How to address difficult behaviour associated with dementia

One of the major challenges in caring for a loved one with dementia can be coping with the troubling behavior and personality changes that often occur. It’s important to remember that the person with dementia is not being deliberately difficult. Your loved one’s sense of reality may be different to yours, but it’s still very real to him or her. Almost everyone living with dementia will show signs of changed behavioural patterns and this happens due of many reasons. Your loved one may react differently because they do not understand what is happening to them or they may have unmet needs. The reasons for changed behaviour varies but a common cause is that those living with dementia are often frustrated because they cannot communicate and therefore can’t control their emotions. These reasons sometimes force them to act in socially inappropriate ways which society labels as difficult.

 

Remain Calm
It is crucial for caregivers to remain calm in these situations. If a caregiver is frustrated or angry, it can affect the loved ones that you are caring for.

 

Identify Causes
As a caregiver, you need to look at behaviors that can harm your loved one or others. You have to try to prevent such behavior and also try and stop it before it becomes too difficult to manage. The best way to prevent difficult behaviour is to try and understand what is causing it in the first place. When this is understood and your loved one’s needs are met, you will notice a decrease in their difficult behaviour. Common causes include pain, over or under stimulation, illness or infection, medication or a change in routine or environment.

 

Look for Triggers and Cues
A trigger is something that causes or influences challenging behaviour and usually pushes the person over the edge, thus leading to an incident. If you can determine triggers, they may be words, people or situations, they can be avoided in the future thus preventing the incident. Cues are indications given by the person with dementia right before an incident occurs, they can include an increase in movement, certain facial expressions or voice tone. If you can identify the person’s cues you can also prevent incidents from occurring.

 

Manage Stress
Stress and the environment your loved one is in could be a reason for challenging behaviour. Different stress-reducing techniques work better for some than others, so you may need to experiment to find the ones that best suit your loved one. Exercise, music therapy, gardening etc. are all useful techniques to limit stress.

 

Follow this step by step approach

  1. What happened? –  Identify the causes of the behavioural problems.
  2. What happened before the incident? Sometimes situations prior to the behaviour can be identified as triggers for the behaviour
  3. When did it happen? – Look for patterns that help you predict and prevent problem behaviors.
  4. Where did it happen? – What effect are environmental changes having on your loved one?
  5. Why did it happen? –  Identify the causes of the behavioural problems.
  6. What happened after the incident?- How did you handle it and could you have handled it differently?
  7. How do I fix it? – Find out how you can get through the difficult behaviour and implement changes.

Support groups are useful to discuss problems and share ideas. These groups allow you to meet other caregivers and get many viewpoints and tips. Shared experiences give ideas of possible reasons for strange behavior, and also possible solutions. We encourage you to join the Livewell Support Groups which take place every month. For more details please contact us directly.

One Response to “How to address difficult behaviour associated with dementia”


  • Dan van Heerden / / Reply

    I’m interested in joining a support group in Pretoria, preferably in the northern suburbs should such groups exist.


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Since 2011, the Livewell Group has been at the forefront of dementia and Alzheimer’s care in South Africa. We are motivated by a personal and heartfelt concern for the dignity and care of our elders and our efforts continue to be encouraged by the strong market need for specialised individual care.

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