometimes, the brain of someone with dementia changes enough to cause problems with paranoia, which can significantly impact dementia care.
Recognizing paranoia
Dementia-related paranoia often involves distrust of family or caregivers. A person with dementia may say they suspect that someone is stealing from them or poisoning them.
If you're one of the people they distrust, they may not tell you directly. Instead, they may hide belongings or money, refuse to eat or drink something you give them or refuse to go with you in your car. If they distrust a doctor, they may resist going to appointments.
Responding to paranoia
If you recognize paranoia in a person with dementia, get in touch with their doctor. They may schedule a consultation to decide on potential treatments.
You don't necessarily need to do anything about the paranoid behaviors unless they pose a danger or there are safety concerns. Reassure the person experiencing paranoia that you're on their side by taking care of their needs. Rather than arguing, distract them with activities or unrelated conversations.
Finding support as a caregiver as dementia progresses
When someone you're caring for has challenging dementia behaviors and decreased thinking skills, you need as much support as possible. Self-care, like regular exercise and a good sleep routine, can be helpful, but talking to someone can help. You may be able to find a support group in your area that can help you connect with people who are going through something similar. Online therapy may be a good option for caregivers, too. You can participate in online therapy from the comfort of your home. Plus, you can reach out to your therapist anytime, 24/7, via phone call or in-app message, and they will get back to you as soon as they can.
Online interventions have been found to effectively help dementia caregivers. They may provide support and improve the mental health of caregivers. To learn more, reach out to a BetterHelp therapist.
Takeaway
What are 5 behavioral symptoms of dementia?
Dementia can be associated with a variety of behavioral symptoms, and the specific symptoms can vary among individuals. Behavioral symptoms can be challenging for both individuals with dementia and their caregivers. Here are five common behavioral symptoms of dementia:
- Agitation and Aggression: Individuals with dementia may exhibit agitation or aggression, which can include restlessness, verbal outbursts, or physical aggression. These behaviors may be triggered by factors such as confusion, frustration, or environmental changes.
- Wandering: Wandering is a common behavioral symptom in dementia. Individuals may aimlessly walk or roam, sometimes becoming disoriented and lost. Wandering can pose safety risks, and caregivers often implement strategies to manage and prevent it.
- Repetitive Behaviors: Repetitive behaviors, such as repeating words, actions, or questions, are common in dementia. These behaviors may stem from memory loss, anxiety, or an attempt to cope with confusion.
- Sundowning: Sundowning refers to an increase in agitation, confusion, and behavioral symptoms that often occurs in the late afternoon or evening. The exact cause of sundowning is not fully understood but may be influenced by factors such as fatigue, changes in lighting, or disruptions in the sleep-wake cycle.
- Depression and Withdrawal: Individuals with dementia may experience symptoms of depression, leading to feelings of sadness, hopelessness, and withdrawal from activities. Social isolation and a decline in interest or pleasure in previously enjoyed activities can contribute to depressive symptoms.
What are common behaviors of dementia?
Dementia can manifest with a wide range of behaviors, and the specific behaviors can vary among individuals and the type and stage of dementia. Common behaviors associated with dementia include:
- Memory Loss: Forgetfulness, particularly for recent events or names, is a hallmark symptom of dementia. Individuals may repeatedly ask the same questions or forget the names of familiar people.
- Confusion: General confusion about time, place, and people is common. Individuals may become disoriented, not recognizing their surroundings or understanding the current situation.
- Difficulty Communicating: Dementia can affect language abilities, leading to difficulties in finding the right words, forming coherent sentences, or understanding others. Communication challenges may contribute to frustration and agitation.
- Wandering: Wandering behavior, where individuals aimlessly walk or roam, is common in dementia. This behavior can pose safety risks, as the person may become lost or disoriented.
- Agitation and Aggression: Agitation, restlessness, verbal outbursts, or physical aggression can occur. These behaviors may be triggered by confusion, frustration, or an inability to communicate effectively.
- Repetitive Behaviors: Repetitive actions or questions are common in dementia. Individuals may repeat the same words, phrases, or actions, often as a way of coping with memory loss or anxiety.
- Sundowning: Sundowning refers to an increase in confusion, agitation, and behavioral symptoms in the late afternoon or evening. The exact cause is not fully understood but may be related to fatigue or changes in the sleep-wake cycle.
