Dementia Care in Penrith

Understanding Changes in Behaviour and Communication

When someone you care about is living with dementia, changes in their behaviour or communication can sometimes be difficult to understand. A person may repeat the same question, become anxious when you leave the room, accuse someone of taking their belongings, ask to go "home" when they are already at home, or become upset for no obvious reason.

It can be distressing for everyone involved, but it can help to remember that behaviour is often a form of communication. The person may be trying to express fear, discomfort, confusion, frustration or a need that they can no longer easily put into words.

Understanding what might be behind a behaviour can help us respond with reassurance rather than confrontation.

Changes you may notice

Repeating questions

A person with dementia may ask the same question repeatedly because they cannot remember asking it or hearing the answer. Although it can be tiring for the person supporting them, to them it may feel as though they are asking the question for the first time.

Responding calmly and offering reassurance can often be more helpful than reminding them that they have already asked.

Repetitive actions

Someone may repeatedly fold items, pack and unpack a bag, move objects or walk the same route around their home. Rather than immediately trying to stop the behaviour, consider whether it is causing any harm and what the person may be trying to achieve.

Sometimes a repetitive activity provides familiarity, comfort or a sense of purpose.

Following or constantly seeking reassurance

Some people begin following a family member or carer from room to room or repeatedly calling out to check where they are.

Imagine how unsettling the world can feel when places, people or situations no longer make complete sense. Staying close to someone they trust can provide a feeling of safety and reassurance.

Looking for somewhere from their past

A person may say they need to go home even though they are already at home, or talk about needing to go to school, work or another place from many years ago.

As dementia progresses, recent memories are often more vulnerable than older memories. The "home" they are looking for may therefore be a childhood home or somewhere associated with feeling safe and secure.

Rather than concentrating only on correcting them, it can be helpful to think about the feeling behind what they are saying.

Asking for someone who has died

A person may ask for a parent, partner or friend who died many years ago because, at that moment, they do not remember the person's death.

Repeatedly telling someone that a loved one has died can sometimes cause them to experience the grief as though they are hearing the news for the first time. How best to respond will depend on the individual, but reassurance and gently exploring what they are feeling can often be helpful.

Difficulty completing familiar tasks

Dementia can affect someone's ability to carry out a sequence of familiar actions. They may know that they want to get dressed, make a drink or use cutlery but struggle to work out what comes next.

Giving simple prompts and allowing plenty of time can help the person continue doing as much as possible for themselves rather than automatically taking over.

Difficulty recognising objects or people

Some forms of dementia can affect the brain's ability to make sense of what the person sees. They may look at a familiar object but not recognise what it is, or occasionally have difficulty recognising familiar people or places.

Clear explanations, familiar surroundings and gentle prompts can help without making the person feel that they are being tested.

Delusions and suspiciousness

A person with dementia may strongly believe something that other people know is not true. They might believe someone has stolen from them or that another person intends to harm them.

Arguing or repeatedly trying to prove that they are wrong can increase distress. Acknowledging how they are feeling, offering reassurance and checking whether something else may have triggered the concern can be more helpful.

Hallucinations

Some people experience hallucinations and may see or hear things that other people cannot. What they are experiencing can feel completely real to them.

If the hallucination is frightening or there is a sudden change in someone's behaviour, professional advice may be needed, particularly as illness, infection, medication or other health problems can sometimes contribute to changes in perception or confusion.

Restlessness at night

Changes in sleep are common in dementia. Someone may wake frequently, get dressed during the night or believe it is time to go out.

Daytime activity, routine, lighting, medication, discomfort and the person's environment can all influence sleep. A sudden change should not automatically be assumed to be "just dementia" and may need further investigation.

Restlessness or agitation

If someone becomes unusually restless, first consider what they might be trying to communicate.

Are they hungry or thirsty? Could they be in pain? Do they need the toilet? Are they too hot or cold? Are they bored, frightened, tired or overwhelmed by noise or activity?

Looking for the reason behind the behaviour can often be more effective than simply trying to stop it.

Losing or hiding belongings

Someone may put an item somewhere unusual and later be unable to remember doing so. They may genuinely believe another person has moved or stolen it.

Being accused can be upsetting, particularly for family members, but try not to take the accusation personally. Helping the person look for the item and providing reassurance may reduce their distress.

Changes in inhibitions

Dementia can sometimes affect a person's awareness of what is socially appropriate. This might include inappropriate comments, undressing, touching themselves or someone else, or other behaviour that would previously have been out of character.

The person's dignity should still be protected. Consider whether there is an unmet need behind the behaviour and seek professional advice if it is persistent, distressing or presents a risk.

Anger or aggression

Not everyone living with dementia becomes angry or aggressive. When it does happen, there is often a reason.

Pain, fear, confusion, frustration, feeling rushed, being approached unexpectedly or not understanding what someone is asking can all contribute.

Try to consider what happened immediately before the person became distressed. Changing the approach, environment or timing may sometimes prevent the same situation occurring again.

Look beyond the behaviour

One of the most useful questions we can ask is:

"What might this person be trying to tell me?"

A change in behaviour should not automatically be attributed to dementia. Pain, infection, constipation, dehydration, medication, poor hearing or vision, tiredness and other health problems can all affect how someone behaves or communicates.

Knowing the person – their history, routines, preferences, relationships and what makes them feel safe – can make a considerable difference.

Above all, the person is still the same individual they have always been. Dementia may change how they communicate or experience the world, but their feelings, dignity and need to be heard remain.

Dementia Support in Penrith

If you're caring for someone with dementia in Penrith or the surrounding villages, it can sometimes be difficult to know what support is available or even where to start.

Eden Country Care has supported people to remain in their own homes in Cumbria for many years, with care provided by locally recruited teams. If you would like to talk through what is happening at home, what help might be useful or what your options are, you're very welcome to contact Dan for an informal chat.

Dan
Tel: 07494 074235
Email: dan@edencountrycare.co.uk

You can also join our Care Begins at Home Facebook group to ask questions, share experiences and talk with others about some of the challenges of supporting someone at home.