Jakarta (ANTARA) – Most people with dementia, apart from memory loss, also experience changes in mood and behavior, which include aggression, apathy, disorientation, depression, impulsivity and delusions.
Many caregivers of dementia patients describe changes in mood and personality as the most bothersome symptoms, while medications often used to treat dementia-related mood problems have limited efficacy.
As quoted in the Channel News Asia broadcast on Sunday (3/11), changes in personality and mood can cause stress in caregivers of people with dementia.
Dr. Nathaniel Chin, a geriatrician and associate professor in the University of Wisconsin-Madison’s department of medicine, said that trying to understand the causes of personality and mood changes in dementia patients can help reduce the stress experienced by caregivers.
As quoted in an article published by The New York Times, Dr. Chin said that being aware of the cause of the patient’s problems can make caregivers at least less annoyed by the behavior of family members who have dementia.
According to information from the Memory and Aging Center at the University of California, personality and mood changes in dementia patients are often caused by deterioration in the parts of the brain that control attention, learning, feelings and other abilities.
Apart from that, Dr. Chin said that people with dementia have less brain energy to process and adapt to sensations such as pain or fatigue and environmental stimuli.
Many experts also agree that people with dementia have a lower stress threshold than before and may feel overwhelmed more quickly, making them likely to suddenly become agitated, act aggressively, or scream.
Fayron Epps, a nursing professor at the University of Texas Health Science Center at San Antonio, said that people with dementia can lose language skills and communicate more through behavior as the disease progresses.
“As a caregiver, you really have to investigate where these moods are coming from,” she says.
Geriatric psychiatrist Dr. Helen Kales in research conducted with colleagues found that caregivers who had a system for dealing with changes in the behavior of dementia patients experienced less stress than other caregivers.
They developed a caregiver education program known as the DICE Approach, which stands for Describe, Investigate, Create, and Evaluate.
This approach teaches caregivers to describe mood changes in detail such as noting when, where, and even with whom the changes occurred, investigating why the changes may have occurred, making informed responses, and evaluating the success of the responses.
Dr. Kales gave the example of how a caregiver trained to implement DICE assisted and calmed a nursing home resident who wandered off at a certain time each day.
After investigating the possible cause and learning that she used to be a gardener, the caregiver began taking the woman to the nursing home grounds once a day and helping her with gardening. This daily activity can stop his wandering habit.
William Haley, a professor of aging studies at the University of South Florida, said that people with dementia may not understand exactly what is being communicated, but they will understand tone of voice and body language.
Therefore, he suggests caregivers speak to them calmly, with a relaxed face and body posture.
He also said that telling people with dementia in a fussy, corrective way can make them anxious and reminding them of forgotten grief can be devastating.
According to Dr. Kales in several studies, ensuring people with dementia get regular exposure to natural light and other forms of bright light can improve their sleep quality and mood.
Because boredom can cause mood swings, setting up a variety of activities that people with dementia can do on their own or with their caregivers can also help reduce mood swings.
Also read: High levels of physical work increase the risk of cognitive impairment or dementia
Also read: Beware of Sitting for Too Long at Risk of Dementia, Here’s the Research
How’s That for a Switch? Understanding Mood and Behavior Changes in Dementia
Well, welcome to the delightful rollercoaster that is dementia, folks! Just when you thought you were familiar with the person you’ve known all your life, the disease steps in to rearrange the furniture and turn the lights down low. Memory loss is just the tip of the iceberg. Hold on to your hats—because changes in mood and behavior can range from aggression to total apathy, with a side of delusions for good measure. If you ever wanted to see your loved one turn into a bit of a diva overnight, dementia is your ticket!
What’s on the Mood Menu?
According to a recent report from our friends at Channel News Asia, it’s not just the memory loss that proves a headache for caregivers. No, indeed! Many caregivers report that these mood changes—let’s call them demen-twists—are what keep them awake at night. And believe me, medication often acts less like a miracle pill and more like a bottle of homeopathic water—great in theory, futile in practice.
Dr. Nathaniel Chin, a geriatric expert from the University of Wisconsin-Madison, suggests that understanding the “why” behind these perplexing mood switches can help caregivers manage their own stress levels. Think of it as detective work for the soul—stylish trench coat optional.
