As a GCM, I am often consulted when a family member or caregiver is extremely frustrated due to ongoing issues with their loved one’s behaviors that they have had increasingly more difficulty controlling. I often feel like a broken record, but the bottom line is that when working with an individual with dementia one cannot expect to change the individual with the dementia, but we can adjust, change and/or adapt the environment that may be triggering the behavior.
Working with someone with dementia can certainly be a challenge and is often frustrating. It is important to understand “dementia.” because without an understanding one could think that the person with “dementia” is simply “acting out” or “annoying, irritating and stubborn” when in fact there are important factors behind the behavior. These behaviors must be looked at and understood so to facilitate better controlled behavior.
The ‘tools’ we were accustomed to using when dealing with our loved ones prior to the onset of dementia is quite different from the tools we need with this new set of circumstances – memory loss, forgetfulness, and confusion can all be symptoms of the dementia. The behaviors vary as well as the difficulty handling the behaviors. The causes of these new behaviors such as agitation, wandering, and irritability can be attributed to different causes.
It is always very important when dealing with behaviors – particularly when the behaviors are new – to determine if the behavior is strictly due to “the dementia.” There may be something “medical or physical” going on such as a reaction to a new medication, a urinary tract infection, or an undiagnosed depression in addition to the dementia.
If the behavior is new and you cannot determine a contributing factor always call your doctor. You do not want to assume that it is simply due to the dementia if it is out of the ordinary. A simple urine test can reveal a urinary tract infection which can be easily treated with an antibiotic.
What I always recommend is to keep a journal and try to determine a pattern. Eventually, if there is a particular behavior such as intermittent agitation, restlessness, anger, or pacing happening, documenting the time these behaviors are exhibited and events that took place before the behaviors began or started to escalate can be very helpful for diagnosis. Here are some links to a few helpful documents which will help you keep track of the behaviors:
- This chart documents the date and time, what happened before the behavior, what behavior was exhibited and what happened as a result of the behavior: http://www.scribd.com/doc/13030287/Behavior-Chart-FormGrowing-Options
- This chart documents the same as the first, but also has a column to document the duration of the behavior and the intensity on a scale from 1 to 5: http://www.scribd.com/doc/13030291/Behavior-Duration-and-Intensity-FormGrowing-Options
- Tip: Keep these charts in a binder to bring to the doctor.