Dementia, an umbrella term that encompasses Alzheimer’s disease, refers to a decline in memory and mental ability that interferes with a person’s capacity to live their life normally. As dementia progresses, a number of common behaviors can impact one’s health and safety. Some of the most common behaviors exhibited by those with dementia include:
What it looks like: During early-stage dementia, your loved one may have trouble finding words to describe their feelings, or they may forget new information. Confusion tends to worsen into middle-stage dementia; your loved one may forget who you are, where they are, what year it is and even details about their own history.
How to manage it: If your parent thinks that you’re their late father instead of their son, trying to convince them that they’re mistaken may upset them more. Instead, try connecting on an emotional level.
“Our goal with the person with dementia is not to reorient them to the here and now,” says Laci Cornelison, licensed baccalaureate social worker, a research assistant and instructor at the Kansas State University Center on Aging. “A better goal is to connect with them and reduce anxiety and other symptoms that negatively affect quality of life. To do this, validating their feelings is a great place to start.”
What it looks like: Some people lash out at family members during middle-stage dementia, accusing them of lying or withholding information.
How to manage it: Remember that it isn’t a personal attack; it’s the dementia talking. Instead of arguing, shift the conversation.
“Redirection is a technique that has been fairly well-documented,” says Kevin Jameson, president and founder of the Dementia Society of America. “It basically diverts someone’s line of thinking to an adjacent subject. The new, shiny object often takes over the conversation. This may be done over and over.”
What it looks like: It’s not uncommon for someone mobile with middle-stage dementia to wander around their home or even outside. They may have gotten up to go to the bathroom or out of boredom. They may be trying to go to work, although they’re retired. They may be trying to get home, although they’re already there.
How to manage it: Once someone with dementia starts wandering outside, full-time monitoring may be needed. But if you notice that your loved one wanders inside when they’re bored, engaging them may help.
“Needs for purpose and meaning do not vanish once a person is diagnosed with dementia,” Cornelison says. “Incorporate meaningful activity within the person’s daily rhythm. Don’t just try to fill time, but establish routines and rhythms that incorporate lifelong patterns that have been meaningful to the person.”
What it looks like: People with middle-stage dementia may become more anxious or agitated in the early evening. They’re likely exhausted by all of the activities that they’ve endured that day, especially if they’ve felt confused, and they may not have the vocabulary to express their frustrations.
How to manage it: If your loved one gets agitated in the evening, schedule stressful activities, like showers, earlier in the day, and offer relaxing activities instead.
“Keep the person engaged in things you know they enjoy — for example, watching their favorite baseball team play on TV,” Cornelison says.
Your impatience can make sundowning worse, so do your best to remain calm.
“Communication with a person with Alzheimer’s requires patience and understanding,” says Ruth Drew, director of information and support services for the Alzheimer’s Association. “[They] can feel another person’s kindness, patience or frustration. They respond to tone of voice, facial expression and body language.”
5. Changes in eating habits
What it looks like: During middle-stage dementia, your loved one may lose weight. Some people forget to eat, or they may not choose nourishing foods, instead subsisting on snacks.
How to manage it: When you notice weight loss or an empty refrigerator, provide meals and beverages regularly, and make sure that they’re consumed.
“Nothing replaces your own eyes and ears or that of those you trust to observe in your stead,” Jameson says.
6. Changes in hygiene habits
What it looks like: Many people with middle-stage dementia stop noticing their appearance. They may forget to change their clothes, bathe or brush their hair.
How to manage it: When personal care tasks fall to the wayside, provide reminders to ensure that habits are kept up.
“Model the action you want the individual to perform,” Cornelison says. “Hand them their toothbrush, and get yours out, as well. Demonstrate what you want them to do, and start their hand in the motion.”
If you are struggling to manage your loved one’s care on your own, consider an in-home caregiver.