Behavior and personality often change when a person has dementia. You may not recognize their old self in the person they have become. They can now be irritable and speak in angry tones whereas as long as you know them, they were mild and gentle in personality. The reverse may also be true; your crusty, cranky dad is much more docile now that dementia is setting in.
Why is this happening? Why is my father’s behavior changing in a positive way and my girlfriend’s mom is becoming testier and more impatient? These are opposites. And they both have dementia.
Behavior in old people changes for many reasons. When they have dementia, the changes often depend on which part of the brain is deteriorating and losing cells. Let’s explain with a biology lesson.
The front part of the brain behind the eyes controls the ability to focus, be motivated, pay attention, and think. This part is called the frontal lobes. So, when your mom is losing cells in the frontal lobes, she is less able to plan and stay focused. That explains why she rarely initiates, and she is more passive.
Impulses are also controlled by this part of the brain. Someone with deteriorating frontal lobes may act rudely or without sensitivity. Memory and movement are also located in this area.
The parietal lobe at the top of the brain controls language and touch. That often may be affected next. The lower parts of the brain are affected later, as dementia progresses. The temporal lobe is where hearing, learning, and feelings are based. The cerebellum down below, not far from the brain stem, controls balance and coordination. That tends to be affected later, too.
Keep in mind that generally dementia affects the way a person responds to their environment and the people in the environment. Noise, conversation, crowds, and activity may stimulate them too much. It’s too hard to process or understand what is going on.
People with dementia also rely on the people around them for emotional cues. They mirror emotions exhibited by people around them. Their ability to feel emotions remains much longer than the abilities controlled by the frontal lobes. So, if you are anxious and worried, try to mask your feelings. Your parent with dementia may copy these emotions and become anxious and worried.
Medication, illness, infection, and pain will also affect the person’s behavior just they do in people without dementia. A frequent cause of inexplicable behavior and talking without making sense is often a urinary tract infection in a senior.
Disruptions in sleep, delirium, aggressive behavior, wandering, hallucinations, and compulsive behaviors may often present in dementia patients.
If you are puzzled by your parent’s changes in behavior, there are things you can do. Don’t assume it’s a dementia-related symptom. First, consider a visit to his primary doctor. It may be a simple urinary tract infection or a side effect of a medication which can be resolved by a medical intervention.
Second, it is helpful to view the change in behavior as an indicator. It’s a form of communication by the old person which may tell you that he is overwhelmed, in pain, or scared. It’s not simple acting out with anger.
Think about possible triggers. What happened just before the outburst or behavior change? Is there a pattern? Did it happen just after someone came to visit and told him about the death of a friend.
Evaluate whether the behavior is risky and dangerous. It may simply be annoying behavior such as pacing. If it poses a safety hazard, you may have to act. For example, if the individual is angry and storms out of the house while feeling upset, you may have to install locks. If it is just agitation, you may try to turn on calming music or start a distracting activity that he may enjoy such as gardening or knitting.
Having a routine with clear predictable times and activities is reassuring and helpful for a dementia patient. It is comforting to move from one thing to another in a recognizable pattern. It is calming, too.
Calming activities for yourself, the caregiver, help, too. If your parent becomes very agitated, angry, or even abusive, step into another room for a few minutes. Count to ten. Use your toolbox of calming thoughts and actions to keep you from flying off the handle with someone who is not responsible for their words and actions.
Get support. Phone support, zoom support groups, caregiver support groups, dementia organizations, and professional mental health support can be sources of helpful information and strategies.
You may not be able to modify the dementia patient’s behavioral changes, but you can modify your own reactions. You can become more resilient with help and respite.
Based on information from the University of California San Francisco.
Other articles from Caring Professionals you may be interested in:
- It’s not you! It’s Modern Life!
- Finding the Balance: Respectful Caregiving and Decision-Making for Aging Parents
- What is Ambiguous Loss? And Why It Matters.
- Who can be a home caregiver? Part 1. The Student
- Insights on Aging from an Expert Geriatrician
- Caregiving and Working: Making it Work with or without using CDPAP
- CDPAP FAQ