Why does behaviour change?
Dementia occurs with changes in the brain called neurodegeneration (degeneration of the building blocks of the brain). Dementia is a progressive disease meaning that as the neurodegeneration spreads in the brain, symptoms worsen and new symptoms appear. Among these symptoms can be a change in behaviour. Dementia affects behaviour in a different way for every individual, but understanding why these changes occur may help you cope with them. Always discuss with your doctor about your concerns in behavioural changes.
Understanding the changes in behaviours & how to respond to them
When a particular behaviour is reoccurring, try the ABC approach:
Think back to times when the person has become reactive and think of what events have led to these outbursts. Can you identify any common triggers? These could give you a clue as to what is troubling them.
Name the behaviour that is happening as a result of these triggers.
Identify what happens when you react in a certain way to the behaviour. Now try to remove the trigger and/or change your response to the behaviour.
Keep in mind that the ABC approach may not always work; do not blame yourself if the distressing behaviour remains.
Behaviour changes and how to respond to them with the ABC Solving Approach are discussed in more details in the following Fact Sheets:
General guidelines for caregivers
There are guidelines you can follow to help manage behavioural symptoms occurring with dementia.
There is no “one-size-fits-all”
An intervention may help in one situation for a particular behaviour and not another. Take what make sense to you, adjust it to your particular situation.
Behavioural symptoms in dementia are not out of will
The person with dementia is not being deliberately difficult: don’t take it personally. Stay calm, be patient and do your best.
A behavioural symptom may be an attempt to communicate an unmet need
Reduce unmet needs by:
- Seeing your doctor regularly to check the person with dementia’s health
- Ensuring the person with dementia gets enough rest and is appropriately fed
- Minimizing sensory loss: keep prescription up to date
- Paying close attention to when the behaviours appear, identifying triggers and removing or reducing them as possible
Keep the person with dementia busy, in company and entertained
Avoid boredom, loneliness, understimulation.
Behavioural symptoms management should be focused on ensuring safety and wellbeing
- Accept their limitations: expecting the person with dementia to behave properly is like demanding someone who had hip replacement to join us in jogging
- Explanation won’t help the person with dementia understand, won’t improve their memory or orientation, but may cause anger, confusion, frustration, low self-esteem and trigger behavioural symptoms
- Validate their feeling and redirect to other activities
Notify your doctor
- Other medical causes for behavioural symptoms in dementia must be explored: interactions between medications, side-effects of medication, infections, comorbid depression, psychosis, etc.
- Your doctor may advise on strategies
- Helps your doctor monitor the progression of the disease
- May indicate the need for medication
Take care of yourself
It is important for you and to offer the best care to the person with dementia.
Non-pharmacological approaches should be first-line treatments
- Old age and dementia decrease drug’s efficiency and increase drug’s adverse effect
- Be informed about risks and advantages
- General rule: lowest possible dose, for the shortest possible time
Behaviour changes and how to respond to them are discussed in more details in the following Fact Sheets: