As a professional caregiver, you may encounter a client that has dementia and will act inappropriately toward you or other people. This behavior may be inappropriate and it may leave you feeling scared, embarrassed, and very uncomfortable.
First, let’s take a look at what might cause this type of behavior. It’s important to understand this is caused by their dementia and is not a reflection on you. Equally as important--this isn’t something they are doing purposefully--it’s the disease. They likely are also acting in this way toward their family, spouse, and friends. They may become angry or agitated when they feel rejected. Knowing all you can about dementia is a great place to start. Check out our eBook to learn more about the many aspects of dementia.
Aggressive or inappropriate behaviors may be verbal or physical. They can occur suddenly, with no apparent reason, or result from a frustrating situation. While these behaviors can be hard to cope with, understanding that the person with Alzheimer's or dementia is not acting this way on purpose can help.
Causes
Aggression or inappropriate behavior related to dementia can be caused by many factors including physical discomfort, environmental factors, and poor communication. If the person with Alzheimer's is aggressive, consider what might be contributing to the change in behavior. Some common reasons include:
- Tired
- Hunger or thirst
- Medication side effects or missed medications
- Physical pain they can’t explain like a UTI
- Overstimulated
- They feel lost
The list can grow longer and is very individualized. One thing to watch for is timing. Many dementia sufferers have these feelings at specific times of the day--often at night. Writing this information down can be very helpful over time.
Dealing with the Behavior
The first thing to remember is to stay calm and remain patient. Getting agitated yourself will only contribute to the situation.
- You should be firm when telling them their behavior is inappropriate.
- Be sure to include verbal and non-verbal cues like shaking your head no or yes.
- Be consistent with the boundaries you set with them so they get the same message each time.
- Offer them alternatives that are appropriate like watching television or eating if they are hungry.
- Remove them from the area to see if changing to a different environment helps.
- Try music or television to relax them.
- If necessary say “No” loudly and forcefully if they won’t stop. Remove their hands from you as necessary.
- Stay safe and call 911 in extreme circumstances only where their safety or yours is at stake.
- You may also report these types of behavior to your employer, depending on their policies and procedures.
One thing to try and rule out as soon as possible is pain. Ask questions about how they are “feeling” and not fact-based questions like “are you in pain”. People suffering from dementia may not be able to describe what’s wrong like “I have a urinary tract infection”, but they may say “my body hurts”. You can ask where, and follow up with questions from there to try and figure out what’s wrong.
Consistency and Redirection
Staying very consistent when dealing with behavioral issues is your best option. This reduces the chances of inadvertently encouraging future negative behaviors.
Quietly let visitors or other people nearby know that your client has some dementia and may act out inappropriately. If you are going in public and it’s an ongoing problem you may consider having business-sized cards printed that say “Please be patient. The person I’m with has dementia”. This may help with your anxiety and the people nearby.
Redirecting or keeping your client occupied with an activity they find enjoyable can help a lot. Often dementia sufferers find solace in doing activities like folding clothes, untangling wires, holding a doll or mechanical puppy. Rocking can also be something they find soothing at home or a combination of things. Some experimentation is often needed but worthwhile. You may want to write down what works for others for later.
Ask your employer to encourage a family conference so you can talk to the family with the support of other professionals like the company nurse or care coordinator. The family may be able to work with the client’s doctor related to medical concerns like pain or anxiety.
Self-Care
Be sure to be good to yourself as these conditions can be especially trying on you. Things can be moving along splendidly one minute and then everything changes and you are dealing with behaviors that had seemed like a bad memory. Have a good support group at work or amongst your friends. Being able to talk to others about your experience often is helpful--even if they just listen--be mindful not to violate HIPAA. Daily Caring is a blog dedicated to Caregivers. They have a wonderful resource for handling caregiver stress. Not every type of client is right for every caregiver. Sometimes people have personal reasons to avoid inappropriate or aggressive behavior. There is still a great need for these caregivers with other clients. Consider having a discussion with your employer and tell them you would prefer, for personal reasons, not to care for dementia clients acting out in this way.
The work you do with Dementia patients can be both trying and rewarding. It is so vitally important to these families and clients that need you!
Interested in what it means to be a Comfort Keeper? Want to learn more about caregiving? Would you like to join us as we provide exceptional care to seniors in the comfort of their own homes? Speak with a member of our team today!
Acknowledgments:
Minnesota North Dakota Alzheimers Association
Daily Caring
Comfort Keepers Inc
WebMD
