No doubt about it: personality changes with dementia can be complex.
It’s hard to watch a person you know and love change as they deal with dementia behaviors of concern. Even if there isn’t much you can do to change dementia with behavioral disturbance, understanding the impact of these disturbances and doing your best to respond productively can make all the difference.
Keep reading for common behaviors of dementia, including tips for how to deal with dementia practically.
Understanding Dementia and Its Impacts
Dementia is a progressive disease affecting cognitive abilities, including thinking and reasoning. People with dementia also experience memory loss, and may struggle to regulate their emotions properly. Generally, dementia affects the geriatric population.
Multiple types of dementia exist, with Alzheimer’s disease being the most common. Although distinctions exist between the types, each kind of dementia prevents the brain from operating properly.
The different types are listed below, along with the main cognitive, emotional, and psychological symptoms they are typically associated with:
- Alzheimer’s Disease: wandering, repeating words, inability to recognize familiar faces, trouble communicating
- Frontotemporal Dementia: problems with planning, emotional extremes (either a lack or excess of emotions), difficulty speaking
- Lewy Body Dementia: trouble concentrating, illogical ideas
- Vascular Dementia: forgetting events or instructions (either current or in the past), misplacing familiar items
Common Behaviors of Dementia
Because dementia affects the brain in somewhat unpredictable ways, there are many behavioral symptoms that a person with Alzheimer’s disease or dementia can experience.
Although there are some differences between dementias and disease stages, the following behaviors are common symptoms of dementia to look out for:
- Disorganization
- Hallucinations
- Impulsive behavior
- Poor judgment calls
Dementia is more than occasional forgetfulness or making a bad decision every once in a while. As mentioned above, it’s progressive disease, meaning symptoms may worsen over time as the dementia progresses.
Knowing the stages of dementia can help you cope with the current stage and prepare for the next stage with the proper support system. Here are the basics to know about each stage as it relates to behavior change:
- Early stage: may still be able to carry on routine activities but have difficulty making sense of more complex decisions, instructions, problems, or communication
- Middle stage: more noticeable difficulty managing daily activities and regulating emotions and a need for more frequent reminders or help, accompanied by worsening difficulties with recognition and possible paranoia or delusions
- Late stage: a need for full-time support usually emerges as the person nears the end of their life, and problems with perception persist
Although each stage and symptom of dementia has nuances that make it challenging, late-stage dementia can be particularly heartbreaking for both the individual with the disease and their caretaker.
At this stage, people with dementia may ask to visit with a loved one who is no longer alive or stop recognizing the familiar faces of children or spouses. They may even struggle to recognize the face they see staring back at them in the mirror.
Dementia Behaviors of Concern
As you watch a friend or family member progress through the different stages of dementia, it can be challenging to decide when to intervene. When does mild memory loss become a concern for physical and mental safety?
If you’re concerned about specific behaviors, keep a keen eye out for when your loved one starts to have difficulties with their daily routine. This can be a great point to step in and offer help, and you can hire additional help (as needed) as the dementia progresses.
Struggling with short-term memory (such as forgetting recent events or communication) can signal that it’s time for enhanced support. Trouble remembering a familiar person’s details (such as a phone number) can also be concerning since the affected individual may be unable to reach out for help in an emergency.
Unfortunately, even in the early stages of dementia, mood and emotional disturbances are common. They can range from mild to severe, so be prepared for a range of any of the following behaviors as dementia progresses:
- Anxiety
- Agitation (including screaming or shouting)
- Aggression (such as with sundowning)
- Apathy (such as loss of interest in hobbies or people they once found important)
- Depression
- Fear
- Frustration
- Irritability
- Lack of self-confidence
- Loss of inhibitions (not understanding what’s appropriate for a given setting)
- Sadness
- Sleep disturbances
- Taking repetitive actions
- Withdrawing
It’s worth noting that dementia also impacts eating behaviors. People struggling with dementia may find it difficult to remember when they last ate. Hunger may also be a need they can’t properly communicate, opening the door for fear or agitation.
In late stages, dementia patients may need a lot of help with eating and could have trouble swallowing, which can ultimately lead to changes in weight. As you can see, the interplay between physical and mental manifestations of dementia can be pretty complex.
How to Deal with Dementia
Contrary to popular belief, dementia isn’t just doom and gloom. Although it can be incredibly taxing and heartbreaking much of the time, it also offers opportunities for meaningful connection (even if for just a few moments).
It’s an intense journey, but being aware of potential behavioral challenges can help you to cope better. From practical everyday strategies to more intensive medical interventions, here are a few ideas worth considering.
