Why do we talk about behaviour in dementia care?

People living with dementia often experience changes to their behaviour that are mistakenly assumed to be as a result of ‘the dementia’. These changes in behaviour are sometimes referred to as ‘behaviours (behavioural) and psychological symptoms of dementia’ (or BPSD for short). Many people with dementia will experience changes in behaviour, and these often impact on a person’s care and/or carers.

Why do people living with dementia experience changes in behaviour?

There are many possible reasons why a person may have changes in behaviour. These include, for example, changes in the person’s health, their social or physical environment, or the impact of medications. There may also be things that prompt certain behaviours. Identifying what causes a person to respond in a certain way lets us consider what changes may help.

What are some common changes in behaviour for people living with dementia?

Changing behaviours may include agitation or aggression (the person may resist help at times, from one or more care partners), anxiety (appearing nervous, tense or unable to relax, or becoming upset when separated from someone), repetitive actions (such as pacing around the house, handling buttons, or doing other things repeatedly), apathy (seeming less interested in usual activities, or in the activities of others), being up at night (being awake during the night or rising very early in the morning) and disinhibition (seeming to act impulsively, e.g. talking to strangers as if they know them, or saying things that may hurt people’s feelings).

What are some of the reasons for changing behaviours?

Familiarity with people, places and routines helps us to feel safe. When any aspect of this familiarity is removed, it can create negative emotions, such as fear, confusion, frustration, or sadness.

A person may experience pain and be unable to communicate their pain clearly. They may have difficulty identifying that what they are feeling is pain or understand why they have it. As a result, pain can go unnoticed and untreated, and the person’s discomfort may be conveyed through other behaviours.

A person may be overstimulated, for example, through too much noise or busyness in their environment. On the other hand, they may be understimulated or bored, through a lack of engagement or activity that is meaningful for them. This can contribute to agitation or anxiety.

People living with dementia may experience sensory changes, including changes to their vision and perception, hearing, taste and smell, and even sense of touch. For example, a person may have vision difficulties because of changes to their sight resulting from ageing or another health condition. Having dementia may add to the challenge of living with these sight changes. Or the person’s eyes may be healthy, but their brain has trouble interpreting what is seen due to the impact of dementia.

How can we respond to changing behaviour to support a person living with dementia?

It is important to try to understand why a person is experiencing changes in behaviour. Identifying patterns in behaviour, and things that prompt certain behaviours, can help us to respond appropriately. What happened, or didn’t, before the behaviour occurred? Was anything unusual going on? Where and when did the behaviour occur? Think about the time of day, the location and environment, lighting, noise, what was happening at the time. This kind of information lets us problem solve to find personalised responses to reduce or prevent the behaviour from occurring again.

How can HammondCare Dementia Support help?

HammondCare Dementia Support works with carers and staff teams who are supporting a person living with dementia where behaviour is impacting their care. This non-pharmacological, relationship-based service delivers:

  • A better understanding of the behaviour of a person with dementia (known as BPSD).
  • Problem solving time with a specialist consultant to agree on the actions which can be taken.
  • Personal and organisational confidence and capacity in response to dementia.

Subscribers can access a library of resources, an e-learning suite and dementia consultant support via Live Chat or phone/video consultation. The dementia consultant will work with the person’s care team to problem solve and make recommendations for responding to behaviours.

What is available without a subscription?

HammondCare Dementia Support provides open access resources for a range of audiences, including people with dementia, family carers, and care and support teams. Resources include helpsheets, bitesize learning, e-books, design resources and research summaries.