The Key to Understanding the Challenging Behaviors of Dementia

• Anger
• Apathy or disinterest
• Changes in personality
• Communication problems
• Following another person around the house all day (sometimes called shadowing)
• Mood swings
• Nighttime waking
• Pacing or wandering
• Violent behavior
• Restlessness
• Verbal Abuse

Tips for Dementia Caregivers

1. Ask for help from others. Getting input from experts and fellow caregivers can help you find a new solution, take a new course of action, or better understand the underlying cause of challenging behaviors.
2. Attempt to accommodate the behavior if possible. Trying to control a difficult behavior often backfires.
3. Be aware that the underlying cause of some symptoms can be a physical problem. Always report behavioral symptoms to a health care provider.
4.  Be prepared to be flexible. What works today may not work tomorrow.
5. Change your perspective. The best way to do something different is to first attempt to see it differently. Changing how you see and react to a situation will oftentimes enable the person with dementia to exhibit different behavior.
6. Develop coping strategies in advance. There are good days and bad days in dementia care. It’s best to be prepared.
7. Disrupt patterns that may contribute to negative behavior. For example, try a different way of asking a person with dementia to do something.
8. Employ compassion, flexibility and patience.
9. Keep in mind that although you cannot change your loved one’s behavior, you can always change your own.
10. Remember that behaviors are motivated by something. Although it may not seem like it, a person with dementia is usually making a statement, even when performing repetitive actions. They may be acting out of a sense of needing to do something meaningful or productive.
11. Try to anticipate the person with dementia’s underlying needs. This will allow caregivers to redirect many negative behaviors. For example, a person who is bored can be redirected to help with simple household chores (with supervision, of course).

How to Handle Agitation and Anxiety

• Addressing any chaos in the environment by reducing noise levels and the number of other people nearby
• Avoiding moving household objects whenever possible (familiar objects located in the same places can provide a sense of security)
• Changing the immediate environment when the person with dementia becomes agitated
• Playing soothing music
• Safety-proofing the environment to allow for as much autonomy as possible

How to Handle Communication Problems

• Giving reassurance
• Limiting outside distractions when attempting to communicate (turn off the radio and television)
• Listening for the meaning of the feelings behind their words
• Speaking clearly and loud enough to be heard
• Using non-verbal means of communication (such as body language, facial expressions, and touch)

How to Handle Delusions, Hallucinations and Paranoia

• Avoid arguing or trying to impose a sense of truth or reality onto the person with dementia
• Consult with a health care provider to find out if medication may be needed
• Reassure the person by saying things like: I am sorry you are getting upset by this.
• Redirect the person with dementia to divert their attention to something more appropriate

How to Handle Sleeplessness and Sundowning

• Avoid giving your loved one alcohol, caffeine or sugar
• Hiring help at night so you can get enough sleep without having to leave your loved one with dementia unattended
• Discouraging long naps during the day
• Talking to a health care provider about natural sleep-inducing medication, such as melatonin
• Turning the lights on and closing the curtains well before sunset to eliminate confusion about the time, particularly in the winter months

How to Handle Wandering

• Adding “child-safe” plastic covers to doorknobs
• Considering a GPS tracking device
• Keeping a current photo on file, just in case the person with dementia goes missing
• Installing door alarms and set them to go off if the door is opened
• Installing locks that require a key (keeping safety issues in mind for all people in the home)