Alzheimer's and Dementia Care: Uncovering the "Why" Behind Behavior Changes

Please don’t forget the “why” in Alzheimer’s and Dementia Care.  Too often, I find that a person living with Alzheimer’s or dementia has a change in their behavior, and the first thought from the caregiver is “well, they have dementia.”.  This saddens me because the person isn’t receiving optimal care with this approach.  

We need to remember to ask ourselves why the change is occurring.  We can only create an effective plan once we determine the reason behind the change.  Let’s consider a couple of scenarios to determine how identifying the “why” leads to the appropriate response to care.

CHANGE IN BEHAVIOR

Scenario A

A person living with dementia displays a decreased appetite or lack of interest in food. Depending on where they are in their dementia journey, we could consider this to be a progression in their decline.  First, let’s ask “why” do they have a decreased appetite?  It may not be the expected journey, so it’s time to put on our detective hats, and figure out what may be happening to cause this change in behavior.  Begin to consider a series of questions, such as:

• Have they started a new medication that has a side effect of nausea or decreased appetite?
• Do they like the texture of the food?
• Is the food too hot or too cold?
• Are they having difficulty chewing or swallowing?
• Is the food too spicy?
• Do they have pain in their mouth or teeth?
• Are they tired during mealtime?
• What color is the tablecloth, placemat and plate?
• How is the food presented on the plate?
• Who is sitting at the table with them during meals?
• Is the environment noisy?

Scenario B

A person living with dementia begins waking up frequently during the night.  We know that days and nights can become confusing in Alzheimer’s and Dementia Care, but let’s again explore the “why” in this change in behavior.  Here are some of the questions you should ask yourself:

• Are they too hot or too cold?
• Do they need to use the restroom? – If they are urinating frequently at night, this is another “why”
• Is the room too dark or too bright?
• Has there been any changes to the furniture or placement of furniture in their room?
• Are they in pain?
• Are they developing a disrupted sleep cycle?
• How often do they nap during the day?
• What medications do they take at night?
• Do they take medication to help them sleep?  What time is it being administered?
• Are the clothes they sleep in uncomfortable?
• Are they afraid?

RESPONSE TO CARE

Scenario A

The approach to care would be very different if the reason for a decreased appetite is related to a new medication side effect vs. an ulcer on their tongue.  Determining the “why” helps the person living with dementia receive the right treatment which improves overall well-being and quality of life.

Scenario B

If the person is napping 2 hours every morning and 3 hours every afternoon, this is creating a disrupted sleep cycle.  By correctly identifying the “why” in Alzheimer’s and Dementia Care, we can begin to reduce nap times so the person is tired when it’s time to go to bed.

Conclusion

By not uncovering the “why” when a person living with dementia has a change in their behavior, we are missing the opportunity to optimize care.  These changes may indicate underlying factors that aren’t immediately apparent.  It’s our responsibility as a caregiver to become an investigator.  

Investigating the reasons behind the change enhances overall well-being and quality of life.  Wellness Strategies Group offers Alzheimer’s and Dementia Care consultation by focusing on individualized solutions. If you need help uncovering the “why”, please call for a free consultation.