Understanding Behavior as Communication

caregiver-body-languageAs dementia affects the brain of our loved one, it can be difficult to understand what he or she is trying to communicate with us through their behaviors. Dementia takes away the ability to express feelings in the way that someone with a healthy brain is able to. To effectively manage difficult behaviors, we must first understand why our loved one appears to be acting out.

The way in which you approach your loved one is just as important as meeting the need he or she has. Your body language, tone of voice and choice of words are very important when tending to their needs. The best thing you can do for the both of you, is to keep calm and go through the checklist below to determine if a negative behavior can be lifted by simply meeting a basic need first. It helps if the person you are caring for  is able to communicate verbally. But if you are unable to receive verbal responses or physical cues and asking causes further upset, go through the following check list:

Begin by asking yourself if agitation is caused by the following:

  • Hunger
  • Thirst
  • Pain
  • Restroom
  • Physical discomfort
  • Exhaustion

If all of the above needs are met, your loved one may be having an emotional reaction to a memory or something in their environment. Observe your loved one to see if it is any of the following causes:

  • Cold/Hot
  • Too much stimulation such as loud TV, music, bright lights, talking
  • Boredom/Lack of activity/feeling useless
  • Lonely
  • Stress
  • Confusion
  • Sad memory
  • Medications
  • Illness
  • Change in routine or environment

Use these tips to better communicate with them:

  • Use positive phrasing such as: “May I help you” or “Can I help you feel better?” instead of “What is wrong?” or “Can you tell me why you are upset?” It’s so easy to use negative words when trying to help without even realizing it. Make a conscious effort to phrase things simply, clearly and positively.
  • When offering choices remember to limit options to two and put the choices at the end of your sentence. For example, “For lunch would you like a chicken or beef sandwich?” instead of “We have beef, chicken, soup, and leftovers from dinner, what would you like to have for lunch later?” Structuring sentences in this way makes it much easier for your loved one to process what you are asking. Limiting confusion helps prevent upset due to communication breakdown.
  • Try to speak clearly and slowly. Talking quickly and not speaking face to face makes computing information difficult. Remember to talk to your loved one at their physical level if possible, sit or kneel if necessary to match their level.
  • If needs are met and agitation continues, try redirecting their state of mind by reminiscing on happy times or reading positive quotes that promote happiness and thankfulness. There are also instances when he or she needs time to themselves and that’s ok too.

When words hurt..

Paranoia, confusion, anger and false accusations are all common with dementia. It can be very difficult to hear your parent, spouse or other loved one accuse you of something unfounded or speak to you in a manner that is out of character and hurtful. Remember that this is the dementia speaking, making it difficult or impossible to reason and communicate with you in the same way they have in the past. For your sake and theirs, validate their feelings and redirect with positivity. Many caregivers feel that Alzheimer’s and other dementia’s cause uninhibited expression or truths to be revealed (similar to being drunk). This common misconception is completely false. When you truly accept that your loved one is not communicating hidden feelings, you will be better equipped emotionally to communicate in a healthier way. You are certainly not alone and it is not your fault. It’s biology causing your loved one to behave in challenging ways, don’t take hurtful words to heart.  If you are having a difficult time emotionally coping with changes in personality caused by dementia, try talking to a medical profession or join a Alzheimer’s or other dementia support group near you.


This article was originally written by,

Kristin Angulo

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