A study from Columbia University estimates that roughly 10% of adults over age 65 in the United States have dementia or Alzheimer’s disease. While the number may not sound particularly high, put it into perspective: 10% is the same as one in 10 individuals. At this number, it is likely that if you don’t know anyone currently facing this cognitive disease, the chances are high that you will in the future—whether that be a friend or family member. As a caregiver, learning that a loved one (or a client) has recently been diagnosed with this degenerative condition is difficult to swallow. Understanding challenging behaviors in dementia clients is crucial to providing them with the best care possible.
What are “challenging behaviors?”
“Challenging behaviors” refer to a wide variety of symptoms that can arise in dementia patients. While the description may seem vague, it is because these behaviors don’t just cover one specific type of problem. They can encompass behavioral problems, disruptive behaviors, and inappropriate behaviors. A few examples include, but are not limited to:
- Hoarding
- Wandering
- Suspicion or paranoia
- Anger and agitation
- Physical and verbal aggression
Some dementia patients only experience a state called “pleasant confusion,” which is characterized by gradual forgetfulness and decreased awareness. While this is ideal, it is not the standard, so it is important to be ready for any of the above challenging behaviors.
When do these behaviors appear?
Dementia occurs over a series of seven stages that vary from normal behavior to very severe decline. Though there is nothing about the condition that one would identify as “good,” you thankfully don’t have to worry about your loved one developing a host a challenging behaviors all at once. They may appear slowly over a series of years, giving you time to adapt to these changes as they come.
In the early stages of Alzheimer’s or dementia, your loved one is likely attempting to fight these changes in their memory. Some seniors develop behaviors that lead to obsessive-compulsive disorder as they attempt to stick to a routine and prevent mistakes. Others begin hoarding to offset when they misplace items or forget they already have it.
Anger, aggression, and agitation may begin to appear in the middle stages as the senior experiences a decline in reason and logic. In some older adults, this can be exacerbated by symptoms such as paranoia and hallucinations (usually auditory). This can lead them to start wandering when they should not.
As the disease progresses to late-stage Alzheimer’s or dementia, seniors may grow apathetic or withdrawn. The challenging behaviors they previously exuded may be replaced with new challenges, such as the need for assistance with personal care.
How to handle these behaviors
Finding ways to manage your loved one’s challenging behaviors will involve some trial and error. However, there are a few tried and true methods that have been shown to work for many older adults. Discovering what that is will make both your lives easier.
- Agitation and anxiety—safety-proof the home preventatively, address any environmental chaos (reduce noise level and/or number of people in the space), keep household objects in the same location, play relaxing music
- Communication issues—limit distractions when having a conversation (turn off television or radio), speak clearly, interpret the feeling behind words, offer verbal and nonverbal reassurance
- Delusions, hallucinations, or paranoia—redirect when possible, treat them with the same dignity and respect, avoid arguing, speak with the doctor to determine if medication would help
- Wandering—install alarms that alert when the door opens, add “child safe” covers to doorknobs, keep a GPS tracking device on their person, keep a current photo of them with you in case they get out
How to make these behaviors easier for YOU to manage
Whether you’re an experienced caregiver or this is your first time caring for an elderly loved one, the process of understanding these challenging behaviors is difficult. Remembering these tips, however, will make the process a little bit easier for you—both in your work and mentally.
- Anticipate their needs by knowing their personal schedule to keep them comfortable
- Instead of trying to control certain behaviors, which can lead to agitation, accommodate your treatment of them
- Know their needs may change from day to day, so be flexible in your treatment
- Remind yourself that you cannot change their behavior
- Be compassionate
- Don’t be afraid to ask for help from family and friends when you need it
If you need more help, consider home care
The needs of a person with dementia or Alzheimer’s are often diverse and demanding. Handling it all on your own can feel practically impossible. If this is something you are struggling with, consider calling upon the help of a direct care worker.
If you and your loved one live in the greater Phoenix area, give Home Care Powered by AUAF a call. Our staff has the training and compassion your loved one needs to live at home. Get in touch with us at (623) 526-6367.
