Understanding challenging behaviours in dementia

James Hourihan, Author

It is estimated that there are 900,000 people with dementia in the UK and one of the hardest aspects for social carers, health workers, and family members who support people with dementia, Alzheimer’s, and other cognitive impairments is managing challenging behaviours. 

Common challenging behaviours in dementia 

A person may start to exhibit behaviours that challenge in the middle and later stages of dementia, ranging from physical or verbal aggression and confusion, to withdrawal, repetitive actions and wandering. Deciphering the cause of these behaviours is not always easy, but there are a few possible explanations. 

For example, they may be experiencing pain and discomfort, or feeling confused, anxious or frustrated as a result of their environment, health or social situation. Challenging behaviours can also be a way for someone with dementia to communicate their needs through body language and gestures, especially when speech is difficult.

It’s also important to remember that challenging behaviours are not deliberate. Dementia is a symptom of abnormal changes in the brain that gradually affects a person’s memory, mood and behaviour. 

Naturally, it can be distressing for everyone involved as the illness progresses, but with patience, understanding and the right approach, it is possible to help vulnerable individuals with dementia and their carers cope towards an improved quality of life.

How to manage challenging behaviours in dementia 

We recognise that there are times when our duty of care might require a physical intervention. For the last 28 years, we’ve developed a system that supports people in crisis using safe restraint techniques based on a positive behaviour support model. 

Like any good detective, we investigate the reasons behind challenging behaviours in dementia, and work to deliver tailored strategies that enable staff to make dementia behaviours more manageable within their own organisation. 

Some positive behaviour management strategies that may be helpful include:

1. Understand the person’s needs and preferences

It is important to try to pinpoint what might be causing the challenging behaviour and weigh up the evidence. Is the person in pain? Are these behaviours displayed at certain times of the day? Do they have a history of trauma? By Identifying these triggers this can help you to develop an individual positive behaviour support plan. 

2. Promote social and recreational activities

Engaging in social and recreational activities can help to reduce challenging behaviours. Activities such as music, art, and exercise can be very beneficial. It is important to choose activities that the person enjoys and that are appropriate for their abilities.

3. Encourage positive reinforcement

Using positive reinforcement can be an effective way to manage challenging behaviours in dementia. This involves rewarding the person for desired behaviours such as praise to help reduce stress and encourage more positive interactions. 

4. Use redirection techniques

Redirection techniques involve redirecting the person’s attention away from the challenging behaviour that may lead to further escalation. This can be done by engaging the person in conversation, offering sensory stimulation such as a gentle hand massage, or providing a distraction using books or puzzles. 

5. Create a safe, welcoming environment

The environment is an important factor. Making sure that their living space is safe, light, comfortable, and stimulating helps to reduce challenging behaviours and make them feel more relaxed. 

Get in touch 

If you work in the health or social care sectors and support people with dementia, book a challenging behaviour training course with Timian. You’ll learn a range of new skills, including physical intervention, communication, positive handling and safe restraint techniques all taught by an experienced body of qualified instructors and experts.

Call us on 0800 987 4075 or fill in the form on our website for more information.

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