It is August already?? Where has the summer gone, school will be starting before we know it for those of you that have kids or grand kids!
Here is the last installment of the possible causes for behaviors that a person with dementia may exhibit. I hope that you have found some of these useful in your professional and/or personal life. If you have any suggestions for topics or ideas that you would like to see on here, or if you have some information that you would like to share about the topic of dementia, let us know at firstname.lastname@example.org!
If someone is resistant to activities of daily living (ADL’s) such as dressing, toileting, oral care, incontinence care, or other grooming activities it may be due them feeling like there is a lack in privacy or loss of their dignity. They may be frustrated that they have lost the ability to do some of these tasks themselves and now require assistance. The person may not recognize the caregiver or the object that is being used, or possibly they do not understand/hear what the caregiver is saying. There may be a misunderstanding of the reason for the activity. There may be a medical reason affecting mobility, balance, or range of motion. Fatigue or weakness could be a cause. The activity may bring on some emotional memories for them, or there may be a cultural difference that you are not aware of. And finally, as with most of the previous behaviors, consider if there is any untreated pain that they are experiencing.
Resistance to bathing is a very common behavior for someone with dementia. Fear of water is something that a lot of people with dementia develop with the progression of the illness. If the caregiver is the opposite sex of the person, there may be some discomfort with that. The person may feel that the room is too cold or possibly that the water is either too hot or too cold. They may be unfamiliar with the surroundings or could be embarrassed to be see naked by someone that they are not familiar with or is not their significant other. Fear of the activity and potentially getting hurt may also cause someone to act out. Just like with the other ADL’s, consider if there are any cultural differences to consider or if the person possibly is having some emotional memories. There could be some pain associated with some of the different movements required to clean different areas of their body.
Sundowning is a very difficult behavior for the people around the person to deal with. Some possible causes of sundowning to be more pronounced may be that the person is overly tired and needs to rest. Consider if there is an unmet need such as hunger and thirst, or if the person needs to be toileted or changed. The person may be bored and looking for anything to do, or there could be some depression going on. As with every other behavior consider if the person is experiencing some pain from something.
The final behavior that I want to bring up is that of wandering. This could be lapping or circling large areas of a room, pacing back and forth in a limited area, or moving from one location to another with or without any apparent purpose. This could be caused by a change in the brain from the illness, or the person may just be stressed and/or anxious about something. They could be acting out a regular routine from their past such as checking on the children or doing the laundry. The need for exercise or activity could be the reason. The person may not know where to find something they are looking for or needing, such as a bathroom or dining area, or the environment is unfamiliar to them and they are attempting to acquaint themselves with it. Something may have triggered a memory for them, good or bad. A very common cause for any of these behaviors once again is pain. Consider this when any behavior comes up.
I hope that you have found some value to this information and some of the other ideas that people have added in the comments below my posts. When working with someone that is exhibiting behaviors, please take some time to try to figure out why they may be acting like that. Yes, it potentially could be caused by the progression of the disease, but it also could be triggered by something that you can do something about!