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   Tips for Dealing with Specific Dementia Problematic Behaviors   
   Carrie Steckl, Ph.D., edited by Natalie Staats Reiss, Ph.D.   
       
   Agitation - Individuals with dementia frequently become restless, anxious, or   
   upset (when filling out a behavior chart, it is helpful to use specific,   
   concrete words that clearly describe what your loved one is doing so you can   
   truly track whether your    
   changes work to decrease the behavior). To decrease agitation, listen to the   
   person as he or she expresses her frustration to get a clue about what kind of   
   antecedent is a trigger; try to eliminate and/or decrease triggers as much as   
   possible. Pain,    
   discomfort (being too hot, too cold, hungry, needing to use the bathroom,   
   etc.), frustration, and overstimulation are all common triggers of agitation.   
   It is also very important to examine your behavior in response to the person.   
   If you are not already    
   doing so, reassure the person that you are there to provide assistance and   
   comfort. If it seems like the person needs something to do, try redirection to   
   an enjoyable activity.   
   Aggression - Aggressive behavior can include shouting, cornering someone,   
   raising a hand to someone, or actually pushing or hitting. Unfortunately,   
   aggression among people with dementia can happen suddenly and seemingly   
   without warning. Try to identify    
   what triggered the aggression so that the antecedent can be eliminated or   
   modified as soon as possible. As difficult as it may be, react in a calm,   
   reassuring way and focus on the person's feelings. Reduce environmental   
   distractions as much as possible,    
   such as loud noises or potentially frightening shadows or movements.   
   Redirecting an aggressive person to an enjoyable activity can be remarkably   
   effective.   
   Repetition - People with dementia often repeat a word, question, or action   
   over and over again (e.g., saying "What are we doing today?" repeatedly). This   
   behavior is usually harmless, but it can be unnerving and annoying for those   
   who are caring for the    
   person. Repetitive behavior is usually a sign of insecurity, since people with   
   dementia are often looking for something comfortable and familiar - something   
   over which they have some degree of control. To address repetition, look for a   
   specific    
   antecedent or reason for the repetition as well as for the emotion behind it.   
   This can reduce your chances of responding impatiently with the person. If the   
   repetition is an action, try turning it into an activity that makes the person   
   feel useful. For    
   example, if the person is constantly fidgeting with his hands, try giving him   
   some socks to sort or some knick knacks to clean.   
   Hallucinations - Hallucinations are sensory experiences that seem real, but   
   are not. The most common hallucinations are visual (i.e., seeing something   
   that is not really there) and auditory (i.e., hearing something that is not   
   really there), but    
   hallucinations can also occur in regard to taste, smell, and touch. Because   
   hallucinations seem real to those with dementia, it is not helpful to try to   
   convince the person that she is imagining things. Instead, recognize the   
   person's feelings, reassure    
   the person that you are there to help, and redirect her to a pleasant   
   activity. Also consider whether the hallucination is actually bothersome. If   
   it is a "nice" hallucination (e.g., seeing a pretty orchard outside that is   
   not really there), there may be    
   no benefit in trying to discourage the behavior.   
   Suspicion - Memory loss and disorientation can cause individuals with dementia   
   to perceive situations inaccurately. They may become suspicious of others -   
   even those close to them - and accuse them of theft, infidelity, or other   
   offenses. As hurtful as    
   it may be to be accused of something you did not do, try not to become   
   offended. Remember that the behavior is caused by a disease that is affecting   
   the person's brain. Try to imagine what it would be like to continuously think   
   your possessions are being    
   taken or hidden (because you cannot remember where you put them). Do not try   
   to argue with the person or convince him or her of your innocence. Instead,   
   share a simple response with the person (e.g., "I see that you're upset that   
   your purse is missing; I'   
   ll do my best to find it for you.") and avoid giving complicated explanations.   
   Redirection to another activity can also be effective in these situations.   
   Another option is to store "back-ups" of commonly misplaced items (e.g., hats,   
   wallets).   
   Apathy - Apathy is a lack of interest in or motivation to engage in   
   activities. While apathy may not seem like a serious behavior problem, it is   
   not healthy for someone with dementia to simply sit around passively. Try to   
   find out what may be triggering    
   the apathy (e.g., being ignored or becoming overwhelmed with a task) as well   
   as what kinds of consequences may be reinforcing it (again, being ignored, not   
   having appropriate choices of pleasant activities). Even though the person is   
   ill, it is important    
   to keep him or her moving and as active as possible in order to maintain   
   physical health and to prevent depression. Try adapting previously pleasurable   
   activities so the person can participate at a level that is comfortable and   
   not overwhelming. Even a    
   small amount of activity is better than none at all.   
      
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   --- SoupGate-Win32 v1.05   
    * Origin: you cannot sedate... all the things you hate (1:229/2)