If you’re happy and you know it, clap your hands!
This is the way the old children’s song goes, with a lilting verse and invitation to a happy-making motion: clapping hands, stomping feet, spinning around.
But what if you’re not actually happy? And what if you don’t know, because you’re suffering from dementia and there’s a lot about yourself that you can’t quite recall and it’s making you feel really angry or upset?
Not a Happy Place: The World of Dementia
Patients who have received a dementia diagnosis typically move through stages, including mild, moderate, and severe/late-stage dementia. The symptoms do not include anything that anyone would look forward to and seek out with intention.
Patients who were once fully engaged, well socialized, and contributing to a household or workplace are often gradually confined to home or nursing facility care, lose the ability to transport themselves to places they may wish to go, diminish in their physical capacities, and lose relational contact with loved ones as their memory fades. It’s no wonder that patients occasionally exhibit aggression or other behaviors that denote frustration with their circumstances.
Triggers: Causes of Aggression and Other Challenging Behaviors
Certain times of day may cause increased agitation in some individuals, which is a phenomena sometimes called “sundowning.” The late afternoon or evening hours sometimes seem to cause an increased state of confusion for some people, perhaps due to physical factors such as exhaustion from the day. People may also react with unexpected aggression if they feel they do not understand what is happening around them or, feel confused about an expectation placed upon them (for example, to eat a meal, use the restroom, move to a new place or position, etc.). Sometimes people seek to resolve their confusion or frustration with repetitive motions or fixation on a certain word or sound.
Physical Irritations
Additionally, pain, urinary infections and constipation, hunger, thirst, and erratic blood sugar levels may also instigate acting out. Prior to experiencing dementia, patients were once able to meet or at least communicate their needs to others. While patients may still have the same needs or desires, the disease may inhibit the ability to get requirements met, resulting in challenging behaviors that both express personal frustration and unmet needs.
Some may act out for reasons that aren’t as apparent, including hallucinations. Dementia can dramatically alter the ways people see, hear, taste, feel, and smell the world around them, resulting in delusions about the reality of what is happening to them.
What Can I Do?
The first thing to do is to check over the basic needs of any human being. Is your loved one fed? Have they recently had enough to drink? Are there any new signs of pain that may have come from a fall, other injury, or bedsore? Is there a fever? Have you recently tested blood sugar and managed insulin levels (if diabetic)? Has the patient received his or her medications at the recommended levels and frequency? Does the medication prescribed for your loved one suggest aggressive behavior as a side effect? Answers to these questions may help provide an answer and relief for challenging behaviors.
Exercise and Activity
Next, consider your loved one’s activity levels. Many dementia patients need more physical activity than they get otherwise in a bed or chair. Activity will provide a better-exercised body
which results in greater clarity of mind and calmness. Exercise will not cure your loved one’s condition, but may provide relief to some of the more difficult side effects. If he or she cannot move from a chair, caretakers can consider providing a rocker or other chair that encourages movement. You may also want to engage the services of a physical or occupational therapist to do some gentle exercises daily or a few times per week.
Environment
Lastly, take into account the person’s overall environment. Do hearing aids have fully charged batteries? Are glasses clean and in the right position to help the person see? Is your loved one in a comfortable environment, free from harsh lighting, excessive noise, and abrupt interruptions or activity? Are they too hot or cold? Do they need to use the restroom? After surveying the area where your loved one is sitting or living, make adjustments as needed for their comfort. If one adjustment doesn’t resolve their anxiety and behavior, try something else until you have a better handle on what the concern might be that is bothering the patient.
Has anyone interacted with your loved one lately? He or she may be bored and acting out of frustration because “boredom” is a more difficult situation to communicate than “hungry” or “ouch, I’m in pain.” If you suspect monotony is troubling your loved one, break up the pattern by connecting with him or her. Hold hands and turn on their favorite music or television show. Try giving them knitting materials or another set of tools to keep them engaged with a familiar activity.
Contact Caring Hands Matter Today!
A loved one with aggressive behavior related to dementia is difficult – it’s not a happy situation no matter how it’s interpreted. Yet, there is hope and there is help. For more information about how to manage dementia patients with aggressive or other challenging behaviors, please call or contact Caring Hands Matter online to learn more about Fairfax, VA home care today.