Here at Pathways we do not focus on this aspect of dementia but it can be just as big a part of the dementia journey as any other aspect. Below, Matt Farrah from Healthcare Jobs gives us a succinct article on managing different behaviours that people with dementia might display. As a recruiter of social care workers he comes at the issue from an employer’s perspective where they are seeking employees who want to work with people with memory loss:
How to handle challenging behaviour
If you are looking for a job in social work in Ireland or the UK, it is vital that you can demonstrate that you can successfully deal with challenging behaviour. However, you also need to recognise that it can be difficult to change the person you are caring for.
Agitation
Agitation is often triggered when an individual feels as if they are losing ‘control’. Don’t attempt to restrain an agitated client; instead, tell them that you understand their frustrations. You can soothe their nerves with music, reading, walks or even a gentle touch. For everybody’s safety, remove any dangerous objects out of sight and reach.
Bathing
As it is sometimes difficult for people with dementia to maintain their daily hygiene routines, they will need your assistance in:
- Changing clothes
- Brushing their teeth and hair
- Going to the toilet
However, assuming control over these personal activities could be a distressing experience for both you and the client. For this reason, it is recommended that you provide them with as much privacy as possible.
Eating problems
Ensuring that a patient has sufficient nutritious food and drink can often be a challenge. However, neglecting their nutrition can result in:
- Weight loss
- Disorientation
- Sleeplessness
- Bladder or bowel problems
- Irritability
Instead of providing the standard three meals of breakfast, lunch and dinner, you could spread them out so that the patient eats five or six times a day. You could even make every meal exceptional by adding flowers or soft music. It is also wise to sit down and eat with your clients as they may mimic your actions. However, remember that providing them with nutrition takes precedence over assumptions about ‘proper’ table manners.
Incontinence
Dementia can cause incontinence due to environmental factors or because messages between the brain and bladder or bowel are no longer working properly. As a result, clients may have accidents. Therefore, it is essential that you try to avoid or at least minimise such occurrences:
- Set a toilet routine and remind your clients of the need to take a bathroom break every two hours
- Put up signs or illustrations to indicate the way to the toilet
- Equip your clients with incontinence pads and easy-to-remove clothing
Paranoia
Dementia can affect a person’s way of thinking, which could cause them to be unreasonably suspicious or jealous. If outbursts do occur, it’s best not to argue or to take what they are saying personally.
- If they ‘lose’ something, help them look for it but then distract them with another activity; try to find their ‘hiding places’
- Explain to other people in the household that any damaging accusations are due to the patient’s dementia
- A hug, a gentle touch or other nonverbal cues can reassure your patients
Perseveration
Although repetitive speech and actions are not serious, they can be stressful for you. Fortunately, there are ways to reassure your clients:
- Try distracting them with some snacks or activities
- Make an effort to recognise specific behaviours; for instance, their agitation or clothes-pulling could indicate that they need the toilet
Wandering
Due to the side effects of their medication, dementia patients can ‘wander’ trying to fulfil a physical need or perhaps overcome boredom. You can address this type of behaviour by taking note of the following tips:
- Reduce their restlessness by introducing regular exercises
- If necessary, install alarms on the doors
- Consider using barriers, such as curtains, to hide a door, and use signs such as ‘stop’ or ‘do not enter’
- Add ‘child-safe’ protective devices to accessible doors
Conclusion
Taking care of a person with dementia will often require a great deal of patience, expertise and creativity. As a social care worker, you will need to address their needs through effective communication. Whilst it can be challenging to keep them engaged, gentle reminders and activities should enable them to remain focused. If a client is agitated or stressed, you can calm them down with kind words and gestures or by utilising distraction techniques.