Monday, November 12, 2007

Managing Behaviors That Occur in Dementia

Behaviors and psychological symptoms of dementia can be a burden to caregivers and effect the quality of life for both the caregivers and the recipient of care. The key to any behavior is to first understand the behavior and what is driving it. What is the nature and extent of the problem?

What triggers the behaviors?
Noisy rooms
Loud music
Being tired
Need for toileting
Change in Routine

The severity of problem behaviors is often evaluated by the risk of harm to the person with dementia or to those caring for him or her. Hitting or kicking would be considered more severe than verbal agitation. Keep in mind that all behavior has meaning. Because a person with dementia cannot think logically, their behavior is more difficult to understand. The person wih dementia is not acting purposefully, they cannot control outbursts or irrational behaviors.

Behaviors have three parts:
1. A trigger: something that causes a response
2. Problem behavior occurs
3. Consequence to behavior

It is helpful to keep a diary to evaluate what is occuring in the environment that may be causing a behavior. Facial expressions and body language may provide some clues. Time of day, a particular activity such as meal time or bathing may trigger a behavior. An activity such as a bath may be well received in the morning when the person with dementia is well-rested, but he or she becomes agitated if the bath is given in the evening when he or she is more tired.

Sleep disturbances are also common with night time awakening and excessive napping during the day. It is important for the person with dementia to get adequate sleep balanced with adequate daytime exercise. Discourage long naps dduring the day and provide regular exercise and activities. If your loved one awakens at night time, keep the lights low, speak softly, provide a light snack, calming music, and perhaps a back rub.

Its also important to evaluate whether or not your loved one is experiencing pain, causing disruptive behaviors. Look for moaning, pacing, grimaces, or increased problem behavior with movement. Speak with the physician to get your loved one appropraite pain relief if this is occurring.

People with dementia find it diffuclt to plan and adapt due to the cognitive changes with dementia. It is extremely helpful to have a consistent routine with few changes from day to day. A change in routine is likely to cause anxiety and an increase in problem behaviors. Schedule personal care activities at the same time every day to avoid needless anxiety.