Wandering, repeating questions, becoming agitated, sundowning. Many people refer to these as “behaviors,” but they can better be referred to as “communications.” When trying to understand what the person with dementia is trying to communicate, it can be helpful to consider three aspects of the situation that could be contributing or causing the behavioral symptom.
Remember that dementia is a physical, permanent change in someone’s brain. They might no longer be able to find the words to say, “I’m cold,” or, “I’m hungry,” or, “I’m in pain.” They may communicate this by crying, becoming agitated, or other actions we refer to as “behaviors.”
The Person with Dementia
The first question to ask yourself is, “Could there be something physical or emotional that the person is experiencing?” Consider the person’s medical history and current medical conditions. Could this person be experiencing pain? A side effect from a medication? What/when did they eat last? Are they hungry? Could they be experiencing an upset stomach or acid reflux? Are they bored? Sometimes, sensory issues could affect the person with dementia as well. If someone is experiencing vision or hearing loss, they may not be able to tell you that.
Consider the environment that the person with dementia is in when this “behavior” is happening. Is the room too cold? Too hot? Are there loud noises the person could be startled or upset with? People with dementia can become very easily overwhelmed or become emotional. Is the news on the TV? Are there challenging and emotionally taxing news stories that could be making this person upset? People with dementia may also have a difficult time perceiving or making out shapes or objects. For example, if there is a coat rack with a coat and hat projecting a shadow on the wall, someone with dementia may believe there is a “strange man” in the room with them.
The Caregiver Approach
As much as we don’t want to believe it, sometimes the way a caregiver approaches a situation could cause the person with dementia to become confused or upset, leading to “behaviors.” People with dementia can easily pick up on emotions, attitudes, and other non-verbal communication put out by caregivers. It is important to be aware of tone of voice, facial expression, and other non-verbal cues in attempt to keep the situation calm and positive. Arguing, correcting, and criticizing someone with dementia can cause them to become upset and agitated. Go with it! Caregivers should focus on creating and leaving their loved ones with positive emotions.
All behavior is communication, whether someone has dementia or not. In caring for someone with dementia, if we can find the reason behind the way someone is behaving, sometimes we can prevent it from happening.
Source: Wisconsin Alzheimer’s Institute – the DICE Approach