July 8, 2022

How to Manage the Behavioral and Psychological Symptoms of Dementia

by Psych Times Staff

Dementia is a general term describing a group of conditions that result in a mental ability decline. Sufferers experience memory loss, language loss, and a gradual reduction of problem-solving and thinking abilities. 

The most common cause of dementia is Alzheimer’s disease, which is a progressive disease in which brain cell connections and cells degenerate and die. The symptoms and effects of dementia can change and progress over time, and many people with dementia start experiencing behavioral and psychological symptoms. 

These symptoms can be challenging for patients, family, carers, and health professionals, but that doesn’t mean they aren’t manageable. With behavioral intervention and environment modifications, the condition might be far easier to navigate for all involved. Here are some of the most common behavioral and psychological symptoms dementia sufferers experience and how you might be able to combat them. 

Agitation and Aggression

Throughout the many stages of dementia, many patients can experience agitation and aggression, which can present as threats, complaints, anger, and physical actions like resistance to help, spitting, hitting, and similar. 

While agitation and aggression can be heart-breaking for families to watch and challenging for carers to manage, there are non-pharmacological techniques you can try to alleviate some of these symptoms. 

Getting to the underlying cause of the agitation and aggression might be the first step toward minimizing these behaviors. The person with dementia might be bored, uncomfortable, depressed, or have unmet needs. Address these causes and consider positive interventions like touch therapy, sensory stimulation, and music therapy. 

Depression

Depression is a common dementia symptom in the early stages of the disease. Dementia patients sometimes appear teary, sad, withdrawn, and tired, or they might be pessimistic and disinterested in the activity happening around them. 

Managing depression in someone with dementia can be challenging, but generating positive behavior in multiple ways might help bring them out of their shell. Carers and family members might like to try a number of different approaches, such as small group and solo activities like puzzles and music, activities that make use of sound, smell, and touch, and even time with pets like dogs and cats. 

Studies have shown that animal-assisted therapy might be a beneficial and effective complementary treatment, especially regarding behavioral and psychological symptoms in patients with varying degrees of dementia. 

Psychosis

As dementia progresses, some patients start experiencing psychosis, which can present as hallucinations and delusions. These delusions differ from those related to schizophrenia or mania and relate to memory loss and perception changes. 

Some people might accuse carers, family members, and medical professionals of stealing from them, being imposters, and even infidelity. Visual hallucinations are also commonly experienced by those living with Lewy Body dementia. 

Managing psychosis can be challenging, especially as it can be upsetting for family members. Caregivers should first confirm that their accusations aren’t founded before looking at potentially reversible causes like the introduction of new medicine and over-stimulation. Sometimes, distraction and memory aids can be practical solutions for managing psychosis symptoms. 

Apathy

While similar to depression, apathy can present as aimlessness, a lack of motivation and initiative, and a reduction in emotional responsiveness. Some of these symptoms can relate to depression, but a lack of sadness can indicate that someone living with dementia is apathetic. 

Fortunately, there are many ways to address this behavioral and psychological symptom, such as focusing on generating positive behaviors. Carers and family members might like to engage them in puzzles, games, pet therapy, music, and exercises like walking. Both group and individual activities to break up each day and create positive experiences might help bring the patient out of their apathetic state. 

Anxiety

Anxiety is one of the most incapacitating symptoms associated with dementia and can occur at almost all stages. However, it can be far more severe in the later stages as a response to changes in environment or routine and separation from family. 

With such a symptom, addressing the trigger can be more important than managing the anxiety itself. Where possible, identify the cause of the anxiety, such as a change in routine, and consider maintaining the patient’s daily structure as consistently as possible. You might also like to look at therapy techniques, such as music and cognitive behavioral therapy, to potentially minimize anxious behavior in the future. 

Wandering Behavior

In dementia care facilities and home environments, wandering can be one of the most significant concerns for carers, families, and medical professionals. While walking is an excellent form of exercise in most situations, it can pose a safety risk for those living with dementia. Some dementia patients can partake in harmless wandering, such as pacing between two areas in a contained and safe area, but they might also walk to random locations with no sense of direction. 

When wandering behavior has been identified, creating a safe space for walking can be crucial. Consider making supervised walks a daily part of their routine, providing them with exercise equipment, and even looking at the benefits of a GPS watch. Caregivers might also like to identify the cause of the wandering, such as whether they’re looking for a specific person or trying to escape from something they see as a threat. 

Disinhibited or Unwanted Behaviors

Disinhibited or unwanted behaviors describe actions that some might see as offensive, rude, or disrespectful. When you know the type of person someone with dementia is, these behaviors are likely out of character. 

Reduced impulse control is one of the leading causes of disinhibited behavior, and their impaired judgment and lack of environmental awareness might contribute. Sometimes, such behaviors can also be worsened by specific medications, a lack of personal affection, missing a sexual partner, or having reduced privacy. 

Disinhibited behaviors can be outside of a patient’s control, but it’s important not to humiliate them when they do something most people would describe as rude or offensive. Identify triggers that might lead to such behavior and divert their attention to other tasks, such as a craft activity or a walk. 

If the patient is displaying frequent sexual behaviors, direct them to their private room to ensure they have the privacy they need for the comfort of others. 

Managing behavioral and psychological symptoms relating to dementia can be challenging, particularly as these symptoms can change and worsen with time and as the condition progresses. If carers, medical professionals, and families can work together with consistent management methods, there might be no reason why most dementia-related symptoms can’t be effectively managed.


Psych Times Staff

At Psych Times, we strive to help increase the awareness of mental health, to reduce the stigma of mental illness, and to provide our readers with high-quality content to help them cope with the stresses of everyday life.

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