Following a diagnosis of dementia, personality changes are common. This is especially true in mid to late stage dementia. It can cause a person to be barely recognizable to their loved ones in many ways.

Coping with these changes is challenging for many family caregivers. Understanding how dementia impacts behavior makes it easier to know what to expect and cope with personality changes. This blog provides some valuable insight.

BPSD

wife-comforting-husband-with-dementia

Behavioral and Psychological Symptoms of Dementia (BPSD) is the medical term used to describe some of the changes that certain people with dementia experience. While medical professionals state that many of their dementia patients experience BPSD, it is not something that every senior experiences. Even when they do, family caregivers often see these changes in varying degrees – or they may note them at certain times of day, see them happening quickly or view them as seemingly unpredictable.

BPSD includes:

  • Aggressive or Threatening Behavior – Anger and hostility are often an indicator that a need is unmet. The person with dementia is frustrated and unable to fully express what they need or why they need it.
  • Anxiety – Worry or fear about the present, past or future is common for seniors who are experiencing dementia behavioral changes. This is especially common in the earlier stages of dementia when a senior is more aware of the changes they are experiencing.
  • Apathy – A lack of desire to perform a specific task or take part in a once-loved activity or hobby.
  • Delirium, Delusions and Hallucinations – These often seem very real to the person, to the point that they might convince even their family caregivers that they ARE real.
  • Less Energy or Drive – A loss of motivation or willingness to try new things or maintain daily functioning.
  • Impulsive Behavior – A very free and sometimes dangerous or unpredictable expression of self.
  • Compulsive Behavior – A desire to repeatedly do something.
  • Sleep Disruptions – Difficulty resting, falling asleep or staying asleep.
  • Wandering – A desire to explore, search or move about even if doing so is unsafe.

Why Personality Changes Happen

While we understand some things about personality changes associated with dementia, we do not fully understand why they happen.

However, researchers believe that the reasons behind these changes have to do with brain changes, body changes (infections, pain or medication changes), perception changes and frustrations related to social changes or stigma surrounding dementia.

While the disease itself might make a person withdraw or lash out, it’s often not the disease but the lack of meaningful opportunities or the perception that meaningful activities are no longer possible that causes this behavior.

Seniors with dementia who have the right level of support, encouragement and positivity in their lives often experience less negative behaviors, which is an indication that meaningful support is key to helping them live better after their diagnosis.

Now that we have a basic understanding of the causes of dementia personality changes, what can we do to help our loved ones overcome them or work through them? If you notice a personality change, there are four steps you can take to decrease suffering and increase opportunities for a positive reaction.

Check for Unmet Needs

woman-with-dementia-grief

A person with dementia often cannot easily express their needs or understand how to best meet them. Family caregivers can do two things to help.

First, try to anticipate needs so that they do not remain unmet.

Second, if you note negative behaviors, look for the reasons behind the behaviors. They may include:

A Senior’s Unmet Physical Needs

  • Is there an infection in the body? Urinary tract infections and other infections can cause pain and discomfort. When a person with dementia is unable to express what they are experiencing or understand why they are in pain, it can result in outbursts.
  • Is the patient experiencing side effects related to medications? New medications or a change in dose can cause physical or behavioral side effects. Medications also sometimes counteract with each other, and this can lead to feelings of discomfort.
  • Do you note signs of any pain or discomfort? Pain or discomfort related to bed positioning, sore joints or muscles or other concerns is important to note. Watch carefully how the person with dementia is carrying themselves. Are they displaying any physical indicators of discomfort?

The Dementia Patient’s Unmet Social Needs

  • Are family members and friends still visiting? It is sometimes difficult for family members to spend time with a loved one with dementia. Visits become less frequent. Missing their loved ones sometimes causes the senior to act out or become aggressive.
  • Has the diagnosis changed your loved one’s ability to go to church or attend social functions? A previously social individual starts to feel isolated when they are homebound and away from their familiar community activities. The frustration they feel may display as negative behaviors.
  • Is your loved one alone for much of the day while you work or care for other family members? If your loved one spends a lot of time alone, it sometimes results in wandering, anger or frustrating behaviors.

Your Loved One’s Unmet Emotional Needs

  • Is your loved one feeling insecure in their identity? It is easy to lose your sense of self when your mind feels like it is slipping away. Help your loved one to feel valued and know that their life continues to have purpose.
  • Are they still finding cognitively appropriate opportunities for enrichment and growth? Cognitive and sensory stimulation are essential for maintaining a healthier mind. They can help to keep negative behaviors at bay and sometimes even slow the progression of dementia.
  • Do they feel empowered to remain autonomous with some daily tasks? Everyone appreciates the opportunity to feel independent. Sometimes supervising or providing reminders is a better route as opposed to doing every task for your loved one.
  • Are they feeling a sense of connection to others? Isolation often leads to emotional outbursts and behavioral concerns. Ensure that your loved one is connected to the people they care about. This helps avoid both.
  • Are there opportunities for joy and happiness? We all need to find joy in life. A person with dementia is no different.

Addressing Personality Changes

After you’ve discovered the unmet need, it is time to creatively consider how to address it. This might involve having a discussion with your loved one’s doctor. Perhaps ask family members to increase the level of support they’re offering.

In some cases, bringing in a professional caregiver for additional support, supervision and assistance can help.

Look to the senior’s daily routines. Is their a way to rearrange the daily schedule to better suite your loved one’s sleeping schedule or needs?

Consider your ways of communicating as dementia progresses. Look to make changes that create more effective and positive conversations.

  • Are there opportunities for you to stay calm or choose more empowering words?
  • Is it possible for family and friends to use more yes or no questions? These are easier for a person with dementia to answer.
  • How can your way of communicating support your loved one in maintaining their independence?

It is never easy to accept the behavior changes that sometimes accompany a diagnosis of dementia, but understanding why they happen helps. Finding the right level of support in this ensures that your loved one’s care is personalized, positive and empowering.

Salus Homecare of San Fernando Valley is here to help. Whether your loved one was recently diagnosed with Alzheimer’s or is coping with the challenges of later stage dementia, contact us. Let’s work together and develop a plan that is effective and improves quality of life for your family.