Dealing with Dementia Behaviors

If you are a professional caregiver, the strategies below will help you have a more successful interaction with the person you are caring for.

• Try to address the patient directly, even if his or her cognitive capacity is diminished.
• Gain the person’s attention. Sit in front of him or her and maintain eye contact.
• Speak distinctly and at a natural rate of speed. Resist the temptation to speak loudly.
• Help orient the patient. Explain (or re-explain) who you are and what you will be doing.
• If possible, meet in surroundings familiar to the patient. Consider having a family member or other familiar person present at first.
• Support and reassure the patient. Acknowledge when responses are correct.
• If the patient gropes for a word, gently provide assistance.
• Make it clear that the encounter is not a “test,” but rather a search for information to help the patient.
• Use simple, direct wording. Present one question, instruction, or statement at a time.
• If the patient hears you but does not understand you, rephrase your statement.
• Although open-ended questions are advisable in most interview situations, patients with cognitive impairments often have difficulty coping with them. Consider using a yes-or-no or multiple-choice format.
• Remember that many older people have hearing or vision problems, which can add to their confusion.
• Consider having someone call the patient to follow up on instructions after outpatient visits.
• If the patient can read, provide written instructions and other background information about the problem and options for solutions.

All family caregivers face challenges, but these challenges are increased for people caring for family members with memory loss or dementia. The person usually declines slowly over the course of several years. This is an exhausting and disturbing experience for many family members. The following suggestions are especially useful for you to recommend to family caregivers in these situations:

• Persuade caregivers to get regular respite, especially when patients require constant attention. Ask if the caregiver, who is at considerable risk for stress-related disorders, is receiving adequate health care.
• Explain that much can be done to improve the patient’s quality of life. Measures, such as modifications in daily routine and medications for anxiety, depression, or sleep, may help control symptoms.
• Let the caregivers know there is time to adapt. Decline is rarely rapid. Provide information about the consumer resources and support services available from groups.
• Help caregivers plan for the possibility that they eventually may need more help at home or may have to look into residential care.

This information is in the public domain and was adapted from the National Institute on Aging of the National Institutes of Health.