- Depression and Anxiety: Symptoms of depression, such as persistent sadness, withdrawal, and loss of interest, can occur in individuals with dementia. Anxiety, characterized by restlessness and heightened worry, is also common.
- Personality Changes: Dementia may lead to changes in personality, such as increased irritability, apathy, or a loss of social inhibitions. Individuals may exhibit behaviors that are different from their pre-dementia personality.
- Difficulty with Activities of Daily Living: Individuals may struggle with routine tasks such as dressing, bathing, grooming, or managing medications. This decline in functional abilities can contribute to dependency.
What do dementia patients mean when they say they want to go home?
The phrase "I want to go home" is a common expression among individuals with dementia, and it can have various meanings. Understanding the underlying reasons behind this statement requires careful observation and consideration of the individual's context and emotions. Here are some possible explanations for why individuals with dementia may express a desire to go home:
- Seeking Comfort and Familiarity: "Home" may represent a place of comfort, safety, and familiarity for the individual. Expressing a desire to go home may be a way of seeking reassurance and a return to a familiar environment.
- Routine and Structure: The concept of "home" is often associated with routine and structure. Individuals with dementia may feel disoriented or anxious due to changes in their surroundings, and expressing a desire to go home could be a way of seeking the safety of a familiar routine.
- Temporal Confusion: People with dementia may experience temporal confusion, where they are unsure of the current time or date. The desire to go home may be related to a perception that it is time to return to a specific place or period in their life.
- Emotional Discomfort: The phrase could be an expression of emotional discomfort or distress. Individuals with dementia may use familiar phrases to communicate feelings of anxiety, loneliness, or frustration.
- Communication Difficulties: Dementia can impact communication abilities. "I want to go home" may be a simple and familiar phrase that the individual can express, even if they are unable to articulate specific needs or feelings.
- Memory Loss: Memory loss is a hallmark symptom of dementia. The person may not remember their current location or may be recalling a previous home from their past.
What should you not say to someone with dementia?
When communicating with someone with dementia, it may be important to be mindful of the language and approach used, as individuals with dementia may be sensitive to certain words or phrases. Here are some general guidelines on how to speak to someone with dementia:
- Use Simple Language
- Be Patient and Take Your Time
- Ask Questions With Definite Answers
- Stay Positive
- Treat Them Like an Adult
- Speak Softly and Calmly
What is the number one trigger for dementia behavior?
There isn't a single "number one trigger" for dementia-related behaviors because the causes of behaviors in individuals with dementia are complex and multifactorial. Dementia affects the brain in various ways, and behavioral symptoms can result from a combination of factors, including changes in the brain, environmental influences, and individual experiences.
However, some common factors that may contribute to challenging behaviors in individuals with dementia include:
- Communication Difficulties
- Environmental Factors
- Facing an Unmet Need
- Physical Discomfort
- Medication Side Effects
- Changes in Routine
- Stress and Anxiety
- Lack of Stimulation
What are the strange behaviors of early dementia patients?
In the early stages of dementia, individuals may exhibit behaviors that are considered unusual or out of character. These behaviors can vary widely, and the specific manifestations depend on the type of dementia, the individual's personality, and other factors. Here are some common strange behaviors observed in individuals with early dementia:
- Repetition: Individuals may repeat the same questions, stories, or activities frequently. This behavior is often a result of memory impairment and difficulty retaining new information.
- Misplacing Items: Forgetfulness and difficulty organizing thoughts can lead to the misplacement of everyday items. Individuals may put things in unusual places or struggle to recall where they left their belongings.
- Social Withdrawal: Early on, individuals with dementia may exhibit changes in social behavior. They might become more reserved, avoid social activities, or withdraw from friends and family.
- Difficulty Planning or Organizing: Challenges in planning and organizing daily activities may become apparent. Individuals may struggle with tasks that involve multiple steps or coordinating different elements.
- Time and Place Disorientation: Individuals may lose track of time or have difficulty recognizing familiar places. They may become disoriented even in environments that were once well-known to them. Caregivers may provide time-tracking devices to help patients to keep a schedule.
- Changes in Judgment: Early dementia can affect a person's judgment, leading to decisions that seem unusual or risky. This could involve financial decisions, personal safety, or other aspects of daily life.
