Lost and Confused Signpost

Caring for a person with dementia can be challenging. Often, negative behaviors are symptoms of the disease process, but they could also be from unmet needs. Caregivers should look for any triggers of negative behaviors and address them directly. For example, if a person becomes agitated every time she needs to use the toilet, then a regular toileting schedule could be started. Look for clues in the person’s behavior. Care for behavioral symptoms of dementia needs to be individualized based on examining the entire picture of personal and environmental factors (such as living situation and what is going on around them). However, some general approaches to managing certain behaviors can be helpful. Here are some suggestions for managing agitation or aggression:

Avoid provoking situations.
Intervene early, before the behavior escalates.
Remain calm.
Speak in a soft voice.
Approach slowly from the front.
Avoid startling the person.
Stay at the eye level of the person.
Avoid touching initially; wait until the person is calmer.
Distract the person by talking about something pleasant.
Avoid rational arguments.
Avoid physical restraint if at all possible.
Identify and address unmet needs (food, fluid, toileting).

Adapted from Schwartzkopf, C. E. & Twigg, P. (2014). Nursing management of dementia. In K. L. Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Burlington, MA: Jones and Bartlett Publishers. Used with permission.

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