5 ADDITIONAL Challenging Dementia Behaviors Explained!

5 ADDITIONAL Challenging Dementia Behaviors Explained! post page

Teepa Snow

By Teepa SnowJuly 23rd, 2020

5 ADDITIONAL Challenging Dementia Behaviors Explained!

Have you ever struggled with these challenging situations, commonly seen in those living with dementia?
People living with dementia often experience changes in their ability to process language, which means they it may become increasingly difficult for them to understand words. This can result in many challenges, including the ones listed below:

1. Constantly saying “What?” or asking you to repeat yourself
This usually leads to an assumption that the person is experiencing hearing loss. While this may be true, it is also quite likely that their hearing is actually not the issue. Instead, they may be experiencing changes in their ability to understand language.
Did you know that people with mid-stage dementia commonly miss one out of every four words that are spoken to them? When that many words are being lost, it becomes increasingly difficult to understand what someone is trying to say to them, so they may often ask you to repeat yourself.
Try this: Instead of increasing your volume, try using less words and speaking more slowly.
2. Having trouble following instructions
While some might assume that the individual is being stubborn or defiant, it is very likely that they may in fact be having trouble following a set of directions due to changes in language processing.
Try this: When providing instructions, give only one step at a time and keep the number of words to a minimum.
3. Resisting Care
There are a wide variety of reasons that this may occur, but one of the most significant is that the person living with dementia is simply not understanding what the care partner is attempting to do.  Even though the care partner believes that they are explaining things adequately, they are often providing too many words and speaking too quickly to allow for the individual living with dementia to process and understand.
If the individual is missing some or most of the words, then it is likely they will become confused, startled, or alarmed when someone tries to remove their pants or touch their face, and they may strike out in self-defense. 
Try this: When providing care, use just a few words, speak more slowly, and provide visual cues to allow for optimal processing.
4. Being agitated or distracted in noisy environments
It is extremely common for individuals to have a much more difficult time processing language in noisy or busy environments. The more stimuli present, the more challenging it can be to follow and process the words in a conversation.
Try this: Choosing a calmer environment, such as a quiet restaurant rather than a bustling one, or an empty day room rather than the busy common area, can help optimize the ability to process language.
5. Turning up the TV or radio volume
It is very easy to assume that this action is due to a hearing loss, or maybe even a desire to irritate a spouse or roommate! However, it is quite likely that the individual may be experiencing a change in the ability to understand language. They likely do not understand this change is occurring, so they may feel that they may be able to understand the words better if they increase the volume.
Try this: Sometimes suggesting a gradual shift to a different type of programming, such as a music station rather than all-talk radio, may help to ease some frustration for someone struggling with language processing.

 (If you missed our previous post, read about the other 5 Challenging Dementia Behaviors we discussed)

Throughout the GEMS States in the progression of dementia, the ability to understand language typically changes significantly. When you gain awareness of this common dementia symptom, you are able to respond more compassionately and effectively, and therefore create more positive daily interactions.

Learn more about vision changes and the GEMS States from these Positive Approach to Care Resources:

Resource Card
Learn More >>
Dementia Care
Provisions DVD
Learn More >>
Progression of
Dementia DVD
Learn More >>

For a deeper dive about coping with challenging situation, check out these additional resources:
 Solutions to Challenging
Situations DVD/Workbook Combo

Learn More >>
Challenging Behaviors
in Dementia Care
Learn More >>

10 Comments on “5 ADDITIONAL Challenging Dementia Behaviors Explained!”

  1. Avatar

    I like this information it helps me understand what my Mom is experiencing. I’ve learned to slow down, give extra time, and offer one or two choices vs a list – and when ever she is expressing a desire I really try and run with that choice and let her go as long as she is safe.
    I’ve learned to LOVE the slow down and do things that allow her to do things that were a part of her life before and see her satisfaction in even doing part if not all of a task.

  2. Avatar

    I need some help with taking away the car from my parents (dad: severe vascular dementia and mom; mid stage Alzheimers). How can I do this in a firm but kind and compassionate way?

    1. Alejandro DeJesus

      My name is Alejandro and I work for PAC as a mentor.

      Thanks for leaving the question. Finding the right balance is difficult in any situation and having both parents involved can be even more tricky. Driving is a topic that come up often as a place that changes need to happen.

      You can reach out to one of our PAC Consultants for assistance with your situation. We have free 30 minute consultations. You can find more information here, https://teepasnow.com/services/consulting/phone-consultations/.

      Additionally, Teepa has some recorded webinar sessions that are specifically about driving. https://teepasnow.com/product/driving-under-the-influence-of-dementia-family-friends/

  3. Avatar

    I use a lot of Teepa’s techniques and find it to be a great help in caring for my residents. I’m interested in getting certified; to become more effective in this field . To help my staff, families and most of all my residents is my goal !!!
    Thank you
    Simone Thomas

    1. Alejandro DeJesus

      Hi Simone,

      My name is Alejandro and I am a PAC mentor. We are so glad that the techniques have been helpful. I have passed along your name to my colleague, Diane so that she can reach out to you about certifications. Also, you can send in any inquiries about our PAC certifications to, certifications@teepasnow.com

  4. Avatar

    This was helpful in many ways due to the fact that I work in a living Center and work with dementia residents every day. Thanks for the encouragingly help.

  5. Avatar

    This is very helpful. Thank you.
    Can you provide some helpful hints for the care-giver to decipher what the person with dementia is trying to tell you when they have lost the ability to say proper or common nouns? I am noticing that because I cannot understand her, she becomes more and more frustrated as she seems to know what she wants to say but I can’t figure it out.
    Thank you.

  6. Avatar

    This information was very informative for me. I am starting to see some of these changes in my husband. I am concerned because he drives a lot. I don’t like being the passenger when we are riding together. Thank you for all you do. Be Blessed and be safe.

  7. Avatar

    Hello, my name is Therese and I can’t thank you enough for walking me through “everything” my mom was going through. And helping me to recognize when it was time to tell her that she did a great job holding on for us. But I knew she was tired and I told her we would all be fine if she wanted to leave. I made sure to tell her how precious she was but I knew I had to give her permission. Teepa, now when I hear your name or see your emails, it warms my heart. I could never ever thank you enough for being so caring to those who suffer from these diseases. But also for showing so many of us how to take care of those we love with the dignity and respect they deserve. My mom was my “precious pearl” I will miss her always, Thanks Teepa 🙂

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