How to best manage behaviours that challenge

This is for anyone who has a loved one with dementia and may be finding it hard to understand what they are experiencing or how best to respond. Communication difficulties can be one of the most upsetting elements of caring for someone with any form of dementia. It can often be hard to understand why people with dementia act the way they do, the explanation is attributable to their illness and the changes it causes in the brain.

Being fully aware of the common situations that may arise with someone who has dementia, will enable you to respond effectively. The following strategies will help manage the more known challenging behaviours. With each of these common situations is guidance on how to respond and better them.

Aggressive speech or actions

“I don’t want to drink that!” or “I want to go home!” are comments that may arise and sometimes spiral into distressed behaviour. The most important thing to remember about verbal or physical aggression, is that they are not doing it on purpose. Stressed behaviours are is usually triggered by something else, often environmental factors such as being in an unfamiliar situation.

Responding to distress caused by dementia is to try to identify the cause, what is the person feeling to make them behave this way? Once you have made sure they aren’t putting themselves (or anyone else) in any danger, you can try to shift the focus to something else, while speaking in a calm and reassuring manner. Avoid engaging in an argument or forcing the issue that’s creating the tension, don’t restrain the person unless there is absolutely no other choice.

Confusion

Comments and questioning such as “I want to go home!”, “Why are we here?” or “When are we leaving?” are common. The wanting to go home is a natural response for anyone feeling lost or disorientated, a longing to go back to a place where they had control.

Try simple explanations accompanied by photos and sentimental reminders or alternatively, it sometimes may be kinder to redirect the conversation. For instance, if you are preparing them to move into a care home, find instead a different activity to focus on. Be it going for a walk or making a cup of tea, choose whatever will make them feel the safest.

Impaired judgement

If your loved one states odd accusations, it is to be ignored as errors in thinking are a commonality in dementia. These inaccurate beliefs can range enormously from slight to extreme. Minimise their frustration by offering help, for example, help them stay organised with bills or perhaps make a phone call on their behalf. Be encouraging and reassuring if you’re seeing these changes occur. Do not question the person’s ability to manage the situation at hand or engage in a disagreement, simply remain on their side.

Anxiety

Anxiety and depression are more common earlier in the condition. Behaviours including becoming withdrawn, not being able to sleep, low of energy and being noticeably more emotional. As the symptoms for anxiety and depression are very similar it can be difficult to know if someone with dementia is depressed, so it’s important they visit their doctor as this can be treated with medication.

Remain positive and reassure them help can be given. Making sure your loved one feels secure in their routine will help ease this. Encouraging them to focus on the elements of their day they can still comfortably do will improve their wellbeing.

Communication Techniques

Learning how to connect effectively with a loved one who has (any type of) dementia will help you to cope far better and maintain a relationship with them. As a starting point, here are some communication pointers to keep in mind when spending time with someone who has moderate to severe dementia.

• Names are important when greeting a loved one with dementia. For instance: “Hi Gran, it’s me, Laura,” as opposed to “Hi, it’s me.” Avoid pronouns like “he,” “she,” and “they” to provide reassurance.
• Consciously conduct conversations, speaking clearly but naturally in a calm tone. Try to never talk to them as though they are ill or as if they are a child.
• Avoid loud environments so distractions are minimised. Whenever possible find a place and time to talk where your loved one can focus all their mental energy on the conversation at hand.
• Patience is the most central focus, it’ll help maintain positive and open conversations. Give your loved one extra time to process what you say and to respond. It’s natural to feel frustration occasionally, and may signal you need a small break, simply pause the conversation for a moment.
• Actively listening to what your loved one is telling you and politely let them know if you’re a little unclear.
• Focused conversations on one topic at a time is very helpful. Someone with dementia might not be able to adapt to multiple conversation streams easily, which could lead to frustration.
• Nonverbal cues such as holding eye contact and smiling will help comfort your loved one and help them understand the situation.
• If conversation is strained or difficult try music instead. Music is stored in portions of the brain that often remain vibrant late into various dementias. Sharing their favourite music with them can often create great meaning.
• Gentle acceptance of the situation, understanding that people with dementia will gradually have a more difficult time understanding others as well as communicating in general, it’s neither their fault or within their control.
• If any delusions are shared don’t correct their inaccuracy. Not only will it not help your conversation, it may in turn cause considerable upset so steer talks on to other topics.
• Just like anyone else, people with dementia will have ups and downs. Embrace the fact that there’ll be good days as well as bad days, taking each as they come.

If you are looking for care,Care Sourcer offers a free searchable directory of local care agencies. If you need care urgently, we also have a team of care experts who are available by telephone to help guide you through the process.