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Disability and dementia

In this session we will cover:

  • Affects of dementia
  • Forms of dementia
  • Who gets dementia
  • How dementia changes behaviour

The session will take around 30 minutes to complete. At the end, you will be required to complete a short, comprehensive quiz.

What is dementia?

Dementia is a progressive decline in brain function. Dementia has many causes and is not one specific disease.

  • Dementia affects

    • thinking
    • behaviour
    • the ability to perform everyday tasks
    • reduces a person’s capacity to communicate their needs
    • the ability to cope with environmental stressors (things, people or events around them that cause stress)
    • a person’s ability to be involved in their normal social life or working life.

  • Most common causes of dementia

    There are many different causes of Dementia. The most common causes are:

    • Alzheimer’s disease
    • Vascular dementia
    • Dementia with Lewy bodies
    • Fronto Temporal Lobar Degeneration (FTLD)
    • Huntington’s disease
    • Alcohol related dementia (Korsakoff’s syndrome)
    • Creutzfeldt-Jakob disease.

Dementia Australia

Dementia Australia provides a number of help sheets on managing behaviours, you can find these here.

In the video to the right, Dementia Australia provides a short overview of dementia.

For more information please see the Dementia Australia website.

 

Who gets dementia?

Most people with dementia are older, but it is important to remember that not all older people get dementia. It is not a normal part of ageing.

Dementia can happen to anybody, but it is more common after the age of 65 years. People in their 40s and 50s can also have dementia, this is called younger onset dementia.

People with intellectual disability are at an increased risk of dementia.

People living with Down syndrome are more likely than the general population to develop Alzheimer’s dementia. About 30% of people with Down syndrome who are in their 50s have Alzheimer’s dementia. About 50% of people with Down syndrome in their 60s have Alzheimer’s dementia.

Between 50-80% of people living with Parkinson’s disease develop dementia as a progression of the disease. Usually this is dementia with Lewy Bodies.

How dementia changes behaviour

Changes in the behaviour of a person with dementia are very common.

Dementia is a result of damage or changes in the brain. As these changes to the brain occur they affect memory, mood and function.

These changes can be more difficult to recognise in a person living with intellectual disability and are often confused with normal decline. So practitioners will rely on what family and support staff observe and experience of the changes to make a diagnosis.

Knowing what different parts of the brain do will help us understand behaviours and actions of people when the brain is damaged. It will also help us to look for signs of change in the clients we support.

  • Let’s watch this video 'How the brain influences behaviour'

  • Reflection

Behaviours and what to do

Managing changed behaviours can be very difficult, and is often a matter of trial and error.

Always remember that the behaviour is not deliberate. Try to understand why someone is behaving in a particular way. Look for what triggers a behaviour. The behaviour is out of the persons control and they may be frightened or frustrated. They may need reassurance or redirecting even though it may not appear like it. It can be particularly upsetting when someone previously gentle and loving behaves in a strange or aggressive way.

Aggressive behaviour is usually an expression of fear, anger, or frustration. Often directed at family members and carers because they are the closest to the person. Check if the aggression is about getting something the person wants and if possible try to anticipate their needs.

Some people with dementia over-react, for example, yell, scream make unreasonable accusations, are stubborn or cry or laugh uncontrollably. This is part of the disease and is called a catastrophic reaction. It is one of the first signs that a person has dementia. Looking for triggers will help to avoid catastrophic reactions.

Hoarding for keeping things safe and obsessively looking for things that they believe are missing are common behaviours. Learning about hiding places can help. These activities can be a reaction to isolation. Giving people things to do and providing company can help.

Repetitive behaviours or clingy behaviours can be simply because a person cannot remember what they have to do or what they have said.

  • Question

  • Answers

    • Provide a calm, unstressed environment
    • Familiar routines
    • Keep the environment familiar. People with dementia can become upset if they find themselves in strange situations or with unfamiliar people. It can be very confusing and scary.
    • Allow for repetition, answer questions as though it’s the first time they were asked, be prepared to repeat information or instructions
    • Listen, acknowledge the person, the feeling, a memory or the comment they make
    • Reduce expectations
    • Use distraction
    • Learn and avoid triggers for behaviours
    • Remain quiet or neutral, don’t argue or correct, do not punish
    • Speak slowly, calmly
    • Use reassurance
    • Encourage activity and exercise
    • Socialise, as isolation can cause depression
    • Provide activities, provide things for hands to do. People like to feel useful and be occupied (even a draw or box of odds and ends to sort or clothes to fold)
    • Approach slowly, in full view and from the front
    • Always explain what you are doing.

Living with intellectual disability and dementia

This video talks about intellectual disability and dementia. This resource is provided by Dementia Australia for workers providing services in the disability sector.

  • Discussion

  • Apart from dementia, what are some other things that may cause a change in behaviour for a person living with an intellectual disability or acquired brain injury?

    • The severity or effect of their disability
    • Communication
    • Frustration
    • Changes occurring in the person’s environment, or an environmental stressor
    • Other people
    • Their health, pain, illness or infection
    • Medication.

  • Discussion

Anglicare's dementia training quiz
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