Understanding and Responding to Dementia-Related Behaviors

Behavior is a powerful form of communication and is one of the primary ways for people with dementia to communicate their needs and feelings as the ability to use language is lost. However, some behaviors can present real challenges for caregivers to manage. Learn to decode behavioral messages, identify common behavior triggers, and create strategies to help intervene with some of the most common behavioral challenges of Alzheimer’s disease. 

Produced in partnership with the Alzheimer's Association, Tall Oaks Assisted Living and the Positive Aging Community

Aaron Schulman Volunteer Community Educator with the Alzheimer's Association 

• www.ALZ.org/nca                       
• 24/7 Helpline 800-272-3900

Tall Oaks: 12052 North Shore Dr. Reston, Va. 20190. 703-834-9800

• George Winters, Executive Director: gwinters@talloaksal.com
• Crystal Todd, Director of Marketing and Admissions: ctodd@talloaksal.com

Questions Asked

• I have a 10 year friend who has developed dementia along with a terminal cancer.  She is under Hospice Care.  Last time I visited her she got very angry with me and almost hit me.  Previously, she “dissed” me - prior to her dementia - and several times told me things were “none of my business”.  I’m hurt and angry and am inclined not to visit her again.  What should I do?
• I'm a social worker and have a client diagnosed with dementia. She is currently facing evication due to hoarding. How can we assist her with getting into compalince with her adult living facilitie's requirements and fire safety codes? She has storage units and we have encouraged her to move the excess items into the units in order to meet compliance, however, she does not see her hoarding as an issue and feels that everyone is harrassing her. The complex has given her 14 days to "make progress."
• We learned recently that our neighbor was diagnosed with dementia about a year ago.  It has come to our attention because her husband is struggling to care for her and she is getting out and wandering or calling out the window that she needs to get out becuase there are strangers in her house.  The police have been called  a couple of times in the last week by people walking by who don’t know the situation.  Her husband is very old fashioned and is resisting help offered by neighbors.  How can we help?  We were outside last night until almost midnight trying to help him convince his wife to go inside.
• Is it important to first obtain an official diagnosis? I assume that means a treatment plan. Or should the behaviors be addressed as they arise?
• What about neuroplasticity and other alternative things to help. Such as Daniel Amen's Memory care program on PBS. Are you familiar with him and his bright minds protocol?

Chat Transcript

12:05:27     From  Sheila Griffith   to   Hosts and panelists : Welcome to Understanding and Responding to Dementia-related Behaviors                                                             Alzheimer's Association-   www.ALZ.org/nca                       Our 24/7 Helpline 800-272-3900

12:08:33     From  Steve Gurney - ProAging Community : Tall Oaks Assisted Living:

Tall Oaks: 12052 North Shore Dr. Reston, Va. 20190. 703-834-9800

George Winters, Executive Director: gwinters@talloaksal.com

Crystal Todd, Director of Marketing and Admissions: ctodd@talloaksal.com

12:10:02     From  Steve Gurney - ProAging Community : From Sheila Griffith to All Panelists 12:05 PM

Welcome to Understanding and Responding to Dementia-related Behaviors                                                             Alzheimer's Association-   www.ALZ.org/nca                       Our 24/7 Helpline 800-272-3900

12:10:28     From  Steve Gurney - ProAging Community : Anonymous Attendee 12:04 PM 

I have a 10 year friend who has developed dementia along with a terminal cancer.  She is under Hospice Care.  Last time I visited her she got very angry with me and almost hit me.  Previously, she “dissed” me - prior to her dementia - and several times told me things were “none of my business”.  I’m hurt and angry and am inclined not to visit her again.  What should I do?

12:23:23     From  Steve Gurney - ProAging Community : Here is another question that folks might want to help with. I will make sure Aaron responds as well Anonymous Attendee 12:21 PM 

I'm a social worker and have a client diagnosed with dementia. She is currently facing evication due to hoarding. How can we assist her with getting into compalince with her adult living facilitie's requirements and fire safety codes? She has storage units and we have encouraged her to move the excess items into the units in order to meet compliance, however, she does not see her hoarding as an issue and feels that everyone is harrassing her. The complex has given her 14 days to "make progress."

12:35:21     From  Steve Gurney - ProAging Community : Anonymous Attendee 12:04 PM 

I have a 10 year friend who has developed dementia along with a terminal cancer.  She is under Hospice Care.  Last time I visited her she got very angry with me and almost hit me.  Previously, she “dissed” me - prior to her dementia - and several times told me things were “none of my business”.  I’m hurt and angry and am inclined not to visit her again.  What should I do?

