Experts say that all types of behavior are forms of communication. Behavior problems
surface for many reasons. If you can identify the reason for the behavior, you can have a better idea of how to handle it.
Common causes of Behavior problems:
– Fatigue
– Medications
– Frustration
– Dementia / Alzheimer’s / Other Brain Disorders
– Established Behavior Patterns
– Outside Conflicts
– Desire for Attention (children especially)
Oftentimes, dysfunctional behavior increases at the
end of the day as stress builds and the person becomes
tired. Pacing and wandering are clues that tension and
anxiety are building. Certain stressors can trigger agitated behaviors.
Ignoring agitation behaviors is one of the worst
things you can do. Try to discover the problem that is
prompting the behavior, and fix the problem if you can.
Common triggers of agitation behavior in clients with Dementia.
– Fatigue
– Sudden or frequent changes in their environment. Sameness and routine help to
minimize stress.
– Responses to overwhelming environmental stimuli. Excessive noise,
commotion, or people can trigger agitation behavior. Large group activities can
be disturbing.
– Excessive demands. Caregivers and family must accept the fact that the
dementia client has lost and continues to lose mental functions. Pushing these
clients to improve their capabilities will only cause stress.
Dealing with challenging behavior is never easy. Caring for a client with
dementia, Alzheimer’s, and other brain disorders poses many problems for
caregivers. Keep an open mind and be patient.
Suggestions for dealing with common behavior
problems
Angry/Agitated Behavior
• Determine whether medications are causing adverse side effects.
• Reduce caffeine intake.
• In severe cases, and as a last resort, medication may be prescribed to
keep a dementia client calm.
• Reduce outside noise, clutter, or the number of people in the room. Keep
objects and furniture in the same places.
• Help the confused person by making calendars and clocks available.
• Familiar objects and photographs may offer a sense of security and
remind the person of pleasant memories.
• Gentle soothing music, reading, or walks
may help an agitated client.
• Do not try to restrain a client during an
outburst.
• Keep dangerous objects out of reach.
• Acknowledge the client’s anger over the loss of control in his/her life. Say
that you understand the person’s frustration.
• Distract with a snack or an activity.
• Limit choices. Instead of asking, “What would you like for lunch, soup or a
sandwich?” Say, “Here’s a sandwich” or “How about some Fruit?”
• Allow them to forget the troubling incident. Confronting a confused person
may increase anxiety.
Repetitive Phrases and Actions
• Avoid reminding the client that he/she just repeated the same phrase
or asked the same question. Ignoring the repeated phrase or question
may work in some cases.
• Agitated behavior or pulling at clothing may indicate a need to use the
bathroom.
• Do not discuss plans until immediately prior to an event.
Paranoia
• Explain to family members that suspicious accusations are part of the
illness.
• Check out paranoid behaviors with the client’s doctor.
• If the dementia client says money or an object is missing, Assist him in
locating it. Avoid arguing. Try to learn his/her favorite hiding places.
Wandering and Pacing
• A person who paces incessantly may burn off too many calories. Also,
pacing may turn into wandering. Provide inviting places for the pacer to sit
and relax.
• Locking a client in his room or restraining him in a chair is inappropriate.
Implement activities and adjust the environment to relieve agitation.
• Put away items such as coats, purses, or eyeglasses. Some clients with
dementia will not wander without taking certain personal articles with
them. If they can’t find them, they won’t leave.
• Provide regular exercise and rest to minimize restlessness.
• Dark-colored mats placed in front of doors may prevent the client from
stepping outside. Black or dark blue areas may look like holes in the
ground to a client with dementia, prompting the person to avoid the area.
Hoarding or Gathering
• Provide the client with a safe place where he/she can store items, such
as a canvas bag.
Incontinence
• Assist client to the bathroom every two hours (or ask family members to do
so).
• Limit fluid intake in the evening before bedtime.
• Place a commode at the bedside at night.
• Use signs to indicate which door leads to the bathroom.
Sleep Disturbance or Nighttime Agitation
• Make sure the living quarters are safe—put away dangerous items and
lock the kitchen door.
• Try soothing music.
• Keep the curtains closed to shut out darkness.
• If hallucinations are a problem, keep the room well lit to decrease
shadow effects that can be confusing. Remove shadowy lighting,
televisions, dolls, etc.
• Use medications as a last resort.
Communication
• Maintain eye contact to help keep attention.
• Use short simple sentences.
• Avoid negative sentences such as “Don’t go outside.” Instead, say
“Stay inside.”
• Speak slowly and clearly.
• Encourage the client to talk about familiar places, interests, and past
experiences.
Adjusting the person’s surroundings or activities can help. Some simple, basic
interventions can be used to ease agitation behaviors.
Music therapy. Some studies have proved that playing calming music can lead to a
decrease in agitation. Music may be played during meals, baths, or relaxation.
Exercise and movement. Light chair exercises can help to maintain the function of limbs
and decrease problem behaviors.
Activities. Look for activities that the client enjoyed in the past.
Socialization. Human interaction is essential for people with Alzheimer’s disease. Large
groups are out, but a volunteer can converse, reminisce, or engage in activities with a
client. Sometimes videos are good for clients with advanced dementia because they
mimic a conversation or a sing-along.
Emalee Walton, May 3, 2021
Would you like to learn more? 10 Elderly Behavior Problems and How to Handle Them – AgingCare.com