Trouble behavior with elderly with dementia


By Micha Shalev

Dementia is the loss of mental abilities that most commonly occurs late in life. Of all people over age 65, 5 to 8 percent are demented. This percentage increases considerably with age. Twenty-five to 50 percent of people over 85 are affected.

The most common form of dementia, Alzheimer’s disease, accounts for 50-75 percent of all cases of dementia. Another 20 to 30 percent is due to blood vessel disease (multi-infarct dementia or mini-strokes). The remaining cases result from a variety of less common disorders.

Some of the greatest challenges of caring for a loved one with dementia are the personality and behavior changes that often occur. You can best meet these challenges by using creativity, flexibility, patience and compassion. It also helps to not take things personally and maintain your sense of humor.

To start, consider these ground rules:

•We cannot change the person. The person you are caring for has a brain disorder that shapes who he or she has become. When you try to control or change his or her behavior, you’ll most likely be unsuccessful or be met with resistance. It’s important to:

Try to accommodate the behavior, not control the behavior. For example, if the person insists on sleeping on the floor, place a mattress on the floor to make him or her more comfortable.

Remember that we can change our behavior or the physical environment. Changing our own behavior will often result in a change in our loved one’s behavior.

•Check with the doctor first. Behavioral problems may have an underlying medical reason — perhaps the person is in pain or experiencing an adverse side effect from medications. In some cases, like incontinence or hallucinations, there may be some medication or treatment that can assist in managing the problem.

•Behavior has a purpose. People with dementia typically cannot tell us what they want or need. They might do something, like take all the clothes out of their closet every day, and we wonder why. It is very likely that the person is fulfilling a need to be busy and productive. Always consider what need the person might be trying to meet with their behavior. When possible, try to accommodate them.

•Behavior is triggered. It is important to understand that all behavior is triggered — it doesn’t occur out of the blue. It might be something a person did or said that triggered a behavior or it could be a change in the physical environment. The root to changing behavior is disrupting the patterns that we create. Try a different approach or consequence.

•What works today, may not tomorrow. The multiple factors that influence troubling behaviors and the natural progression of the disease process means that solutions that are effective today may need to be modified tomorrow — or may no longer work at all. The key to managing difficult behaviors is being creative and flexible in your strategies to address a given issue.

•Get support from others. You are not alone — there are many others caring for someone with dementia. Call your local Agency on Aging or the local chapter of the Alzheimer’s Association to find support groups, organizations and services that can help you. Expect that, like the loved one you are caring for, you will have good days and bad days. Develop strategies for coping with the bad days.

Micha Shalev, MHA, is the owner of Dodge Park Rest Home and the Adult Day Care Club at Dodge Park located at 101 Randolph Road in Worcester. He can be reached at 508-853-8180 or by e-mail at View more information online at Archives of articles from previous issues can be read at