Personality and behaviour
As dementia progresses, this can often result in changes to someone’s personality and behaviour. For example, some people living with dementia may become withdrawn or lose interest in things that they used to enjoy. These behaviour changes can be the result of brain damage from dementia, unmet needs, or as a result of low mood, frustration or fear.
Understanding, accepting and coping with these personality and behaviour changes can be difficult. It is important to remember that these changes are outside of the control of the person and they are not trying to upset anyone.
In some situations, the person living with dementia may be behaving in a way which is sometimes described as “challenging”. Some people may act aggressively and may shout or hit out at those around them, or may become disinhibited and say or do inappropriate things (for example sexual comments or behaviours). If someone is behaving in this way, it is important to seek help and advice from a healthcare professional, most often your GP. Your GP will be able to assess the person’s health and wellbeing. They will be able to check for any physical causes of changes in behaviour such as infection or constipation. For example, if aggression is the result of pain from an injury or illness, your GP may be able to prescribe medication to treat pain and discomfort. This should help the person to feel better, less distressed and calmer.
It may also be the case that changes to the person’s environment can help. For example, if the person is uncomfortable in their bed, changing the mattress or adding extra pillows may resolve this. There are also non-medical treatments available which may help, such as massage, aromatherapy, and distraction and relaxation techniques.
If you notice any changes in the personality and behaviour of the person living with dementia, it is important to look at whether there are any triggers or particular situations which cause the person to behave in a certain way. If it is possible to reduce the person’s exposure to these triggers then this may reduce these behaviours.
Physical health and the environment should be considered first, but if the person continues to have distressing behaviour, and this behaviour is a possible risk to their wellbeing or the wellbeing of others, a doctor may consider using medication to help. One type of drug that may be used is known as antipsychotic medication – these do have side effects and are usually only used when all other non-drug options have been considered. They may be prescribed by your GP or a psychiatrist; however they should only be used for as short a period of time as possible, and preferably no more than a few months.
Planning ahead to meet the comfort and care needs of the person can help as this can ensure the person’s needs are met at all times. If the person is comfortable, then they are less likely to experience triggers which cause aggression or other unusual or difficult behaviours as a result of unmet needs. However, not all personality and behaviour changes can be resolved, as some of these changes may be a direct result of the particular dementia the person is living with. It is important to seek help and advice from your GP if you notice any behaviour changes, or if you are concerned for the safety of the person living with dementia or others around them.