How to Manage Disrupting Dementia Behaviors

People with Alzheimer’s have a brain disorder that causes agitation, impaired memory, impaired thinking and (at times) aggressive behaviors. Despite this, there are techniques you can use to help decrease unwanted behaviors.


Affected brain tissue contains:


  • Amyloid plaques (abnormal deposits of protein) that damage and destroy brain cells

  • Brain cells require the normal structure and functioning of a protein called tau. In Alzheimer's, threads of tau protein twist into abnormal tangles inside brain cells, leading to the death of brain cells (Focus Medica).

Behaviors are a form of communication. Look at all behaviors as an unmet need.


ENVIRONMENTAL FACTORS THAT CAN INCREASE AGITATION






TOO MUCH STIMULATION – The brain can be overstimulated by background noises, clutter, crowds, or lights. As a result of overstimulation, restlessness can occur. Example, more than one person talking to them, too many choices given, TV on inappropriate channel or on all day without a break.


Solution: Turn off the TV during lunch – put on some soothing music or give residents a break from noise during lunch. During a movie, turn down the lights. To allow the person to focus on the movie, don’t talk during the movie, unless it’s necessary.


Select appropriate television programs. Programs that they can relate too are the most suitable.


Appropriate DVD’s: Old movies can help activate senior’s memories as well as the emotional connections that go along with them. The best movies are Musicals, Travel, Comedy, Nature, Animals and movies with children.


*Movies and television should not have any violence. Someone with Alzheimer’s may think these events are happening in the room. Therefore, “violent movies can cause agitation, anxiety and disruptive behavior.” (National Institute on Aging).


  • Hallucinations involve hearing or seeing things that are not really there.

  • Delusions are false beliefs that the person thinks are real.

Select appropriate activities

Music: Select music that the person enjoys that was popular in their younger days as it can trigger long term memory.

Ask the person to sing along. The best sing alongs are programs that display the words to the songs.


Art: Make sure to select adult art and not art that is for children. For example, select pictures of nature and not of a cartoon character for the person to color.


DON’T

The most important thing to note is DO NOT ARGUE WITH THEM. In the mind of the person living with dementia, their reality is very real.

Don’t Scold Them. Scolding escalates disruptive behavior.


DO

Remain calm and speak in a soothing voice. Reassure the person that you are there to help them. Comfort the person by addressing how they feel. Example: “I’m sorry you are feeling anxious/upset/frustrated. I’m here to help you.”

Gently tell the person what you want them to do.


Distract the person with conversation and (if possible) take them for a walk. For example, if a person says she needs to go to her car and pick up her children, you could say that the kids have been picked up already and will be home soon. With redirection in a calm voice she/he will forget about going to the car.


A light touch or soothing hand massage can sometimes calm the person.

Massage cream with lavender can help calm the person.

Keep directives simple: give one directive at a time.


If a resident keeps grabbing items that don’t belong to them, give them something to hold. A life like looking baby doll or a fake but realistic looking pet works well.

Think about what could be causing the behavior. Example – a resident who requests to go the bathroom frequently. It is possible that the resident has a UTI.


Is the resident constantly getting up from her chair or fidgeting? Don’t assume that the person is just behaving that way on purpose. She/He could have a pressure soar which needs to be addressed. Or the person may need some physical activity.


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