Sheila Griffith 12:24 PM 

As Aaron said, please continue to visit, understanding that her behaviors are part of the disease process she is going through and may not be about you personally.   Try to determine the best time to visit, when is she at her best- mornings, after lunch and be patient with her.

12:35:41     From  Eileen Castelli   to   Hosts and panelists : When the trigger is an imagined threat (imaginary people are trying to hurt me), how should we respond to that?

12:35:59     From  Jan Brito   to   Hosts and panelists : Sorry that i have to hop off early. Great info. Thanks for being here. Good to see you Aaron!

12:37:12     From  Steve Gurney - ProAging Community : Sheila Griffith 12:35 PM 

That's a complex problem!  It's pretty typical that someone with dementia may have a problem recognizing unsafe behaviors and begin to feel paranoid or angry.  This client may need professional psychological help to work on the hoarding and also professional organizational help because of the quick deadline.  Hopefully the client's family can help with this situation.  Is the client still appropriate for the current living situation or would it be a good idea to move to a more supervised level of care?  As far as dealing with the person with dementia- try to be agreeable not criticizing when discussing the situation, be honest about the risks of living in a hoarding situation. Try to understand the emotion behind the behaviors.  Depending on what the dementia diagnosis is leading to (Alzheimer's or something else) the behaviors may not last as the disease progresses.

12:39:00     From  Steve Gurney - ProAging Community : Discussion with TV Show Host Matt Paxton - Hoarders and Legacy List https://www.retirementlivingsourcebook.com/videos/discussion-with-tv-show-host-matt-paxton-hoarders-and-legacy-list

12:41:09     From  Steve Gurney - ProAging Community : Anonymous Attendee 12:40 PM 

We learned recently that our neighbor was diagnosed with dementia about a year ago.  It has come to our attention because her husband is struggling to care for her and she is getting out and wandering or calling out the window that she needs to get out becuase there are strangers in her house.  The police have been called  a couple of times in the last week by people walking by who don’t know the situation.  Her husband is very old fashioned and is resisting help offered by neighbors.  How can we help?  We were outside last night until almost midnight trying to help him convince his wife to go inside.

12:41:51     From  Eileen Castelli   to   Hosts and panelists : This has been mostly at night

12:45:05     From  laura wagner thibodeaux : Really confused how trying to address the psychological needs of a dementia patient is possible?  If they are slowly going to lose ability to retain the most recent things learned, seems they will hold to the long term thoughts and behaviors.  Saying they need a year of therapy when they have 14 days to clear out or face possible eviction does not seem to address the immediate need.  Often it is an immediate need that must be addressed and you are trying to have rational conversations with someone who is not able to retain the info, yet decisions need to be make.  That lends itself to a conversation about competency/POA and who can really help at what time?

12:48:21     From  Steve Gurney - ProAging Community : @laura wagner this is such a challenging situation. What town or county does this person live in?

12:55:15     From  laura wagner thibodeaux : This is a general question, but I work in Baltimore County and city.

12:57:21     From  Annette Shinafelt   to   Hosts and panelists : is there any association with this disease and nightmares?  walking up frequency in fright?

12:58:49     From  laura wagner thibodeaux : When MCI/dementia patient is still at the stage when they are confused, sort of aware there is memory loss, but are still calling multiple times to ask the same thing …what is the best way to respond to them?  And then they question your decisions to keep them safe and out of harms way? Taking this time becomes taxing on the caregivers own life.

12:58:52     From  Puru Sharma   to   Hosts and panelists : Will certainly visit training.alz.org. I wish I knew about and have attended this webinar 10 years back. Glad it happened. Eye opener. Thank you!!

12:59:31     From  Steve Gurney - ProAging Community : From Puru Sharma to All Panelists 12:58 PM

Will certainly visit training.alz.org. I wish I knew about and have attended this webinar 10 years back. Glad it happened. Eye opener. Thank you!!

13:00:52     From  Leslie McTyre : Thank you as always Steve.  You were all great!!

13:01:30     From  Steve Gurney - ProAging Community : Sharon Sirkis 01:01 PM 

What about neuroplasticity and other alternative things to help. Such as Daniel Amen's Memory care program on PBS. Are you familiar with him and his bright minds protocol?

13:03:09     From  Steve Gurney - ProAging Community : Memory Makeover With Daniel Amen, MD https://weta.org/watch/shows/memory-makeover-daniel-amen-md