What are some of the difficult symptoms of dementia?

Dementia will, at some stage, make the person you know behave in new ways that can often cause you and them distress. Here we shall identify some of these difficult behaviours and practical tips of what you can do to deal with it together. 

In the early stages of dementia, people with dementia say that the most irritating aspect is being treated differently, as soon as the diagnosis is received. It’s worth remembering that in the very early days and for quite a while afterwards, depending on personal circumstances, the person is still the same person, so treat them the way they would normally. 

Later on down the road with dementia, people with it are more likely to behave in ways that are harmful to patient and carer, but note, this may not signal a permanent change in character, symptoms come and go. This stands to reason as confusion is more apparent and it is likely to be at the time when you consider your care options. 

Let’s look at the behaviour:

Aggression

Frontotemporal dementia which affects the front part of the brain is more likely to cause aggression than the other types, because the frontal lobes are the place where inhibitions lie. GP’s and/or psychiatric team can help, letting you know in advance what to expect. Aggression does not always occur in people with dementia and it is generally for a short period of time but it can be the most dangerous, so tactics to deal with this are important. 

Leave the room -  get out of harm’s way, that is the first priority. This will hopefully allow the aggressor to calm down. Even verbal aggression can be damaging to well being, so giving yourself a break will help. Creating distance also removes the possibility of the actual carer becoming aggressive in return, which will likely escalate the problem. 

Do not argue back -  resist the temptation to argue back, it will not help the situation. Even if you managed to prove they were in the wrong, there is a decent chance that the person with dementia will forget that position and start off again on the same theme. Arguing back can also create an emotional hangover, with the person with dementia feeling angry and suspicious increasing the chance of further aggression and arguments. 

Check the person is not in pain - untreated pain in a patient can sometimes be the root cause of the disturbing behaviour. Make sure you consult your doctor on this.

Are there obvious triggers for the behaviour - aggression can be a coherent response from a person who is misinterpreting what is happening because of issues with their understanding and recall. They think something is wrong, so become angry and scared and want to fight. If they have always been confident and strong, and in their eyes, everything begins to go wrong, they may lash out. For example, is the person undressing them a nurse or someone trying to take advantage? 

You will need to set up a diary or lists of situations that occur that make the person agitated and work to improve and change these situations. Seek professional help where you can. 

Keep them active - take them for walks. Exercise reduces stress, and at it’s most basic level, exercise will result in fatigue which makes it harder for someone to fight and be aggressive. Some people may get irritable when tired, but even so, a long walk will generally make a person feel somewhat better about the world. 

Make life more simple/calmer - life is challenging for the best of us, so making someone’s day as easy as possible will help. How to make the house more dementia friendly, highlighted in other blogs will help and making items around the house more obvious and easy to use will all contribute to reducing the chances of someone losing their temper. 

Agitation and anxiety

Agitation and anxiety will be brought about in a person with dementia because they find it harder to distract themselves or move away from things that are upsetting them. You will need to be a detective to work out what is causing the anxiety, so we have covered off some of the ways in which to reduce stress in a person with dementia. You can try some of the following twiddle muffs/aromatherapy/calm atmosphere/light therapy and music.

The advice given above when dealing with aggression also works well for people with anxiety, aggression often just being a physical manifestation of agitation and anxiety, so employ those methods to see what works best for you. 

Depression

Activities that relieve boredom and facilitate distraction are good for avoiding depression. Being inactive can lead to people feeling listless and unworthy. 

Pet therapy is great for helping people stay happy. Petting an animal is known to increase dopamine levels and the exercise through walking a dog etc also staves off depression. There are also products that you can purchase such as cuddle kittens or puppies which are toys which can be petted, when a pet is not appropriate or possible. We cover more on pet therapy here.

Remembering the past can also help. People with dementia will remember events that have happened earlier on in their life far better than recent events, so reading old stories, listening to old music from their youth can be great ways of increasing happy moods. 

Multisensory therapy also helps. Items that give off light and music and even smells can lift people. Fibre optic lights that can be touched are ideal. 

Counselling can also help and is often recommended to deal with depression. The counsellor will need to know about dementia as some of the most common techniques will not work on dementia patients.

Companionship is really useful with depression. Getting people together who are facing the same challenge can bring people together, stave off loneliness which is a common cause of depression. Search out social gathering, events and encourage the person with dementia to go along. 

Other behaviours:

Incontinence - a common problem. A useful technique is to create a pattern and routine to when you take the person to the toilet to do the business. If they are regular with their bowel movements, then this will help. It’s a difficult subject, a tad taboo, but the more you are open about this with the patient, the better.

Hallucinations or delusions. In particular people who are diagnosed with Lewy Body dementia (more here) are at risk from hallucinations due to the rate of brain function deterioration. We cover hallucinations and delusions in more detail here

Hightended sex drive - you may think that people with dementia would have a reduction in their sex drive, but don’t be fooled, it can often lead the other way. If this starts to cause a problem, for example, aggression, then this needs to be addressed with the GP.

Repetitive behaviour - this can be very annoying for the carer/loved ones when the person with dementia keeps asking the same questions, or saying the same thing over and over again. Distraction is the best thing for it, as well as keeping your cool and staying relaxed. 

Summary 

Make sure that other people who come into contact with the patient, care workers/GP’s etc are very much dementia aware. A ‘new’ person coming into deal with the person, may make the person with dementia feel uneasy and could trigger a disturbing behaviour. Make sure the patient is completely aware of who is there to look after them.

Finally - give yourself, the carer, a break. Dealing with some or a number of these behaviours can be exhausting, so it is crucial you get the breaks you need!