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Behavior_Dementia Brochure
Risk factors for developing delirium include:

being very old

having a history of alcohol abuse

seeing or hearing problems

medical illnesses


severe anemia (low levels of red blood
cells)

being bedridden for a long time

taking certain medications
It is important to recognize delirium because it
may signal a new illness or serious health con-
dition. Health care providers can use certain
tools called rating scales to help determine
if a person has delirium. The health care pro-
vider may also order lab tests to see if there is
medical reason for delirium. Attention should
be paid to the exact timing that the older per-
sons mental functioning began to change. For
example, was a medication changed or a new
one added? Did a living situation change?
Catastrophic Reaction (major overreaction)
Sometimes, people with dementia have cata-
strophic reactions to things most people
would consider a minor stress. In this case, the
older person might become very angry. Some
people shout, some might throw objects or hit
other people. These aggressive behaviors can
be triggered by frustration or confusion.
Other changes in behavior older people with dementia
may exhibit: Lack of interest in things they once enjoyed Hoarding things Calling out or yelling Refusing to do things Withdrawing from others Being uncooperative Wandering
What Can Be Done?
In general, treatment for older people is
based on finding out the cause and avoiding
it, if possible. Family and caregivers should
discuss possible solutions for reducing these
behavioral symptoms with the older persons
health care provider and health care staff at
the nursing home/long-term care facility.
For example, if the older person is extremely
agitated, providing a routine schedule is
sometimes helpful. Having a routine with
plenty of supervision can be calming , and
prevent some behaviors, such as wandering.
Trying to distract an agitated person can also
help, such as having the person watch a tele-
vision show.
Sometimes, older persons with behavior
problems respond to a reward, such as
being given a favorite snack if they stop yell-
ing, for example. Some people might need
medicine to reduce certain problem behav-
iors, such as aggression.
D
ementia is a condition of declining men-
tal abilities and memory loss. It usually
affects people older than 60 and it becomes
more common as people get older. Dementia
is not a normal part of aging, even with the
very old. Many conditions and disorders can
cause dementia. Although not all dementia
runs in families, people with a family history
of certain kinds of dementia are at greater
risk of developing it.
As people get older, it is normal to have
some memory problems, like misplacing
keys or eyeglasses. But, the symptoms of
dementia are different and more severe than
everyday forgetfulness.
The most common type of dementia is
Alzheimers disease. About one-third of peo-
ple 85 years old and older have Alzheimers
disease. Although there is no cure for demen-
tia, there are some medications that may
help. Researchers are working hard to find all
the causes of dementia and new treatments.
Older people with dementia often act in
ways that upset themselves and others. An
older person with dementia can experience
personality changes, become irritable easily,
and/or suffer from anxiety. During the middle
and late stages of the disease, delusions (false
beliefs that cannot be reasoned with), deliri-
um, agitation, hallucinations, aggression, and
wandering may develop.
Changes in Behavior Related to Dementia
Agitation (Extreme emotional disturbance)
Agitation is the most common behavioral
symptom for older people with dementia.
As many as 80% to 90% of older people with
dementia may be easily agitated.
It is important to look at the time when the
agitated behavior started. Sometimes agitation
can be due to the persons surroundingstoo
many people or too much noise, for example.
Other times, agitation can be due to stress,
such as death of a loved one or change to a
different caregiver. Once the cause of agitation
is determined, it should be avoided.
Delirium
Delirium is sometimes also called a confu-
sional state. People with delirium have a quick
change (over a few hours or days) in their
mental ability. They have trouble focusing their
attention and are easily distracted. Delirium
can also be a symptom of a medical illness
such as pneumonia, bladder infection, or dia-
betes that is not controlled properly. Unlike
dementia, delirium is a temporary condition,
although it can last as long as a few months.
Delirium can make people mentally excited
and restless, but it can also make some peo-
ple quiet and drowsy. Their speech can be
confused and they can have hallucinations.
Often, people with delirium have disorganized
thoughts and they make no sense while they
talk. Some are worse at different times of the
day. Unfortunately, delirium can be confused
with depression or dementia.



The AGS Foundation for Health in Aging
The Foundation for Health in Aging (FHA) builds
a bridge between the research and practice
of geriatrics health care professionals and the
public. FHA advocates on behalf of older adults
and their special needs through public educa-
tion, clinical research, and public policy.
The Empire State Building
350 Fifth Avenue, Suite 801
New York, New York 10118
212-755-6810
FAX 212-832-8646
e-mail: staff@healthinaging.org
www.healthinaging.org




What you can do to help the nursing home
resident Talk to the nursing home staff about what
you are seeing. Ask the nursing assistants
and nurses about behaviors they are see-
ing. Let them know if your loved one
expresses feelings of sadness, depression
or worthlessness. Tell them about things
that are useful in detecting and treating
dementia. Contact your loved ones social worker for
additional help. Every resident in a nursing
home has a social worker assigned to him
or her. Contact a clergy person or chaplain
if thats appropriate for your loved one. Look around at the environment of the
nursing home. Does it feel like home?
Making the nursing home environment
feel more like home can improve a resi-
dents mood. Plants, pets and other touch-
es may help make it feel like home. You
may want to bring in items, such as family
photos and personal bedding that your
loved one will enjoy and make their room
more homelike. Ask the staff about ani-
mals that live in or visit the facility. Make
sure your loved one has an opportunity to
interact with these animals or with visitors
and volunteers in the facility. Ask the staff
about the rules for bringing in your own
pets to visit. Encourage children to visit
with your loved one. Advocate for your loved one. Request that
the facility conduct a care planning meet-
For additional information contact:
Alzheimers Association
1 800 272-3900
www.alz.org
The National Long Term Care Ombudsman
Resource Center
202-332-2275
www.ltcombudsman.org
The American Geriatrics Society
The American Geriatrics Society (AGS) is dedi-
cated to improving the health and well-being
of older adults. With a membership of over
6,000 health care professionals, the AGS has
a long history of improving health care for
older adults.
Dementia
Related to
Understanding Behavior Disorders
ing to address your loved ones behavior.
Tell the staff that you would like to attend
the meeting. Ask if all staff who care for
your loved one will participate, for exam-
ple, nursing assistants, activities staff, the
social worker, and mental health providers.
Including everyone involved in caring for
your loved one is important to ensuring
that a comprehensive care plan is devel-
oped and put into practice.
A Guide to Helping
Nursing Home Residents
with Dementia
Production of this brochure has been supported by
an unrestricted grant from Janssen Pharmaceutica Inc.