General Guidelines Related to Behaviors of People with Dementia
Understand the Symptoms of Dementia
Before discussing guidelines for responding to the behavior of people with dementia (PWD), it is important to understand the 10 Common Symptoms of Dementia according to the guidelines from Alzheimer’s Indonesia (ALZI). This guide is provided to assist communities in identifying the presence of dementia in family members or residents in the community. These symptoms generally provide an indication of the onset of dementia (early phase), whereby based on world statistics, someone is diagnosed with dementia every three seconds.
Although each individual may exhibit these symptoms
in different ways, these symptoms are quite common among all
types of dementia. Therefore, this understanding can help explain the behaviors of people with dementia in general.
1. Memory Problems
- Often forgetting events that just happened.
- Difficulty in remembering things from the short term.
- Asking or doing the same things over and over again in a short time.
- Able to still recall things from the distant past, with sufficient detail.
2. Difficulting Concentrating
- Easily distracted and unable to concentrate/focus for long periods.
- Challenged in performing daily activities and tasks.
- Difficulty in performing simple calculations.
- Taking a longer time than normal in completing routine tasks.
3. Difficulty in completing familiar tasks
- Difficulty in planning or remembering how to perform routine and previously familiar tasks.
- Forgotten how to operate equipment, for example a car.
- Challenged in managing finances due to difficulties in calculating.
- Confused about time of day (day/date/time).
- Confused on where they are, or how they arrived there.
- Easily gets lost, cannot figure out how to return home.
- At one moment, may forget what era it is and believe they are in their younger years, and not recognize the people around them.
5. Difficulty with depth preception and sense of space
- Difficulty in determining distance or distinguishing colors.
- Not recognizing/understanding the reflection of a mirror.
- Running into glass windows or doors.
- Difficulty pouring water into a glass.
- Difficulty in carrying a conversation or finding the right words.
- Using the incorrect words or often misunderstanding.
- Often stopping mid-sentence and unsure on how to continue a train of thought.
- Becoming withdrawn, afraid/embarrased to speak.
7. Placing/keeping items in unusual/atypical places.
- Forgetting where something is placed/kept.
- Keeping/storing an item in an odd place, for example keeping their wallet in the refrigerator.
- Becoming suspicious and accusing someone of stealing or hiding their belongings.
8. Making poor decisions
- Wearing mismatched clothing, for example different socks on each foot.
- Buying unnecessary things or more easily pursuaded to buy something.
- Not paying attention to personal care/hygiene or appearance.
- Unmotivated or lacking initiative to participate in activities or hobbies that they used to enjoy.
- Reluctant to gather with friends.
- Avoiding or having excuses for not meeting people or to do something with others.
10. Change in behavior and personality
- Drastic emotional shifts
- May become paranoid or suspicious
- May become depressed, anxious, or becoming overly dependent on the company of family members.
- Easily disappointed and feeling hopeless.
- Irregular sleeping pattern.
Of course the behaviors that may arise from a given PWD can vary according to the uniqueness of each individual. The cause of a particular behavior can also differ from one case to another. However, because the characteristics of dementia include progressivity, symptoms that at first appear quite mild may gradually get worse. So, as time goes by there may be a shift in the intensity of the symptoms or behavior that will require adjustment from time to time.
Whatever the behavior, intensity, or phase of dementia, the following basic principles should serve as a guide in communicating and serving a PWD:
A Person with Dementia does not have rational control over his/her behavior.
- Instructing a person with dementia to not do something is an ineffective effort. It’s better to invite/encourage them to do something else instead.
- In general, a behavior management strategy should entail:
- finding the root cause of the behavior
- evaluating the situation/circumstance that may have contributed to the behavior.
You must “enter their world” and serve them with patience.
- Empathy is the key factor in your effort to feel/understand what a PWD is experienceng at that moment.
- Recognize that especially in the early phases of dementia, someone may have difficulty in accepting/understanding the changes that are happening. Consequently, they may become confused or stressed because they are losing control over their own will.
- Related to this point, it’s improtant to also understand the Validation Method whereby you validate (acknowledge) their perceptions and feelings such that your interactions adjust according to the reality that theu are expressing. For example, a PWD may state that she is waiting for her husband to return from the office eventhough he has passed away. Your conversation and interaction with her must be conducted as if her reality is true, that her husband is still at the office and has not yet returned home. The key to applying the Validation Method is in your ability to remain sincere in your interaction related to her perceived reality, and not just as a tool to extinguish her need to express he feelings.
Your emotional state and behavior will have an impact on the person with dementia’s behavior and emotional state.
- Yelling, being aggresive, scolding, or even physical handling a PWD will not make them be more cooperative. On the contrary, kind and understanding treatment is what is necessary to instill calmness and trust from a PWD.
The needs of the person with dementia must have higher priority that our needs.
- Although the demands or needs of a PWD may come at a time that is not ideal for you, the ability to nimbly adjust to the needs of a PWD often allows you to avoid conflict and result in a more peaceful environment. For example, bathing or meal time often need to follow the mood swings of the PWD and cannot be set to a hard schedule.
All interactions must preserve the dignity of a person with dementia as an adult that deserves to be respected.
- Due to the brain function failure, generally a PWD’s abilities will decline such that at one point they will begin to behave like a child. At that moment it is important to remember that the PWD must constantly be treated with respect as you would any other adult. Recognize that although their rational ability may have diminished, their emotional sensitivity will continue to function long after their momory and cognitive abilities have failed. So, emotional feelings such as being embarrased, afraid, sad, happy, and proud can still be experienced fully.
About RUKUN Senior Living
We believe that happiness and comfort are the keys to a person’s quality of life. So, RUKUN Senior Living has offered a range of residential facilities and services for seniors to support all their needs – from seniors with an independent and dynamic lifestyle to those who need assistance with daily activities.
The range of service options available provide flexibility to adjust to a senior’s needs. For seniors who prefer to live on their own or with family members, there is:
- RUKUN Senior Club
for independent seniors to participate in a full day schedule of activities.
- Dementia Day Program
for senior with dementia to participate in a series of activities and interactions designed to optimize their day. Available at Darmawan Park, Sentul dan Dementia Support Center, Cipete.
- RUKUN Home Care for seniors who need profesional caregiving in the home (Service the JaBoDeTaBek area).
Those interested in residing at RUKUN Senior Living, Sentul, can enjoy a Continuing Care Retirement Community (CCRC) offering a range of residential options and integrated services as a solution for each phase of a senior’s life:
- RUKUN Senior Living Resort
with complete facilities and a range of supporting services including Activity, wellness monitoring, food and beverage, housekeeping dan
laundry, and Assisted Living services. The complete facilities include:
Activity Room, Game Room, Art Room, Swimming Pool, Jacuzzi, Fishing Lake, Jogging Path, and Gazebos.
- RUKUN Senior Care
offering an intimate facility and services for seniors needing Dementia Support and Nursing Care. Includes activity program, 24-hour wellness staff and doctor on staff.
Phone: 021 8795 1525