- Impaired Sense of Direction: Individuals may experience difficulty navigating familiar routes, becoming lost in places they've known well.
What triggers dementia to get worse?
Dementia is a progressive condition, and its progression can be influenced by various factors. While the underlying causes of dementia, such as Alzheimer's disease or vascular dementia, contribute to its course, certain triggers or factors can exacerbate symptoms or lead to a more rapid decline in cognitive function. Here are some factors that may influence the progression of dementia:
- Medical Conditions: Coexisting medical conditions, such as infections, dehydration, vision or hearing loss, or metabolic imbalances, can worsen cognitive function in individuals with dementia. It may be important to manage and treat any medical issues promptly.
- Stress and Anxiety: High levels of stress or anxiety can contribute to worsening symptoms in individuals with dementia. Creating a calm and supportive environment is important for minimizing stress.
- Lack of Mental Stimulation: A lack of mental stimulation and engagement may contribute to cognitive decline. Activities that provide cognitive stimulation and social interaction can be beneficial.
- Depression: Depression is common in individuals with dementia and can cause emotional pain and worsen cognitive function. Identifying and treating depression is essential for overall well-being.
- Poor Nutrition: Inadequate nutrition can impact cognitive health. A well-balanced diet that supports brain health is important for individuals with dementia.
- Sleep Disruptions: Changes in sleep patterns may impact the progression of dementia. Studies have shown that dairy before bed, such as a glass of warm milk, may help to improve sleep. There are also various over-the-counter medications that may aid in sleep as well.
- Social Isolation: Lack of social engagement and isolation can negatively impact cognitive function. Encouraging social interactions and participation in activities can be beneficial.
- Lack of Physical Activity: Regular physical activity has been associated with cognitive benefits. Lack of exercise may contribute to a decline in overall well-being.
What are signs that dementia is getting worse?
The progression of dementia symptoms varies among individuals, and the signs that dementia is getting worse can depend on the specific type of dementia, the underlying causes, and the person's overall health. However, there are some common signs and symptoms that may indicate a decline in cognitive function and worsening of dementia:
- Increased memory loss
- Challenges with communication
- Disorientation and confusion
- Decline in problem-solving abilities
- Changes in mood and behavior
- Loss of motor skills
- Difficulty in doing a specific task
- Worsening judgment
- Inability to recognize familiar people or familiar objects
- Loss of independence in activities of daily living
- Changes in sleep patterns or new sleep problems
- Difficulty swallowing
- Hallucinations or delusions
- Wandering behavior
As symptoms get worse, families or caregivers may take a larger role in managing memory loss symptoms. In some cases, a memory care facility may be the best option for managing symptoms and providing individuals with the support they need.
What is the anger stage of dementia?
The term "anger stage" is not a specific or universally recognized stage of dementia. However, according to the Alzheimer’s Association, some individuals with dementia may exhibit anger or aggression as part of their behavioral symptoms. Agitation, anger, or aggressive behavior can occur at various stages of dementia and may be triggered by a range of factors. It may be important to understand that these behaviors are typically a manifestation of the underlying changes in the brain and are not intentional.
What are 3 things to never do with your loved one with dementia?
Caring for a loved one after a dementia diagnosis requires patience, understanding, and adaptability. Here are three things to avoid when interacting with someone with dementia:
Arguing or correcting:
Avoid arguing with or correcting the person with dementia, especially if they express false beliefs or memories that differ from reality. Correcting them can lead to frustration, confusion, and distress. Instead, try to validate their feelings and enter their reality. Redirecting the conversation or providing reassurance can be more helpful.
Rushing or impatience:
Individuals with dementia may need more time to process information, make decisions, or complete tasks. Avoid rushing them or expressing impatience, as this can lead to stress and frustration. Allow them the time they need, and approach tasks with a calm and patient demeanor.
Taking their behavior personally:
Changes in behavior, including aggression or agitation, may occur in individuals with dementia. It may be important not to take their behavior personally or to feel guilty. Dementia affects the brain, leading to behavioral changes that are beyond the person's control. Instead of reacting emotionally, family, friends, and other caregivers may try to understand the potential triggers for the behavior and respond with empathy and compassion.
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