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Dementia Care: How to Cope With Personality Change

Dementia and Alzheimer’s disease bring many devastating symptoms like memory loss, physical impairments and the inability to recognize loved ones. What can make it even worse are the personality changes caused by the disease; outbursts, agitation, personality changes, paranoia and aggression. These are common symptoms of dementia and can make it extraordinarily difficult for caregivers as they watch their loved one change. Here are some suggestions on how to cope with the personality changes that dementia can cause.
According to the Alzheimer’s Association, the most common personality changes are:

  • Apathy
  • Loss of interest in favorite activities
  • Insensitivity
  • Paranoia
  • Delusional thinking
  • Inability to make decisions
  • Social withdrawal
  • Agitation and aggression

Your loved one may experience different personality changes as the dementia progresses. Each stage brings different symptoms.
Early stage dementia brings withdrawal: In the early stages of the disease your loved one may experience increased irritability, anxiety and depression.
Mid-stage dementia brings more profound changes: As your loved one enters the middle stages of the disease you may begin to witness aggression, agitation and paranoia. He or she may begin to believe that you are hiding or stealing things. You may also see a loss of inhibitions or self-control. Your loved one may uncharacteristically begin talking to strangers, asking them for food, tissues or money. Dementia takes away the ability to judge socially appropriate behavior.
How are you supposed to cope with these personality changes?
(Personality changes are not detailed for end stage dementia because in this stage patients are very ill, often non-verbal and frequently immobile.)
1. Remember that your loved one is not doing this on purpose. He or she has not suddenly decided to be rude, angry or insulting. Dementia damages cells in different areas of the brain at different stages of the disease causing these behaviors.
2. Always default to a position of calm. If you yell or are agitated it will increase your loved one’s confusion. Remaining calm and redirecting behavior is the most successful strategy. It is upsetting to witness your loved one exhibiting this behavior and to watch them losing their presence and social skills. However, you can be their guide and their calm navigator through uncertain waters.
3. Use the power of redirection. You can use the short attention span created by the disease to the benefit of your loved one. When agitation and panic begin redirect your loved one’s attention to something completely different; talk about a flower, open a picture book or walk him or her into another room to listen to calming music. Redirection is a successful strategy used in clinical and long term care settings and it can work for you as well.
4. Think small, think quiet. As dementia progresses, social situations, noisy environments and new people can become frightening to the sufferer. You may take your loved one to a restaurant with the best of intentions, only to watch them become increasingly agitated and panicked. The disease removes the ability to decipher those situations and make sense of them. If you want to take your loved one out for a short “field trip” a small coffee shop is better than a large restaurant.
Other steps you can take to cope with personality changes experienced by your loved one include:

  • Simplify the environment for your loved one, wherever they are
  • Simplify tasks and routines and continue making them simpler as the disease progresses
  • Allow adequate rest between stimulating events
  • Remind the person what you are doing and where you going. For example, “Mom, we are going to the store where we buy food,” or “Dad, we are going to go see your grandchildren for one hour.”

Dementia Care has a learning curve – communication and coping are hands in hand. Although it is distressing to watch a loved one change because of the disease, you can make life easier and calmer for them with these suggestions. As a caregiver, you play an essential role in your loved one’s life and you can learn to cope with their personality changes while calming and reassuring them.