How to manage older adults with dementia | Inquirer Lifestyle
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How to manage older adults with dementia

Alfredo Torres, OTRP, chief occupational therapist of the National Center for Mental Health, has provided a list of behavioral and psychological symptoms of dementia and tips on how caregivers can deal with them.

Anger and Aggression

Assure the angry individual that they’re alright, and that you understand that they can’t help themselves.

Be prepared to receive insults and verbal abuse.

Speak in a well-modulated voice.

Offer food or drink (it is difficult to eat and be angry at the same time).

Sit or stand a little to the side some four to five feet away rather than facing them directly to appear less intimidating


Provide a night light to help them see and locate familiar things, prevent falls in the dark and protect against wandering.

Encourage reminiscence.  Gently assist them with keeping facts reasonably accurate and related to the past

Use communication techniques rich in reminders, cues, gestures and physical guide to increase personal awareness.

Provide them personal space filled with familiar things where they can  rest and feel safe and secure.

Ask permission if something must be moved or changed to establish feelings of trust and control.

Hoarding, rummaging behavior

Ignore the behavior if it’s not particularly troublesome or unsafe.

Clean out the person’s collection but leave a few items behind.

Learn the person’s hiding places.

Provide a box or private space that is theirs alone to keep things in.

Sundowner’s syndrome

Set up a rigid daily schedule to reduce their anxiety about what happens next

Alternate activity with programmed rest.

Reduce all stimuli during rest periods.

Prepare the impaired person for special events so they don’t come as a shock.

Suspicion, distrust

Avoid grand gestures and promises that cannot be carried out.

Do not argue about or rationally explain disappearances of the person’s possessions.

Offer to look for items they say  is missing.


Try to rebuild self-esteem through reminiscence, participation in activities and decisions.

Notice pictures and mementos. Ask about them and listen.

Spend time with them.  Do not ignore quiet, uncomplaining people.

Alert the person’s doctor; medications may help.

How to Facilitate Interaction with an Individual with Dementia

Approach the person slowly from the front, never behind, and give him or her time to get used to your presence.

Maintain eye contact. A gentle touch may help.

Introduce yourself to them daily and call the person by name. Do not ask “Don’t you remember me?”

Treat them like adults and don’t talk down to them.

When possible, attempt all communication in a calm, relaxed and quiet environment using your natural voice. Shouting only agitates them.

Try and talk about feelings rather than arguing over facts.

Invite an individual to an activity using gentle assertion rather than a question that may be easily refused.

Give short simple directions.  Do not overwhelm them with too much information at once.Repeat or rephrase if they don’t understand you right away

Do not rush them. Allow them enough time to answer questions, follow directions and express themselves at a pace they choose and find most comfortable.

Reduce distractions in the environment and tone down radio and TV sets

Too many people in the room can be over-stimulating for them.

If the impaired person seems frustrated and temperamental and you don’t know what he or she wants, try to ask simple questions answerable by “yes” or “no.”