Best Tips To Navigate Dementia Behavior Changes
Wellness Strategies Group has developed an essential guide to help older adults and their families navigate dementia behavior changes. These changes can be worrisome and concerning so it’s best to educate yourself on unspoken needs. These tips will help you discover what may be causing the dementia behavior changes and respond appropriately.
When your loved one with dementia has a change in their behavior, personality or mood, it’s time to dive further into the possible causes for this change. Look at dementia behavior changes through the eyes of someone who is living with dementia.
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Dementia has stolen my ability to communicate my needs in a way you are used to. I may be unable to speak clearly or find the right words, or maybe I can’t speak at all.
Sometimes, agitation is the only way to communicate with you when I’m not well. I’m asking that you listen to me as a behavior detective, with your eyes and ears, and support me as I struggle to relay what I need.
Look at my physical needs first.
Am I sick?
Am I in pain?
Is the room too hot or too cold?
Am I thirsty or hungry?
Assess my environment.
Is it too noisy?
Are you asking several questions, and I can’t process what you are saying?
Are there too many food choices on my plate, and it’s overwhelming?
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As a registered nurse and certified dementia practitioner, I often see dementia behavior changes in a person that is not considered their baseline. The caregiver or family member reports the dementia behavior changes to the physician, and psychotropic medication is ordered. It’s immediately assumed that this change is a normal progression of the cognitive impairment.
This, in my opinion, is not the best path.
I understand that seeing someone you love who once was polite and calm now displaying agitation is quite scary and upsetting.
The practical response is, “We need to fix this”, but let’s consider how to navigate this change.
Navigating Dementia Behavior Changes
I firmly believe there needs to be a formal evaluation by a healthcare professional trained in dementia care before starting a new medication.
This should include a physical assessment and a cognitive assessment (with possible lab studies), an environmental screening, a review of medication (prescribed, over-the-counter, and supplements) and an evaluation of data from a behavior calendar. A behavior calendar is an objective way to record changes in behavior that helps identify patterns and triggers for a change in behavior.
All of these assessments are pieces to a puzzle.
If you add medication to the puzzle without finding out if something else is contributing to the change in behavior, the pieces to the puzzle won’t fit.
If the evaluation is omitted, you may overlook providing treatment for an infection or identifying an essential trigger in the environment that could have been prevented.
While there certainly are times when psychotropic medication is necessary to help someone struggling with persistent agitation, it shouldn’t be the immediate response at the onset of dementia behavior changes.
These medications can be sedating when not at the appropriate dose (it may take some time to find the right dose and medication).
Sedation can contribute to one’s inability to participate in activities of daily living, or it may increase the risk of falls. It can also mask an underlying medication condition.
It’s our job to advocate and be the voice for those who don’t have one, especially during dementia behavior changes.
Listen when your loved one’s communication style differs from yours and reserve medication for agitation only when all other contributing factors have been ruled out.
See my blog “8 Questions to Ask When New Medication is Prescribed” when it’s time to add medication. https://wellnessstrategiesgroup.com/2022/08/new-medication-is-prescribed/.
Visit the Alzheimer’s Association for more information on this topic.https://www.alz.org/media/documents/alzheimers-dementia-related-behaviors-ts.pdf