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BY CHANTELL BRAMLEY Communication Manager, Dementia Canterbury
Mackenzie Ebbett, Clinical Nurse Specialist, Older Person’s Health, regularly presents on Behaviours in Dementia as part of Dementia Canterbury’s Specialist Dementia Education Series. This article by Chantell is a summary of Mackenzie's most recent presentation.
Behaviours in Dementia As dementia | mate wareware progresses, many people experience behavioural and psychological changes. These changes may be caused by the condition itself, changes within the brain, physical health, medication, daily routines, or the surrounding environment. Understanding why these changes occur can help both the person living with dementia and those supporting them to respond with greater confidence and understanding.
Understanding the Brain
Different parts of the brain are responsible for different functions:
• Frontal lobe – thinking, initiation, memory, behaviour, and movements
• Parietal lobe – language and touch
• Temporal lobe – hearing, learning and feelings
• Occipital lobe – vision
• Cerebellum – coordination and balance
• Brain stem – breathing, heart rate and temperature regulation. Different types of dementia affect different areas of the brain. Alzheimer's affects all areas but particularly the parietal and frontal lobes in the early stages. Parkinson's dementia and Dementia with Lewy bodies primarily affect the frontal, parietal and occipital lobes. Vascular dementia mainly affects the frontal lobe, while frontotemporal dementia primarily affects the frontal lobe.
Five Guidelines to Live By
When responding to behavioural changes, Mackenzie encourages carers to keep five key principles in mind:
• Think of behaviour as a form of communication
• Try to identify the cause of a behaviour change
• Consider whether a behaviour is genuinely risky or hazardous, rather than simply frustrating or annoying
• Maintain a structured and predictable routine wherever possible
• Create an attitude of acceptance.
Behaviours We May Encounter
Anxiety, apathy and disrupted sleep are all common changes experienced by people living with dementia.
As dementia progresses, people often have less ability to cope with stress and become more dependent on those around them to help manage their emotions. Apathy, or a lack of interest and enthusiasm, is also common. The person living with dementia is often unaware of it or bothered by it, although it can be very noticeable for whānau/family members and carers, particularly if they were previously highly motivated. Importantly, apathy doesn’t necessarily mean the person is depressed, even though it may appear that way.
People living with dementia may need help getting started with activities or support to complete them. Many carers worry that reduced
