Understanding & Managing Challenging Behaviors in People with Dementia

November 13, 2024 —Navigating the challenges of dementia is a journey that requires empathy, patience, and a commitment to self-care for both the person with dementia and their caregivers. When people with dementia exhibit challenging behaviors, it is often a form of communication, expressing needs or discomfort they can’t otherwise convey. By understanding the underlying reasons for these behaviors and implementing supportive self-care strategies, caregivers can create an environment that fosters well-being for everyone involved.

Understanding Self-Care for People with Dementia

Self-care is an essential component of life, contributing to both mental and physical well-being. For those with dementia, it can become a complex and sometimes stressful process. The key lies in balancing the necessary tasks, which might be challenging, with moments that bring joy and relaxation.

The Dual Role of Self-Care: Mental and Physical

1. Mental Self-Care: Activities that promote cognitive well-being help people with dementia feel calm, engaged, and mentally stimulated. These might include listening to favorite music, engaging in calming activities, or enjoying nature.
2. Physical Self-Care: Physical activities support the body’s health, helping to maintain independence and motion. Daily routines like teeth brushing and bathing might seem routine, but they are critical to a person’s overall health and require special care for those with dementia.

The Realities of Self-Care for People with Dementia

The Challenging Side of Self-Care

Certain aspects of self-care can be overstimulating or distressing for those with dementia, especially when sensory sensitivities are involved. Bathing, dental care, and other hygiene tasks can be difficult to understand or tolerate. Factors like water temperature, lighting, or even the physical sensations involved may cause discomfort or confusion.

It’s essential to approach these necessary tasks with empathy and flexibility, remembering that these routines are often challenging for the person involved. A calm, patient, and understanding attitude can help in easing these moments.

The Enjoyable Side of Self-Care

Self-care isn’t only about completing necessary tasks; it can also be a source of pleasure and positivity. Engaging in activities that bring joy — like painting nails, wearing favorite jewelry, or dressing in beloved outfits — can improve mood and reduce stress. For people with dementia, making mundane tasks more enjoyable by taking them outdoors or playing calming music can create a more pleasant experience.

How Caregivers Can Support Self-Care for People with Dementia

Caregivers can enhance the benefits of self-care with a few simple techniques:

• Encourage dressing up: Wearing a favorite outfit, even when staying home, can positively impact mood and self-esteem.
• Push for outdoor time: Spending time outside, especially in the morning, offers mental and physical benefits, while fresh air and natural light have been shown to reduce agitation in those with dementia.
• “Water” battles and establishing familiarity: Gentle reminders to drink water or complete other simple tasks may work better in a familiar environment. Creating comforting spaces with “object permanence” helps people with dementia feel calm even if they don’t remember the specifics of an activity—they remember the positive feelings associated with it.

Practicing Self-Care as a Caregiver

Taking care of yourself is just as essential. Caregiving can be demanding, especially when challenging behaviors arise. Here are some ways to prioritize your own well-being:

• Step away if needed: If your loved one is being unkind or aggressive, give yourself permission to take a break. Revisit the interaction another day.
• Live in their reality: Trying to keep your loved one “up to speed” can sometimes cause frustration or confusion. Instead, immerse yourself in their version of reality and let go of the need to correct details.
• Bring activities along: To avoid stressful or circular conversations, have a plan for activities. Bring special projects or join events with your loved one. For example, try bird watching with binoculars, playing favorite music on a Bluetooth speaker, or simply enjoying quiet activities together.

Ideas to Enhance Visits

Some activities caregivers have found helpful include:

• Listening to music with a Bluetooth speaker
• Painting by numbers or coloring
• Bringing along knitting, crocheting, or other handwork
• Bird watching with binoculars
• Bringing along grandkids, pets, or favorite snacks

Final Thoughts: Navigating Challenging Days

There will be days that are difficult, and it’s okay to walk away if a visit isn’t going well. Caregiving for someone with dementia can be unpredictable, and sometimes the best course is to let emotions settle and try again later. Remember that their behavior is not a reflection of you; it’s often an expression of the difficulties they face in understanding and navigating their world.

Supporting a loved one with dementia is challenging, but with understanding, flexibility, and compassion for yourself and your loved one, you can create meaningful, positive experiences. Take care of yourself, be present in the moment, and remember that your support brings them comfort, even if they can’t express it directly.