Understanding the Behavior of Residents with Dementia

The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life.” A common symptom of dementia is difficulty communicating, both understanding and being understood.

Dementia residents in a long-term care facility may often encounter situations where they don’t understand what is happening to them or when they are unable to communicate what they want or need. When these breakdown in communications happen the resident can react in frustration, anger, confusion and other challenging behaviors.

For example, suppose a resident with dementia requires a caregiver to assist him with bathing. When a caregiver is removing the resident’s clothes to prepare for a bath the resident may not understand what the caregiver is saying or why someone is trying to remove his clothing. He may be combative and resist the caregiver. If you put yourself into the resident’s position, you can see how that would be a natural reaction, if you didn’t understand why someone was removing your clothing.

Residents may also have difficulty communicating what they want or need. For example, if a resident is hungry, she may become upset or angry as she deals with the discomfort of hunger, but is unable to communicate the problem. Facility staff must be prepared to anticipate resident needs to prevent these types of situations. Better anticipation can occur by evaluating the physical and emotional needs of the resident.

When evaluating what is happening, consider that the resident could be:

  • Uncomfortable due to temperature
  • Hungry or thirsty
  • In pain
  • Upset by another resident
  • Frustrated by a task
  • Missing family
  • Scared

Staff must be able to recognize the patterns in behavior and document the symptoms and solutions for dealing with challenging behaviors. For example, a resident may act a certain way when they are hungry. Recognizing recurring behaviors will help all staff address the need and overcome the behavior. Residents may also have routines that provide structure and comfort. Understanding these routines could help identify instances where a broken routine may be causing stress. Finally, make sure this data is documented and reviewed in care plan meetings with staff and family.

Residents suffering with dementia face many challenges navigating day-to-day life and exhibit challenging behaviors when communications fails. By recognizing the cause of these behaviors, caregivers can meet the needs of their residents and improve their quality of life.

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