How Caregivers Can Effectively Address Dementia-Related Behaviors

The key to managing dementia behaviors is patience, adapting to changes in the environment, and learning to understand a person’s “no.” As a caregiver, it’s important to remember that these dementia-related behavioral changes are not intentional—they are a result of changes in the brain and can often be reduced through proper communication, identifying triggers, and providing person-centered care.

The Right Solution for Dementia-Related Behavior: At a glance

As a skilled caregiver, the most effective way to manage complex dementia-related behaviors is to adopt a person-centred care approach. This guide, based on clinical studies and advice from experienced experts, will help you identify the underlying causes of behavior and find effective solutions. Understanding the different stages and behaviors of Alzheimer’s is essential for tailoring your approach.

Dementia Behavior: Not a Problem But a Communication

When people with dementia or Alzheimer’s can’t verbalize their physical discomfort, fears, or needs, they try to communicate through behavior. According to researchers, this is not a ‘problem’ but rather a way for them to communicate.

According to recent data from the National Institute on Aging (NIA), about 90% of people with dementia experience behavioral problems at some stage of the disease. These behaviors are usually triggered by hunger, thirst, pain, discomfort from infections (such as UTIs), or boredom. In some cases, a patient might even refuse medication because they cannot communicate their fear or physical discomfort.

4 Effective Steps to Managing Dementia Behavior (DICE Framework)

To scientifically manage the complex behaviors of dementia, experts recommend using the DICE (Describe, Investigate, Create, Evaluate) framework. It helps a caregiver work in a planned manner rather than blindly reacting.

Step 1: Observe the behavior accurately (Describe)

Understanding exactly when and under what circumstances the behavior occurs is the first step to success. As an expert, I recommend keeping a diary of each occurrence.

• Main tasks: Keeping a record or log of behavior.
• Observation: Who was present at the time of the incident? Was the room excessively dark or noisy?
• Goal: Identifying the repetition or pattern behind the event.

Using a Caregiver Organizational Planner can make tracking these patterns much easier.

Step 2: Investigate the root cause

Find the ‘hidden reason’ behind why the behavior is happening.

• Physical reasons: Check for hunger, thirst, constipation, or any physical pain.
• Environmental factors: Is the room too hot or too dark? Are there any strangers present?
• Drug effects: Check for side effects of new medications.

Step 3: Create a working solution

After identifying the cause, a realistic and humane solution should be developed. At this stage, we need to find some ‘creative distraction’ or way of diverting attention that maintains the patient’s self-esteem.

• Environmental change: Eliminate excess noise, provide adequate lighting, and keep the house tidy.
• Quiet communication: Validation is the process of agreeing with the patient’s feelings rather than correcting them.
• Distraction: Play a favorite song, look at old pictures, or involve him in small tasks (such as folding a handkerchief).

Step 4: Evaluate the results

Regularly review how well the steps you take are working. Remember, a method that doesn’t work today may work tomorrow. Patience and flexibility are your biggest strengths here.

• Success Verification: Has the behavior subsided?
• Flexibility: If the method doesn’t work, don’t get discouraged and change the plan.
• Professional advice: If the situation gets out of hand, seek help from a specialist.

Common Challenges and Their Solutions

As a caregiver, you may often face the following problems:

A. Asking the same questions repeatedly (Repetitive Questions)

Patients may repeat the same words over and over again due to memory loss in the brain.

• Solution: Don’t point out their mistakes. Instead, give short and reassuring answers. Sometimes, a light snack or playing a favorite song can be effective in diverting their attention.

B. Agitation & Aggression

Don’t be afraid if you suddenly have a tendency to scream or hit.

• Solution: According to the Alzheimer’s Association’s 10 Practice Recommendations, in this situation, the caregiver’s biggest weapon is to ‘stay calm’. If you yell back, the patient’s tension will increase. Speak in a low voice, maintain a safe distance, and look them in the eye and reassure them.

C. Sundowning or confusion at night (Sundowning)

Many dementia patients experience increased confusion in the afternoon or evening. Our Sundowning Workbook offers targeted strategies to manage this specific phenomenon.

Keep them exposed to sunlight during the day and get them physically active. Keep the lights in the house bright after dusk so that there are no shadows, as shadows can create fear in them.

Environmental Change and Its Importance

The home environment plays a big role for dementia patients. A ‘dementia-friendly’ environment can greatly reduce their anxiety.

• Reducing overstimulation: Avoid playing music too loudly or using bright flashing lights.
• Sticking to a routine: Getting into the habit of eating, bathing, and sleeping at the same time every day creates a sense of security in them.
• Familiar objects: Place old photos or their favorite items around them that can spark their memories a little.

Mentioned in a Medbridge blogSensory stimulation (such as the scent of lavender oil or a soft blanket) can sometimes reduce anxiety faster than medication. Using music therapy or engaging the senses with our Sensory Deficit Workbook can sometimes reduce anxiety faster than medication.

Caregiver Self-Care: Emotional Mirroring

One very important thing is that your mood has a direct impact on your patient. This is called ’emotional mirroring’. If you are anxious or angry, the person you are caring for will subconsciously pick up on that excitement.

According to a study in the Journal of the American Geriatric Society, caregivers who take regular breaks and take care of their own mental health are less likely to have behavioral problems in their patients. So:

1. Set aside at least 30 minutes for yourself every day.
2. Don’t hesitate to ask for help.
3. Join a caregiver support group if necessary.

When should you consult a doctor?

Not all behavioral problems can be managed by a caregiver. Seek immediate medical attention if you notice any of the following symptoms:

• If the patient becomes dangerous to himself or others.
• If the behavior change occurs suddenly and very quickly (this could be a sign of infection).
• If there is no improvement despite changing the environment or following a routine.

Conclusion

Caring for someone with dementia is one of the most difficult jobs in the world. If you are feeling overwhelmed, it is vital to overcome caregiving stress before it impacts your health. If you need personalized guidance on these complex issues, learn how a caregiver strategist can help you navigate this journey.

Remember, you are not alone. The right information and community support will help you move forward on this path.