A Proactive Approach to Avoiding Difficult Behaviours in Dementia

June 3, 2022
Mike Good
Caregiver with elderly patient with walker

(Note: An extended version of this article, written by Mike Good from Together in This, originally appeared on the CPI US blog).

Our behaviour is typically a result of our environment or the people around us. For people with dementia, whether it's Alzheimer's disease or another type of cognitive impairment, it's no different. However, the way their brains process sensory input is not within their control.

This often leads to a double standard when people with dementia exhibit behaviours that are deemed inappropriate. The same actions, when exhibited by someone without dementia, might be frowned upon, but are often accepted.

Once a person with dementia has exhibited what is deemed undesirable behaviour, it generally takes a mix of empathy and skill to alleviate the situation. Often care professionals don't have this ability and, as a result, instead of helping the person work through the behaviour, the approach becomes overly directive:

"You can't do that."  "You can't go there."  "You have to stop."

Infringing on someone's will to do something, or treating them in a condescending manner, will only escalate the issue and can have a negative impact on the individual's wellbeing. However, if the 'undesirable' and sometimes aggressive behaviour can be avoided, everyone will have more pleasant interactions, and the wellbeing of the individual can be maximised.

Typically, but not always, something in the environment triggers the behaviour. Identifying this trigger, or triggers, is key to eliminating the cause. Whether you're helping a family care for a loved one at home or working with residents in a care home, becoming a 'dementia detective' is a skill worth developing.

Start by observing the individual's surroundings. Pay attention to sounds, temperature, other people, and the demeanour of those around them. Note anything that might be affecting them. Behaviours often repeat in dementia care, so keep a log of your observations, noting:

  • The time of day.
  • What they were just doing.
  • Who they were with.
  • What they ingested, including food, medication and liquid.

Look for patterns and discuss your findings with colleagues.

It's also helpful to review the individual's profile to help you better understand their likes and dislikes. This, coupled with their life history, will often help provide clues.

Triggers can be the course of anger and aggression, and while some are easily remedied, other can take considerable observation, analysis and creativity. Remember that all situations take empathy, and remember to respect the individual and treat them how you would want to be treated; this will help you maintain a perspective on the care you are providing.

Implementing your findings from successful dementia 'detective work' will result in fewer undesirable behaviours, ensuring that everyone's wellbeing will benefit, and avoiding potential crises.

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