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Caring for people living with dementia poses many challenges. As the disease progresses, personality and behavior changes often occur.
Challenging or concerning behavior is used to describe behavior that interferes with a person’s daily life. It is common in people living with dementia and is considered one of the most difficult issues facing staff in residential care and caregivers at home.
Challenging behavior is distressing for both the person exhibiting the behaviour and for those that care for them. It is important to try and understand why the person is behaving in a particular way and remember that it is the behavior that is challenging and not the person.
Related: 10 Communication Strategies for Dementia Care
Common behavioral problems for people living with dementia include:
1. Catastrophic reaction
Over-reaction to trivial matters; this may result in weeping, screaming or unreasonable accusations.
2. Repetitive behaviour
Compulsion to follow relatives or staff asking the same questions over and over.
Hoarding all sort of items for safe keeping. Often accusing others of stealing their precious possessions.
4. Inappropriate sexual behaviour
Loss of inhibitions and the consequent lack of awareness of the rules of appropriate behavior.
Physical (pushing, hitting) or verbal (abusive language)
Often suspicious of staff and neighbours; they imagine that people are plotting against them.
Aimless or purposeful wandering that can result in getting lost, leaving a safe environment or intruding in inappropriate places.
Related: How to manage wandering behaviour
Pacing and fidgeting; this could be due to thirst, pain, medication side effects or even boredom, stress, noise, lack of exercises.
9. Screaming and shouting
Calling out continuously or weeping and whimpering for extended periods of time. (Sometimes this behaviour is a result of brain damage or hallucinations and medical assistance is needed)
An end-of-day confusion and restlessness that manifests as dusk approaches.
Related: 14 Ways to Manage Sundowning
The more you know about the person with the challenging behavior the more likely you are to understand them. Assessment of the behavior should be functional and comprehensive. It should include:
Sometimes problematic behaviors are caused by changes in the brain as dementia progresses and sometimes by triggers in the environment. Triggers could include:
Understanding what may be causing the challenging behavior and learning how to respond to it will enable carers to take control of situations when they arise and diminish the occurrence the behavior.
Related: Goal-Directed Behavior
People living with dementia that exhibit challenging behaviors are trying to communicate needs that have not been met.
Cultivating work practices to treat the individual and not just the illness for best results.
Related: Person-Centred Care
We'd love to hear your feedback!
What strategies have you found to work well?
Periodically I would have a kindness group
Ask the residents what it means to be kind
Ask them to give examples of how they are kind
I have found that some residents can be mean without meaning to be and just a friendly reminder of being kind is very helpful here are some kindness activities
World kindness day is in November but you could have a kindness day every month or every week to remind the residents especially your resident with difficult behaviors to be kind to everyone
Forgiveness day is in August but you could also have that as part of your calendar as well here are some ideas for that