Cater to the Stage
As mentioned above, understanding the dementia stage can help you to serve an individual with dementia best. Even though some tips and tricks can apply regardless of stage, cluing in their care needs right now can help you address the stage they are currently in.
Each situation will be different, but some general care guidelines may inform the way you assist a person with dementia. Try to help them remain as independent as possible in the early stages. Assist them in their routine, and employ reminders, clues, cues, or prompts to help them handle daily tasks.
For the middle stage, much more assistance will be needed, such as help with the basic tasks of dressing or bathing. It’s helpful to acknowledge that your loved one or the person you’re caregiving for may feel embarrassed about this, even if they don’t know exactly why. Often, hiring professional caregivers at this stage is appropriate. Understand that sundowning, behavioral changes around late afternoon, sometimes signals that a need (like hunger) has not yet been met.
In late-stage dementia, it’s helpful to know that the affected person may still be able to make some sense of body language, such as gestures or facial expressions. While they may not be able to communicate well, you may be able to obtain some sort of exchange of information through non-verbal cues. This can be a valuable way to assess their feelings or needs.
Self-Care and Support for the Caregiver
Caring for a person who exhibits relentless behavioral issues can take its toll on you. Setting aside time and space for yourself is crucial, whether that be a daily self-care practice or a biweekly therapy session.
As you learn to regulate better and express your own emotions, you may see a positive change in your relationships. Even though you’re dealing with a person who has dementia-related behavioral problems that may not change, you’ll likely be better able to handle the curveballs this person throws your way when you’re taking care of your own physical and emotional needs.
Have a Mantra In Mind
Although it’s easier said than done, staying calm can help when agitation occurs. Many people find peace by keeping a mantra, saying, or affirmation in mind when the going gets tough.
One popular practice with dementia is to repeat the phrase, “It’s the disease talking, not the person I know and love.” This can help provide perspective during difficult moments and separate the person who means a lot to you from the disease damaging their ability to respond appropriately.
Consider Home Care
Caring for someone with dementia can get to be too much for one person. Involving family or friends can help, but some level of outside help is often needed for everyone to feel supported in their roles. Although hiring a professional service can be a costly option, it may be worth pursuing if it would best suit the needs of your loved one suffering from dementia.
One aspect of home care to remember is that many degrees of help are available. In the early stages, you may be able to hire help to visit once a day. In the later stages, you may opt for a facility specifically designed for dementia patients. There are multiple options for meeting the needs of an individual with worsening dementia.
Look Into All Treatment Options
Even though dementia doesn’t have a cure, possible treatments are available. Certain medications may help reduce the severity of some symptoms, and it’s worth asking your doctor about these options. However, some medications may have side effects on mood and behavior, so it’s important to discuss the risks and benefits of each medication thoroughly.
You may also want to pursue more “out-of-the-box” therapies like music therapy. Although not necessarily conventional, art or music therapy may stimulate different brain parts and allow someone with dementia to connect or communicate uniquely.
Sometimes both the person with dementia and the caregiver can participate in these therapies, which may help you create new, positive memories with your loved ones if managing their care has recently felt like more of a burden than a blessing.
Seek Out Support
Building a web of supportive people can make the daily struggles of dementia a lot more manageable. If you don’t have family and friends nearby, looking to professional organizations or behavioral specialists for help is okay.
Ideally, you’ll want someone to share responsibilities with and a couple of people you can call in case of emergency who are reliable options for care. There’s no shame in admitting you can’t manage the difficulties of dementia all on your own and enlisting added help.
Beyond the complex emotions your dementia patient is feeling, you may be experiencing a complex set of emotions yourself! Finding support groups can help and connect you with great resources and practical tips you may not have been exposed to otherwise.
If possible, try and find a support group of people dealing with the specific stage of dementia you’re concerned with. This can help you individualize your approach and apply tips more apt for the unique stage you’re struggling with.
The Bottom Line on Dementia Behaviors
Since dementia affects the brain, it can be an impactful disease. Beyond memory loss, changes in behaviors may cause concern to the individual battling dementia and the loved ones and caregivers watching them change.
Enlisting the right support squad can help you make sense of signs and symptoms, and can provide you with stage-specific information.
References:
Alzheimer’s Society. The progression and stages of dementia. Alzheimers.org. Published 2021.
National Institute on Aging. Understanding Different Types of Dementia. Nia.nih.gov. Accessed December 2023.
National Institute on Aging. What Is Dementia? Symptoms, Types, and Diagnosis. Nia.nih.gov. Published December 2022.
