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Practical Insights for Busy Caregivers

How to respond to challenging behaviours when caring for someone with dementia


April 3, 2017, by Pat Morden, Caregiver Exchange

Shortly after my father was diagnosed with Alzheimer disease, he woke up in the middle of the night and insisted that he and my mother leave the house, which he believed was under attack. They stood out on the middle of the street until my brother arrived and persuaded my father to go back inside.

If you’re caring for a person with dementia, chances are you’re familiar with this type of situation. Professionals sometimes call it “responsive behaviour” because they believe people with dementia are responding to something in the environment around them -- possibly a stimulus their brains have misinterpreted, or a need they can’t clearly communicate.

This short video explains what happens when the brain is affected by injury or disease and can no longer make sense of the many stimuli it receives. “Messages get garbled,” the video explains. “This can lead to behaviours that are challenging to understand or deal with. It’s important not to take these behaviours personally.”

Caregivers must be “detectives,” searching for clues to what’s causing the difficult behaviour and then finding suitable strategies to manage them. Creating a diary may help to identify patterns and triggers. “Try to take a deep breath and approach the behaviour from a different angle,” says Danielle VanWyk, Family Support Counsellor with the Alzheimer Society of Huron County. “Difficult behaviours can be the result of an unmet need, perhaps simply a need to be loved and reassured.”

Wandering is a common responsive behaviour. Ensuring that the person with dementia gets regular exercise, reassuring her, or distracting her with another activity may help. To mitigate the risk of wandering, move locks out of reach, tell neighbors about the problem, sew the person’s address into her coat, and register with the MedicAlert Safely Home program. If she is getting lost repeatedly, VanWyk suggests substituting another activity, such as an exercise class.

Other behaviours may include restlessness, repeated actions, suspicion, sexual behaviour, and aggression. Learning to understand and deal with these behaviours takes time, patience, and empathy. “You have to be willing to accept where the person is, and to support her in what she is trying to do,” says VanWyk. “But that’s always easier said than done.”

For additional advice on how respond to behaviours, visit the Alzheimer Society Ontario website.