Wandering:Wandering is said to occur in 11- 39 per cent of all cases of dementia. Defined as the tendency of people to keep on the move, typically people want to go home or move around in an aimless confused fashion.
The wandering person may become physically exhausted or disruptive to other residents and care-givers. It is also associated with risks. A person may get lost in bad weather conditions or wander out on to a road.
There are different reasons why a person with dementia may wander, according to the needs-driven behaviour model. It may be located in the individual's background and the daily environment may also be contributing.
Is the immediate environment boring, stressful, noisy, cluttered? There may also be a need to analyse how the person feels. Is the behaviour being used to express some inner unmet physiological or psychological need?
Sometimes all that may be needed is a safe place for the person to wander at no risk.
Repetitive behaviour:
Asking of the same question over and over again, telling the same story or repeatedly searching or rummaging can be very tiring on family members, care-givers and other patients. It can increase frustration, strained relationships and a desire to find ways to stop the behaviours.
The needs-driven behaviour model suggests that looking behind the behaviour may shed some light on it. Repeatedly telling a story may be born out of a need to communicate. It may also serve the function of increasing the person's sense of self-esteem by recalling past achievements or may evoke pleasant memories.
Studies have shown that reminiscence therapy can improve people's mood and self-esteem. In the case of rummaging - if it's not doing any harm, why stop it? The patient may derive much satisfaction from feeling that they are still helping out even if that's not obvious to the casual observer.
Aggression:
Verbal and physical aggression is the behavioural symptom that has the greatest impact on care-givers and is cited as a factor leading to institutionalisation. Older age, being male and the severity of dementia are associated with increased levels of aggression in people with dementia.
The older approach to dementia may view aggression as a characteristic of brain dysfunction associated with dementia and the respective changes in brain chemistry. Strategies used to address the problem would include restraints - either chemical or physical.
The new model takes a more holistic view. Interventions here might include aromatherapy, music therapy, multi-sensory gardens, recreational activities and reminiscence. Attention is also given to the physical environment such as the temperature, sound and lighting and the way in which these could be used to promote a sense of peace and reduce agitation.
Intrusion into a person's physical space is often a trigger factor. Helping with a person's daily living activities may trigger this behaviour.
There is also a close correlation between aggression and delusion or false beliefs. The presence of paranoid delusions, false beliefs relating to one's self may also increase the likelihood that a carer's approach is misinterpreted as a threat and a person with dementia may react with aggression.