- It is important to recognize changes in
behaviour as they are often the only sign of a change in health
- Negative behaviours can be a great burden for
- There are numerous strategies to avoid or
reduce negative behaviours.
- Negative behaviours require a team approach
with health care providers and caregivers.
- Sudden changes in behaviour are important to
recognize as these are often the only clue that an older person is
sick, getting worse in their dementia, becoming depressed, or having
a side effect from a new medication.
- Attention to your family member's
behavioural and psychological symptoms are key to improving and
maintaining their quality of life.
of Negative Behaviours
Behaviours that cause the greatest burden on
caregivers include the following:
- physical aggression
- showing signs of depression
- resistance to help with activities like
dressing, washing, toileting, eating
- accusations (e.g., theft, infidelity)
- paranoia about having clothing, jewelry or
Over time, these kinds of behaviours place a
growing burden on caregivers. Therefore, by eliminating or
controlling these behaviours, care giving arrangements can be
maintained for a longer time.
to Avoid or Reduce Negative Behaviours
|| ↓ next
Ways to avoid or
reduce negative behaviours include:
- set up daily routines
- avoid big changes in the environment
- make the environment safe and less irritating
- encourage physical activity during the day,
such as exercises or walks, to help work off anxiety and excessive
- respond to your family member's
emotions, provide reassurance, touch, and hugs
- avoid arguing
- be empathetic to your family member's
- maintain a consistent approach among all
caregivers in managing the behaviour
- consider whether a day program may be
helpful, as program staff are usually familiar in dealing with
behavioural issues and it will provide a break for you, the
you notice a negative change in your family member's behaviour,
here are some suggestions about what to do.
Write down what the changes are, how long they have been going on,
and what makes them better or worse. This information will help the
health care provider decide what the problem might be, how it
started, and how to treat it.
Never change medications or add new ones – this is the
responsibility of the health care provider.
Ask others who have contact with your family member to see if they
have noticed any changes in behaviour.
- If you notice a negative change in your
family member's behaviour, talk to the health care provider
directly about the problem. Make an appointment as soon as possible,
and watch for any signs that the behaviours are getting worse or
changing in some way.
health care provider may prescribe medications to treat the
- Some newer anti-psychotic and antidepressant
medications, as well as the use of cognitive-enhancing drugs, have
been shown to be helpful.
- Often it is a case of trial-and-error to
figure out which drugs (or combination of drugs) have the best
effect in improving behaviours.
- A team approach is the best way of providing
care to an older person with behavioural problems and supporting the
caregiver(s) as well.
content of each Caregiver College Topic may be linked to a
variety of other Topic areas, the following have been identified as a
Key Linkage which you may be interested in also reviewing:
This article by Dr. John Morely, University of Illinois discusses
dementia and behavioural disturbances in older people. It provides
an excellent flow chart for handling problems associated with these
- This website provides the user with
information on older people and identifies other important sites
with direct links to them.
- Confusing Behaviours
- This website explores the various components
of depression and behavioural changes. It includes a wide array of
further readings and online resources on depression and depression
Geriatrics Society – Foundation for Health In Aging
- This website, developed by BC Partners for
Mental Health and Addictions Information, provides easy-to-read
information including fact sheets, toolkits and workbooks.
Society of Canada
- Understanding Behavior Disorders Related
to Dementia examines changes in behaviour and resulting
Wandering Registry – Safely Home
- This Society has developed a list of 10
warning signs to help you know what to look for. It is important to
see a doctor when you first notice any of the warning signs as they
may be due to depression, drug interactions, infections or
- This is a nationwide identification program
developed by the Alzheimer Society and the RCMP to help people
return home safely.
- Introduction to Behavioral and
Psychological Symptoms of Dementia: This resource provides a
very detailed educational package on the behavioural issues seen in
4 is excellent and helps caregivers understand the
potential roles they play in caring for individuals with behavioural
problems. Medication and non-medication therapies are also covered.