Caregiving Tips - Dementia - VA Caregiver Support Program
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Caregiving Tips - Dementia

Dementia

Managing Difficult Behaviors in Dementia

Millions of Americans have a diagnosis of dementia. Caring for someone with dementia can be a difficult and rewarding job. Difficult behaviors may present themselves during the various stages of dementia.

Most of you caring for a Veteran with dementia will experience at least one difficult behavior that leaves you feeling overwhelmed, unsure about what to do, and even surprised to see your loved one acting this way.

Universal Rules to De-Escalate Difficult Behaviors

  • Try not to personalize the behavior but recognize the dementia is causing the changes in your loved one
  • For any sudden or escalation in behaviors, seek medical advice to ensure there is no underlying medical condition or pain attributing to the behavior
  • Reassure and agree instead of reasoning and arguing
  • Share a memory or reminisce versus saying “Remember”
  • Dissect the behavior to help give you a better understanding of possible triggers
  • Remain as calm and patient as you can

Managing Common Difficult Behaviors

  • Resistance to Bathing
    • Experiment with changing days and times of days of bathing
    • Ensure the environment is comfortable and free from distractions
    • Allow them some control over actions they are still able to do
    • Make simple and direct statements such as “Your bath is ready!
    • Consider equipment such as a shower chair and hand held showerhead
  • Eating and Motivating to Eat
    • Find a meal time routine and try to stick to it
    • Keep the meal place setting simple and free from distractions
    • Reintroduce foods they may have liked in the distant past
    • Provide smaller meals throughout the day
    • Prepare meals together so they know it
  • Incontinence
    • Consult with medical providers to rule out an underlying medical condition
    • Try a toileting schedule bringing them to the bathroom every few hours
    • Consider incontinence products such as waterproof sheets, adult briefs and pads
    • Pay attention to non-verbal cues such as pulling at their pants or pacing
  • Agitation
    • Create a calm and soothing environment decorating with their favorite color or playing soothing music
    • Use reassuring words such as “you are safe”
    • Find activities that your loved one enjoys and enjoyed doing
    • Be aware of the impact of changes in their environment
  • Wandering
    • Provide structure, a routine and activities to keep them reassured and busy
    • Ensure basic needs are met as they could be restless because they are hungry or need to go to the bathroom
    • Use childproof knobs on the doors and camouflage doors to deter them from leaving
    • Enroll in a Safe Return or Medic Alert so they can be assisted when found wandering

Office of Rural Health - Caregivers "Dementia Video Series"

Title Link to Video
Medication Issues for People with Dementia http://www.ruralhealth.va.gov/vets/mipm.asp
Recognizing and Managing Pain in People with Dementia http://www.ruralhealth.va.gov/vets/Rmppd.asp  
Engaging People with Dementia in Meaningful Activities  http://www.ruralhealth.va.gov/vets/Epdma.asp

Series Two: “Managing Dementia Behaviors: ABC’s for Caregivers”   

Title Link to Video
Communicating with Someone with Dementia https://www.ruralhealth.va.gov/vets/comm_selfcare_assemb.asp
Understanding the ABC’s of Dementia Behaviors https://www.ruralhealth.va.gov/vets/understand.asp
ABC’s of Dementia Behavior: Scenario #1 https://www.ruralhealth.va.gov/vets/abc_scenario1.asp
ABC’s of Dementia Behavior: Scenario #2 https://www.ruralhealth.va.gov/vets/abc_scenario2.asp
ABC’s of Dementia Behavior: Scenario #3 https://www.ruralhealth.va.gov/vets/abc_scenario3.asp

Series One: “Information and Support for In-Home Dementia Caregivers” 

Title  Link to Video 
Communicating with Your Doctor  http://www.ruralhealth.va.gov/vets/caregivers-module1.asp  
Overview of Dementia http://www.ruralhealth.va.gov/vets/caregivers-module2.asp  
Caring for the Caregiver http://www.ruralhealth.va.gov/vets/caregivers-module3.asp
Support Group  http://www.ruralhealth.va.gov/vets/caregivers-module4.asp
Relaxation Techniques http://www.ruralhealth.va.gov/vets/caregivers-module5.asp  
Visualization of Relaxation Techniques http://www.ruralhealth.va.gov/vets/caregivers-module5a.asp 
Self-Care for the Caregiver http://www.ruralhealth.va.gov/vets/caregivers-module6.asp  
Legal Issues http://www.ruralhealth.va.gov/vets/caregivers-module7.asp  
Facing Legal Issues http://www.ruralhealth.va.gov/vets/caregivers-module8.asp  
Communication http://www.ruralhealth.va.gov/vets/caregivers-module9.asp
Home Safety http://www.ruralhealth.va.gov/vets/caregivers-module10.asp
Home Safety Tips http://www.ruralhealth.va.gov/vets/caregivers-module11.asp
Problem Behaviors http://www.ruralhealth.va.gov/vets/caregivers-module12.asp
Dealing with Problem Behaviors http://www.ruralhealth.va.gov/vets/caregivers-module13.asp
Finding Caregiver Assistance http://www.ruralhealth.va.gov/vets/caregivers-module14.asp
Resources for Caregivers http://www.ruralhealth.va.gov/vets/caregivers-module15.asp
Implementing a Daily Plan http://www.ruralhealth.va.gov/vets/caregivers-module16.asp
Dealing with Incontinence http://www.ruralhealth.va.gov/vets/caregivers-module17.asp
Wandering http://www.ruralhealth.va.gov/vets/caregivers-module18.asp
Choosing a Nursing Facility http://www.ruralhealth.va.gov/vets/caregivers-module19.asp
Caregiving in a Nursing Home http://www.ruralhealth.va.gov/vets/caregivers-module20.asp

PSA---Caregiver Support Line Video:  

Coping and Resources

Need Help?

Call VA’s Caregiver Support Line (CSL) at 1-855-260-3274 to learn more about the support that is available to you, and for assistance connecting with the Caregiver Support Team/Coordinator, at your local VA Medical Center.

VA CSL Expanded hours:
      -Monday-Friday 8:00 a.m. to 10:00 p.m. ET
      -Saturday 8:00 a.m. to 5:00 p.m. ET

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