Dementia is a very complex illness that can manifest in many different ways. Knowing how best to look after your loved one when they cannot communicate what is wrong can be a real challenge. Here, we are going to discuss tackling tricky behavior in dementia patients so that you can care for your loved one in the best way possible.
Mood Swings in Dementia Patients
Mood swings in dementia patients are very common and are a symptom of the disease. In some cases it may come across as depression or low feelings. This is completely understandable when whole worlds seem to be changing, and day-to-day events are confusing. Other times the behavior may come across as aggressiveness. There are several reasons why your loved one may be presenting with aggression. It could be that they are feeling unheard or misunderstood. It could be that they are frightened or threatened. Or it might just be that they are embarrassed that they are no longer able to do things independently.
In all cases of mood swings, it is important to understand that the aggression or sadness is not linked to you, but rather a response from the patient's lived experience. To avoid the ups and downs of a loved one’s moods, try to keep lines of communication open. Be sure to ask them how they are feeling. Keep them informed of what is happening day to day and ensure them that their voice is being heard. If the mood swings get too much for you, consider ways that you could have a little time away from the situation, such as a paid caregiver or a day center.
Wandering
When we think about the symptoms of Alzheimer’s or dementia we think about confusion, getting things muddled up, and losing track of one’s thoughts. Wandering can be a by-symptom of this, particularly if a patient is not aware of their reality and is left unattended. However, another symptom of dementia that compounds this issue is walking.
It is not entirely known what it is in people’s minds that trigger an episode of walking in dementia, but some logical explanations could be that they are trying to relive an old routine, they have excess energy they need to get rid of, or that they think they have lost something and need to find it. While this looks like wandering from the outside, in the patient’s mind it is a very purposeful walk to their end goal. Watching your loved one and ensuring that their environment is safe and secure (such as keeping doors locked and hazards out of reach) will alleviate the risks associated with wandering.
Sundowning in Alzheimer’s Patients
A lesser-known behavior trait of dementia patients is sundowning. Described as a period of heightened agitation around dusk or sundown, the patient becomes increasingly frustrated or concerned around dusk, which can affect their moods, make them lash out, or get upset. Sundowning can make patients feel as though they are in the wrong place and that they need to be elsewhere, such as attending a doctor’s appointment or picking up their children from school (despite their children being adults now).
There are a few ways to manage sundowning which include distraction techniques (taking them into a different room or having a snack), discussing their frustrations with them, and comforting them both verbally and physically while they work through the anxiety. You can also try to avoid sundowning altogether by limiting the patient’s caffeine, limiting daytime naps, avoiding large meals in the evening, and introducing an enjoyable evening routine that distracts them from that time of day.
Restlessness
Restlessness is closely linked to wandering and can include fidgeting, moving around, and trying to leave the home. While burning off this excess energy is not a bad thing, it does need to be done in a safe and controlled environment to reduce the risk of danger to your loved one. There could also be other reasons for a person presenting with restlessness which include (but are not limited to) needing the toilet, boredom, having pain, feeling anxious, hungry, or thirsty, or being in an unfamiliar environment.
To deal with restlessness, first ensure that they do not need food, drink, or the toilet. Look for nonverbal cues as dementia patients cannot always recognize these needs. Try to engage them in an activity that will keep them busy, such as a puzzle, craft, or gardening. Use music, reading aloud, or a tv program to keep their attention and give them something to focus on. Fidget toys are activities that keep their fingers busy and are also really useful tools.
Repetition
As Alzheimer’s and dementia affect the brain and memory, repetition is a common symptom of the disease which is often the first sign of the illness. Alzheimer’s, in particular, affects short-term memory, meaning that patients have the comfort of their long-term memory to refer back to while the present and near past are a muddle of thoughts. People will often repeat memories from their childhood or younger years as they are not only fond memories to look back on, but are important milestones in their memories.
There are several ways that you can help your loved one with their short-term memory to avoid repetition. These include memory aids, such as a picture clock, a diary, or a printed daily schedule. Occasionally dementia patients will “get stuck” on an activity or phrase which they feel the need to repeat. Try to distract them from the cycle with a change of scenery or a different activity. Finally, make sure that you value the memories that your loved one speaks about. Talk to them, record them or use photos to reminisce.
Conclusion
Remember that tackling tricky behavior in dementia patients can be a drain on your energy and mental strength. Take some time to care for yourself as well as your loved one and if it gets too much, consider a paid caregiver to lighten the load. There are also lots of caregiver support groups and forums available to help you get the support you need. Please, do not suffer alone.
