You may find that over time the way your loved one responds or acts in certain situations may change. This can be puzzling and at times, upsetting since their actions may be completely out of character. Be aware that this can be due to a number of reasons, such as:
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Not being able to recognise their own needs
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Not being able to communicate their needs effectively
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Changes in their ability to reason or make judgements
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Feeling fearful in a different environment
It is important to remember that their emotions may be driving their behaviour and particularly when they may struggle to express their needs. If your loved one doesn’t feel listened to or feels disorientated they may justifiably become distressed, frustrated and scared. If you can understand why their responses are changing, you may be able to reassure them and help them feel more settled.
It is worth standing back and trying to work out what is happening in order to help them and yourself in the meantime. If their behaviour alters rapidly, such as your loved one becoming more confused and distressed in a short period of time, it may very well be caused by a physical problem such as an infection or pain. Does their body language show this, such as grimacing and holding themselves in a certain way?
Ask yourself whether they have eaten and drunk recently as low blood sugar and dehydration can also cause confusion. Your loved one may also have other physical conditions that may have an impact on their dementia, contact your doctor if you see any rapid changes.
Try and walk in your loved one’s shoes, they may be feeling frightened, ignored or frustrated. Difficulties often occur when their needs are not recognised and they may not be able to communicate them to anyone. People living with dementia may also experience depression, this low mood can also affect how they respond. Try and:
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Involve family, friends and social groups
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Keep to a routine
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Listen to your loved one’s feelings
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Share food
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Be together listening to music
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Go through meaningful photographs or objects
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Try and avoid challenging and disagreeing
If you are concerned and feel out of your depth, stand back and ask yourself a few questions such as:
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Do I see any pattern to this behaviour?
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Is this behaviour in response to certain people?
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When does this behaviour occur?
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Where does this behaviour occur?
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Are they being ignored?
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Has something happened that may have triggered a change in behaviour?
Stay calm, practice some deep slow breathing, and avoid reacting suddenly, show them that you are listening.
If something is clearly annoying them, take time to try and find out what it might me (it may be a need to go to the toilet and they cannot find where to go) and then you are on the way to helping them.
We have to try and imagine how we would feel if we were ignored and our needs not listened to.
I also cannot stress enough, the need to involve other people in helping you both, as a short break can recharge your batteries. If you have no family or friends nearby contact your local Alzheimers Society or Alzheimers Association charity.
Repetitive behaviour often occurs and can be due to a number of factors including your loved one being unable to retain information, their needs being ignored and anxiety if left alone for a time. It may be best to avoid telling your loved one about events coming up until much closer to the time. The anticipation of an event may become stuck in their mind which may create anxiety and repetitiveness. (However, also don’t spring an appointment upon them at last minute either, you may need to use visual clues to indicate where you are going).
Use of clocks and notes around the house may help with their difficulty in judging time.
Be aware of the environment, try to avoid over stimulation such as the television being on constantly or much background noise. (I will cover this more in next month’s column).
If your loved one is restless, they may be bored and need some stimulation or gentle exercise. Look for some items around the house that may engage them in activities, this doesn’t have to be mentally taxing, maybe something to keep them interested or engaged in, such as the use of a button box to rummage through or something associated with your loved one’s background (this could include folding clothes, fingering books, seed packets, pieces of wood and sandpaper, whatever you think your loved one might feel a meaningful association with).
Sometimes it doesn’t always have to involve objects that your loved one associates with the past; tastes in music, interests and food preferences can change so you may need to be creative in your thinking.
For more help and support read chapter 9 – How to listen and respond to the emotions behind mood and behaviour, Finding the Light in Dementia, a Guide for families, Friends and Caregivers
