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Challenging behaviours: tips for carers

People with dementia may develop behavioural symptoms that may be a consequence of the person no longer being able to meet his or her own needs, or be a direct symptom of changed brain function. Behavioural symptoms vary between individuals and change over time as the illness progresses. If behaviour is having an impact on the person with dementia or those around them, consider the following:

Know what functions of the brain have been affected
To manage behavioural symptoms the family carer needs information. This includes finding out from the medical specialist or GP what functions of the brain have been affected by the illness. If the person with dementia has seen a neuropsychologist he or she will also be able to give this information.

Know the person
It is important to know the person well. This includes his or her personality, past experiences, likes and dislikes, and the things which are important to him or her. The family carer is best placed to know this information and use this knowledge when developing behavioural management plans.

Ensure the person with dementia is as physically well as possible
When people with dementia are unwell they will be less able to use the skills they still have. Having check ups with the GP, providing good nutrition, encouraging exercise and managing medications will assist with this. Check for visual and hearing problems and make sure the person has glasses or hearing aids if needed. If behaviour deteriorates rapidly see your GP as there may be a medical cause for this (such as urinary tract infection).

Manage/examine your own behaviour
Behavioural symptoms in people with dementia are made worse when their family carers are stressed. A high proportion of carers develop significant depression which further lowers the ability to deal with the person with dementia.

Modify the environment
The environment has an impact on the ability of the person with dementia to use his or her skills. An environment which has cues for people with memory loss and disorientation will assist in meeting their needs more effectively and can reduce frustration or fear. A noisy and over-stimulating environment may interfere with concentration and comprehension leading to more agitation.

Reflect on incidents
Reflecting on what is happening can be a useful learning tool. Think about possible triggers that have promoted the well-being of the person and triggers that contribute to the person’s behavioural symptoms.

Be aware of your own limitations
Acknowledge when you respond appropriately and when you need assistance from others. We all have our strengths and weaknesses and you may be able to manage some behaviours better than others. If you are having difficulty coping with behavioural symptoms, especially those relating to safety, you may find contacting a health professional useful. Alzheimer’s Australia’s Help Sheets provide general information on various behaviours. They can be found on the website alzheimers.org.au

For more information on changed behaviours and dementia see the Alzheimer’s Australia website Help Sheets section at alzheimers.org.au, then select Publications & Resources > Help Sheets & Update Sheets > Changed behaviours and dementia.

For 24 hour assistance contact the Dementia Behaviour Management Advisory Service (DBMAS): 1800 699 799

Tips for managing aggression
Download “Tips for Managing Aggressive Behaviour in FTD” (PDF)

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