Understanding Dementia and Stubborn Behaviours
When caring for someone with dementia, behavioural changes can be among the hardest challenges to manage. Many carers report their loved one becoming stubborn, irritable, or even aggressive as the condition progresses. These shifts in personality are not random. Rather, dementia disrupts brain function, leading to confusion, frustration, and emotional dysregulation. Understanding the link between dementia and stubborn behaviours is essential for creating a calm and supportive environment.
Why Dementia Triggers Behavioural Changes
Stubbornness in dementia may arise for several reasons. Sometimes, it’s a long-standing trait that becomes exaggerated by the disease. Other times, it’s a new behaviour caused by confusion or fear. As brain cells deteriorate, the person may lose awareness of their condition (a symptom called anosognosia) or struggle to process instructions and emotions.
Some common causes include:
- Memory loss and confusion
- Physical pain or discomfort
- Overstimulating or unfamiliar surroundings
- Unmet needs like hunger, thirst, or needing the toilet
- Emotional stress and fear
Recognising these causes helps in managing dementia and stubborn behaviours more effectively.
Lifelong Difficult Personality: What Can You Do?
Behaviour Background:
If someone has always been short-tempered, critical, or demanding, dementia may worsen those traits. Caregivers often feel guilt or frustration when kindness is met with rudeness.
Easy Solution:
Accept that dementia doesn’t fix a difficult personality. Set clear personal boundaries. If caregiving is affecting your mental health, consider seeking external help or respite care. Therapy and caregiver support groups can also provide coping strategies and emotional validation.
New Mean or Stubborn Behaviours:
Understanding Anosognosia
Behaviour Background:
If your loved one used to be kind and reasonable but now denies anything is wrong or argues constantly, anosognosia may be the cause. This symptom makes them unaware of their condition or deficits.
Easy Solution:
Avoid trying to convince them they have dementia. Instead, redirect conversations or use gentle validation. Say things like, “Let’s do this together,” rather than correcting them. This approach reduces confrontation and helps ease dementia and stubborn behaviours.
Coping with Emotional Outbursts and Irritability
Behaviour Background:
As brain cells deteriorate, the ability to manage emotions weakens. Even small frustrations can cause angry outbursts, crying, or withdrawal.
Easy Solution:
Avoid triggers like complex instructions or sudden changes. Respond calmly, and if needed, pause and give them space. Use one-step directions like, “Let’s sit here,” instead of multi-step commands. This improves cooperation and reduces stress on both sides.
When Caregiver Communication Escalates the Situation
Behaviour Background:
Sometimes the way caregivers speak can make things worse. Overexplaining, correcting, or raising your voice can trigger defensive or aggressive responses.
Easy Solution:
Keep communication short and clear. Use a calm tone and offer choices. Instead of saying, “You need a shower,” try, “Would you like a shower now or after lunch?” Small adjustments can have a big impact when dealing with dementia and stubborn behaviours.
The Problem with Elderspeak or Patronising Language
Behaviour Background:
People with dementia may react negatively to being spoken to like children. This includes sing-song voices, pet names, or baby talk.
Easy Solution:
Use respectful, adult-appropriate language. Speak clearly but kindly. If pet names were always used before dementia, continue them. Otherwise, avoid infantilizing terms. Mutual respect helps build trust and reduce resistance.
Repetitive Questions or Actions: Staying Calm and Redirecting
Behaviour Background:
Repetition is a common feature of dementia and is often linked to anxiety or memory loss. While it can be frustrating, it’s rarely intentional.
Easy Solution:
Use visual cues like clocks or daily calendars. Redirect with engaging activities or gentle distractions. Say, “Let’s go have some tea,” instead of reacting with irritation. This eases anxiety behind dementia and stubborn behaviours.
Managing Restlessness and Wandering
Behaviour Background:
Restlessness may show as pacing, wandering, or fidgeting. It often signals boredom, excess energy, or discomfort.
Easy Solution:
Provide regular physical activity and hydration. Use fidget tools or hand massages to calm the nervous system. Create a safe space where movement is okay. This lowers agitation and increases their comfort level.
Tackling Sleep Problems in Dementia
Behaviour Background:
Sleep disturbances—like waking frequently or sleeping during the day—are common. These can worsen stubbornness and emotional instability.
Easy Solution:
Encourage daytime activity and avoid naps late in the day. Limit caffeine and screen time before bed. Keep their bedroom dark, cool, and quiet. Use calming routines like music or a warm bath. This improves sleep and reduces dementia and stubborn behaviours during the day.
Managing Shadowing and Clingy Behaviour
Behaviour Background:
Some people follow their caregiver constantly, often out of fear or confusion. This can become overwhelming.
Easy Solution:
Offer reassuring words and keep them involved in simple tasks like folding laundry. Avoid leaving them alone suddenly. If separation is needed, use calming objects or music to soothe them. Predictable routines help reduce this behaviour over time.
Rebuilding Lost Confidence and Interest
Behaviour Background:
Disinterest and low confidence can lead to refusal to participate in activities or socialize.
Easy Solution:
Choose simple, success-oriented activities. Visit quieter places and avoid overwhelming events. Offer encouragement and celebrate small wins. This helps build emotional safety and counters dementia and stubborn behaviours tied to fear of failure.
Understanding Aggression and BPSD (Behavioural and Psychological Symptoms of Dementia)
Behaviour Background:
Some individuals may display aggressive behaviour like shouting or hitting. These episodes can be frightening and are usually a cry for help.
Easy Solution:
First, rule out pain, infections, or side effects from medications. Then observe the environment: Is it too noisy or crowded? Try soothing routines, familiar objects, or background music. If aggression continues, consult a healthcare provider. In some cases, short-term medication may help stabilize extreme behaviours.
When to Seek Medical Help
Behavioural changes may be due to health issues like infections, constipation, or untreated pain. If a loved one shows sudden or extreme behaviour shifts, a medical assessment is essential. Addressing medical causes can often reduce or resolve challenging behaviours.
Final Thoughts on Dementia and Stubborn Behaviours
Caring for someone with dementia requires patience, compassion, and adaptability. While stubborn behaviours can be deeply frustrating, they often have understandable roots. Whether it’s a lifelong personality trait or a symptom of the disease, your approach matters. By using simple, respectful communication and adjusting your caregiving style, you can reduce stress and create a more peaceful daily routine.
Always remember: You are not alone. Seek professional support when needed, and take care of your well-being too.
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