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Coping with Behaviour Changes in People With Dementia

People with dementia have difficulty expressing themselves, but their needs are the same as other people: they get tired, hungry, bored, feel too hot or too cold and need their personal care needs met.

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Understanding Out-of-Character Behaviour Changes

If a person with dementia shows behaviour changes, it is important to understand the causes; it may be due to their dementia, but it may just as easily be due to other factors which then affect their physical and/or mental health. They may be in pain, for example, their environment may mean they feel disorientated or they may feel out of control or misunderstood, leading to their feeling frustrated and displaying out-of-character behaviours.

Behaviour changes in dementia should not be seen as a symptom to be treated but as a problem to be solved. Carers are often the first to see changes and the best placed to understand what the person with dementia needs, often resolving the situation quickly.

When behaviour changes are significant – a person becomes aggressive, for example, or extremely agitated – the carer should contact their GP or other professionals to rule out physical or mental health problems, check the effects of changes to medication and identify non-drug strategies.

Approaches for Managing Out-of-Character Behaviour Changes

Carers can benefit from developing non-drug strategies for coping with dementia behaviour changes, working with the person’s GP and healthcare professional as needed to explain what the change in behaviour is and what problem it is causing. For example, is the individual becoming agitated or showing signs of distress?

Once they can explain the problem, they need to look at when the change happens. Is it around a particular person, event, or place, for example, or does it happen when the person is tired, hungry, in pain or feeling ignored or misunderstood?

When the cause and effect are understood, strategies can be developed for managing and reducing out-of-character behaviours. These might include maintaining relationships with family and friends, encouraging the person with dementia to take part in activities they enjoy or removing clutter from their living and sleeping environments to prevent them feeling disorientated. Reducing noise and keeping personal possessions close by may also help, as can developing a routine for the person to follow, giving them choice and control over their day-to-day lives.

What is important when developing strategies and techniques for managing out-of-character behaviour changes in dementia is at the centre of everything that is done. Managing behaviours should be in response to their needs and tailored to them as people. If a person is feeling bored, for example, it might be getting them involved in an activity. If they are lonely, it might be sitting with them and simply talking to them. Each person with dementia is different and each solution will be different, so understanding the reasons behind the change are key to managing behaviour.

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