3 steps to change difficult dementia behaviors

Today I want to talk about my 3 step response to use when someone with dementia is anxious, scared, or upset and you’re not sure what to do.

If you would rather watch a video on this topic, click here.

We often refer to these behaviors as “difficult dementia behaviors” because they are difficult for you or because you aren’t sure how to respond. Sometimes your responses seem to make it worse and you wish the behavior would just stop. It’s also difficult for your loved one because they are very clearly in distress. What we call a "difficult" or "challenging behavior" is a sign that your loved one is in distress. 

Here are 3 steps to keep in mind whenever you are faced with this situation. Also, be sure to head to my “difficult dementia behavior” playlist that has multiple videos on specific strategies and approaches to prevent or lower the chances of these episodes from happening in the future. Those will be a huge benefit to this post today. 

STEP 1: 

FIND THE CAUSE. Remember, they are in distress. A person with dementia who is screaming, crying, scared, and so on is someone who is in distress and they are in distress for a reason. Because that reason isn’t usually obvious to us, it’s easy to think they are acting that way for no reason at all. We try to tell them that everything is okay. We try to use rationalization to tell them why whatever they are scared of isn’t real or true. We try to convince them of what we know is true so that they can stop being scared. But none of that usually works. Just because the cause of the behavior isn’t obvious to us or just because the cause of the behavior doesn’t make sense to us, it doesn’t mean it’s not real for them. If your loved one thinks someone is trying to kick them out of the house, you can try to explain until you’re blue in the face that no one is trying to do that, but it might not work. You have to try to find the cause that makes sense in their mind. That is how you will be successful. If you missed my 2 part video series on how to be a detective and find the actual causes of behavior that doesn’t make sense to you, then be sure to watch these videos- those videos are linked here and here. 

This step is really important because it reminds you there IS actually something causing the beahvior and it helps you to get curious in finding out what that cause is. When we assume the screaming and yelling are just happening for no reason, we don’t look for the cause. This raises the chances that the behavior will continue. 

Okay, so know that you have found the cause or are looking for the cause, we can move on to step 2 (and don’t worry, and the end of this post, I’ll share with you the 1 step you can use if no matter how hard you try, you can’t find the cause...there’s still hope). 

STEP 2:

ADDRESS THE CAUSE OR REMOVE THE OBSTACLE. So if you’ve found the cause because you’ve watched my videos on how to be a detective and get to the bottom of difficult dementia behavior, then you can either address the cause by coming up with a solution that makes sense in their mind OR you can remove the obstacle (if that’s a possibility). 

Let’s stick with the example of your loved one thinking someone is trying to kick them out of the house. Addressing the cause of their anxiety by giving a solution that makes sense in their mind might be to have an “official” letter written saying that they own the house, or by making a sign that hangs outside that says “this is Nana’s house". Or you could tell them you talked to a lawyer and they said that they are safe and no one can take the home away. You would have to adjust your response based on whatever you find out is causing that anxiety. 

Removing the obstacle is an easy approach if you discover that their anxiety and crying happens every month when the mortgage bill comes in the mail. You might realize that connection and you can make sure to intercept the mail daily and remove that bill. Or you could stop paper bills and transition paperless/email billing. That’s an example of removing the obstacle. 

STEP 3:

COMFORT YOUR LOVED ONE. If your loved one is upset, no matter how silly, unusual or strange their reasoning may be, their feelings are still valid. Offering comfort and support rather than reasoning and explanations will usually give you a much better response from your loved one. Usually, they are able to calm down quicker and it also helps to build and strengthen the relationship you have together.  Rationalization, reasoning, and explanation method tend to weaken the relationship and often run the risk of them starting to question, doubt, and resent you. That’s the last thing we want. 

So, what if you’ve watched my detective videos and you still can’t quite figure out the cause and your loved one becomes upset? Without knowing the cause, you can’t do Steps 1 and 2, but you can always use...  

STEP 3:

COMFORT. WHEN IN DOUBT, COMFORT AND LOVE IS A GOOD APPROACH. 

Careblazer, I hope this helps. Again, I’ve linked those specific detective video here and here if you want to try to find out what’s causing a certain behavior. I’ve also linked by dementia behavior playlist here if you want to learn more about how to prevent, reduce, and respond to difficult dementia behaviors.

I hope you all have a wonderful week Careblazers! I'll be back next week with another post.