Anger, confusion, and sadness are a few symptoms a person with dementia may experience regularly. The result of these feelings is a range of unpredictable behaviors including using poor judgment, aggression, mood swings, and repeated questioning or manipulation.
Even though you know your loved one’s dementia behaviors are symptoms of a disease and not intentional, dealing with them is often emotionally and physically challenging. Learn more about typical dementia behaviors in the elderly and expert tips for managing them.
A person with Alzheimer’s disease or another type of dementia may become irritable and even belligerent without being provoked. They may go in and out of confusion and disorientation or attempt to manipulate those around them. Here are examples of common dementia behaviors and phrases you may hear:
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People with dementia may become cruel, lash out, or use combative statements such as “I don’t want to take a shower!” or “I don’t want to eat that!” Sometimes this type of anger may escalate to physical violence. However, it’s important for caregivers and families to keep in mind that this dementia behavior is often the sign of an underlying, unmet need their senior loved one is trying to communicate.
Aggression can be a way of conveying:
Confusion is one of the most common dementia behaviors in the elderly. This could mean saying phrases like:
Like many other dementia behaviors, confusion can often be attributed to triggers or root causes. Disorientation can stem from:
Is your loved one neglecting to pay bills, making lavish purchases, or wearing clothes that are inappropriate for the season? These questionable decisions, a common dementia behavior in the elderly, may signal a larger problem with their mental state.
A person with dementia may invent truths to get what they want. They may say things like “You told me I could drive to the store,” or use bargaining methods such as “If you let me drive to the store, I will take my medicine.” Other displays of manipulation include refusing to listen to family members and caregivers or having emotional outbursts.
Managing dementia behaviors in the elderlymay be difficult, but it’s not impossible. Your words and actions have the power to quickly deescalate intense situations.
Follow some expert do’s and don’ts for calmly and effectively dealing with these four common types of dementia behaviors:
“A lot of times, aggression is coming from pure fear,” says Tresa Mariotto, a social services supervisor in Bellingham, Washington, and certified trainer in dementia and mental health. “People with dementia are more likely to hit, kick, or bite in response to feeling helpless or afraid.” Managing aggression can be stressful for both you and your loved one.
“This is where truly knowing your loved one is so important,” says Ann Napoletan, writer at the blog “The Long and Winding Road: An Alzheimer’s Journey and Beyond”. “In my mom’s case, she didn’t like to be fussed over. If she was upset, oftentimes, trying to talk to her and calm her down only served to agitate her more. Likewise, touching her — even to try and hold her hand or gently rub her arm or leg — might result in her taking a swing. The best course of action, in that case, was to walk away and let her have the space she needed.”
Natural reactions to dementia behaviors can be ineffective or make the situation worse.
Asking questions over and over again, as well as not being able to understand why things are happening are symptoms and behaviors that come with dementia, according to the American Psychological Association.
The deterioration of brain cells caused by Alzheimer’s disease can lead to poor judgment and errors in thinking. Some of these symptoms are obvious and apparent, such as hoarding household items, accusing a family member of stealing, or forgetting how to do routine tasks.
Some signs are more subtle, making it difficult for your aging loved one to realize they’re struggling. “If you’re curious and don’t want to ask, take a look at a heating bill,” suggests Mariotto. “Sometimes payments are delinquent, or bills aren’t being paid at all.”
It’s important to minimize frustration and embarrassment for dementia patients, so know what works for your loved one and incorporate it into your caregiving strategy.
This is what Napoletan did for her mother: “As I sifted through records to complete her tax return, I gently mentioned noticing a couple of overdraft fees and asked if the bank had perhaps made a mistake. As we talked through it, she volunteered that she was having more and more difficulty keeping things straight, and knew she had made some errors. She asked if I would mind helping with the checkbook going forward. I remember her being so relieved after we talked about it.” From there, over time, Napoletan was gradually able to gain more control over her mother’s finances.
Your loved one may have lost the ability to distinguish between truth and falsehoods, and they may no longer have a sense of morality around lying. These symptoms can be especially difficult for a caregiver to handle, as it may feel like a complete change in personality. In fact, a person with dementia may not realize they’re lying.
Manipulation is often the root behavior for trust, control, and security. Sometimes, it can even be a cry for help.
Dealing with dementia behaviors can quickly wear out a caregiver or family member. If you care for a person with dementia and are feeling resentment, anxiety, or depression, don’t hesitate to seek help. A caregiver support group, counselor, friend, or family member can offer camaraderie and advice.
American Psychological Association, Living Well With Dementia.
John Hopkins Medicine, Facing Dementia in the Family.
National Institute on Aging, Alzheimer’s and Hallucinations, Delusions, and Paranoia.