What is actually the nature of challenging behavior in dementia within family environments? Why can some caregivers and family members not cope with behavioral and psychological symptoms of dementia (BPSD)? A British study answers many important questions.
For example, up to 90 percent of people with dementia are affected by restlessness, repetitive calling, sleep disturbances, wandering, and apathy. However, some caregivers and relatives find these behavioral and psychological symptoms (BPSD) challenging. How can and should one cope with changed behaviors or manage the stress that symptoms cause in both those affected and the caregivers themselves?
In 2016, British scientists set out in a review article to „better understand the nature of challenging behavior in dementia in family settings.“ They were also interested in why some caregivers have difficulty managing BPSD while others do not.
Loss of identity and emotional bonds
„The underlying belief that their loved ones had lost or were inevitably going to lose their identity due to dementia was a significant reason why caregivers perceived the behavior as challenging,“ the researchers write. In addition, there are changes in communication and relationships that lead to a „feeling of neglect“ or even a loss of emotional connection.
„Caregivers perceived BPSD as a challenge associated with a sense of relationship deterioration, but also with the violation of social norms by the care recipients and the underlying belief that individuals with dementia inevitably lose their ‚personality.‘
Better handling of the situation
The study authors succeeded in outlining a psychological understanding of the unmet needs of caregivers and relatives who find it difficult to accept and adapt to changed circumstances. This creates „the caregiver's own unfulfilled need for care and emotional security.“ However, if this feeling is present, it can help caregivers perceive behaviors no longer as challenging and cope better with the situation.
Uncovered need for support
Caregivers' reactions to BPSD vary, and the way caregivers accept their situation and cope with dementia-related problems can influence the course of BPSD. This, the researchers write, could be the reason why two-thirds of families, even when receiving professional support, report an unmet need in managing BPSD.
Tip for practice: To better manage the behavior and psychological symptoms of dementia, intervention programs should not only be based on the needs of the family member with dementia but also consider the (unmet) psychological needs of the informal caregivers. These could, for example, support informal caregivers in defining their new role, finding new means of communication, and creating more opportunities for shared activities.
Here is the link to the study:
