Visory Veteran Community Caregiver Series: Managing Difficult Behaviors in Dementia

Millions of Americans have a diagnosis of dementia. While caring for someone with dementia is rewarding and improves their quality of life, it may be challenging for the caregiver.

Most Veteran’s with dementia will exhibit difficult behavior that can leave you feeling unsure of what to do.

This series is intended to help our Visory Veteran Community understand what to do when your loved one with dementia exhibits difficult behavior/s.

What is Dementia?

Dementia is a brain disorder affecting a person’s memory, thinking, and social abilities. Dementia impairs a person’s ability to carry out daily activities.

What Are Difficult Behaviors Associated With Dementia?

Any behavior that you cannot mitigate, or control may be characterized as difficult. Some common difficult behaviors in dementia patients include:
Aggression
Anxiety
Depression
Repetitive Behavior or Questions
Rummaging, Hiding, and Hoarding
Inappropriate Behavior
Wandering
Sundowning (symptoms and behaviors worsen at the end of the day)

While these types behaviors may be difficult to manage as a caregiver, we are here to support you through your caregiving journey.

**The following information is shared from the VA Caregiver Support Program.

Tips on How to De-Escalate Difficult Dementia Behaviors

De-escalating difficult dementia behaviors means trying to stop or lessen the behaviors as they are occurring:

Consult medical advice for any sudden or escalation in difficult behaviors to rule out a possible underlying medical reason or pain causing the behavior.
Remain as calm and patient as possible.
Ensure you understand that the difficult behavior is a result of the dementia and is not personal.
Don’t try to reason or argue with your loved one. Instead, reassure and agree.
Share a memory or reminisce of a happy thought or time to redirect their behavior.

Evaluate the behavior to try and understand possible triggers.

How to Manage Common Difficult Dementia Behaviors

Managing Incontinence (loss of bladder or bowel control)

Consult with a medical provider to rule out an underlying medical condition.
Look for non-verbal cues such as pulling on pants or pacing.
Initiate a toileting routine and schedule every two hours.
Consider the use of adult briefs, pads, and waterproof sheets.

Managing Resistance to Bathing Behaviors

Change the days or times of bathing to see if that helps with resistance.
Ensure the temperature, environment is comfortable.
Ensure distractions are minimized.
Make simple and direct statements: “Your bath is ready.”
Consider using assisted equipment: shower chair and/or hand-held shower head to help.

Eating and Providing Incentives to Eat

Find a regular mealtime and maintain a routine.
Keep the meal place setting simple and free from distractions.
Reintroduce foods your loved one enjoyed in the past.
Provide smaller meals throughout the day.
Prepare meals together so your loved one knows the food is “safe” to eat.

Manage Wandering in Dementia Patients

Ensure basic needs are met. Hunger and the need to toilet may cause agitation and initiate wandering.
Provide activities and a routine to keep your loved one busy and occupied.
Use childproof safety measures (cabinet locks and knobs) and conceal doors to deter your loved one from leaving.
Enroll in a Safe Return (check with your local law enforcement), Medic Alert or similar program so that if your loved one is found wandering, they can be assisted.

Managing Agitation in Individuals with Dementia

Remain calm and create a calm environment.
Play soothing music.
Use reassuring words and quiet tones; “you are safe.”
Find activities your loved one enjoys.
Understand changes in the environment may contribute to agitation.

Tips for Coping with Dementia Behaviors and Additional Resources for Caregivers

Caring for yourself is as important as caring for your loved one with dementia. You need to stay as healthy and strong as possible.

Try meditation or quiet yourself with deep breathing for several minutes.
Reach out to family, friends, and other caregivers for support. Don’t isolate yourself.
Contact your local Caregiver Support Coordinator – who can match you with eligible services and provide resource information that can help as you care for the Veteran you love.
Access all available resources and training materials at caregiver.va.gov
Call the Caregiver Support Line: 1-855-260-3274
Visit the VHA Office or Rural Health website for dementia caregiving videos at: http://www.ruralhealth.va.gov/vets/resources.asp
Contact your local Area Agency on Aging eldercare.gov

At Visory Health, we see you and hear you! We understand the challenges of managing difficult behaviors and we support the safety, respect, and dignity of our Visory Veteran Community.

Continue to take good care of yourself, so that you can care for the Veteran you love. Our Visory Health Discount Prescription Card can help you save money on your prescription medications: www.visoryhealth.com

One Team, One Fight…Always!