The Brain’s Cranky Response
As laid out by the Memory and Aging Center at UC, our beloved brains—those squishy grey matter bags—start to flake under the pressure. Key areas governing attention, feelings, and other essential life skills start to give us the silent treatment as they deteriorate. It’s like having a breakdown during a family gathering! But that’s not all; as Dr. Chin notes, the energy levels are depleted, leading to less tolerance for sensations. So, when Grandma yells, “Turn that awful music down!” it might just be her brain throwing a tantrum.
A Caregiver’s Comedy of Errors
Now, let’s talk communication. According to Fayron Epps, a nursing professor at the University of Texas Health Science Center, as dementia progresses, language skills can take a nosedive. This means grandpa may start acting out instead of articulating his feelings—rather like a bad remake of a Shakespearean play gone horribly wrong. Epps urges caregivers to channel their inner Sherlock Holmes and investigate these mood swings.
In a study by Dr. Helen Kales, she found that caregivers who employed a systematic method—aptly named the DICE approach (Describe, Investigate, Create, Evaluate)—saw a drop in their stress levels. Sounds simple, right? It’s like playing Twister, but for your emotions. Just remember to describe every mood change in detail—down to who was in the room—because every detail counts!
To Garden or Not to Garden?
Dr. Kales had a lovely example: one trained caregiver assisted an agitated resident who liked to take little strolls at the same time every day—probably to see if the grass had grown any taller. Turns out, that resident used to be a gardener! By taking her outdoors to tend to plants, they redirected her wandering into a rewarding experience. Who knew that combatting dementia could include a bit of green thumb therapy?
The Fine Art of Tone
Now let’s chat about tone. Behavioral expert William Haley mentions that while dementia patients might not always grasp what you say, they certainly pick up on your tone and body language. So, when explaining why Grandma doesn’t need butter on her toast today, try not to look like you’re auditioning for a horror film. Keep calm, and speak gently—after all, a smile can often bridge the gap where words fail.
Light, Camera, Mood!
On a brighter note, literally! Regular exposure to natural light can boost mood and regulate sleep quality. Sometimes, all it takes is a well-placed sunny spot to turn a mood from gloomy to groovy. And if boredom is causing those mood swings? Setting up various activities can keep them engaged and, hopefully, out of trouble.
Final Thoughts
In the end, caregivers are put through the emotional wringer, dealing with shifts that can be as sudden as a stand-up comic’s punchlines. So, whether you’re channeling your inner therapist or simply trying to keep the peace during dinner, remember that every little strategy helps. And if all else fails, there’s always the option of a good chuckle—because sometimes laughter really is the best medicine, even when applying it to dementia.
**Interview with Dr. Nathaniel Chin on Mood Changes in Dementia Patients**
**Interviewer:** Welcome, Dr. Nathaniel Chin! Thank you for joining us today to shed light on the often-overlooked mood changes that accompany dementia. Could you start by explaining why these shifts in mood and personality are such significant challenges for caregivers?
**Dr. Chin:** Thank you for having me! Mood changes in dementia patients can be particularly troubling not only for the individuals experiencing them but also for their caregivers. As the disease progresses, caregivers often find themselves dealing with rapid mood swings—everything from aggression to apathy—much of it seemingly without cause. It’s not just the emotional toll; these changes can lead to confusion and stress for everyone involved.
**Interviewer:** That’s a very important point. You mentioned that understanding the “why” behind these mood changes can help caregivers. What should caregivers focus on?
**Dr. Chin:** Absolutely. Gaining insights into the underlying factors can significantly alleviate caregiver stress. Many of these changes result from conditions in the brain that degrade areas responsible for attention, emotions, and learning. When caregivers can identify triggers—like pain or environmental stressors—they can respond more effectively. Essentially, if we understand that a loved one is acting out due to discomfort or confusion, we can approach the situation with more compassion instead of frustration.
**Interviewer:** It’s fascinating how much caregivers can learn from simply observing. Speaking of observations, can you tell us about the DICE approach developed by Dr. Helen Kales? How exactly does it help?
**Dr. Chin:** The DICE approach stands for Describe, Investigate, Create, and Evaluate. It encourages caregivers to meticulously document mood changes, investigate potential reasons behind those changes, and then create a tailored response. For instance, if a patient gets agitated at certain times of the day, finding out that they used to be a gardener might lead to a calming daily activity that aligns with their history. This systematic approach not only helps the caregiver manage stress but can also greatly improve the patient’s quality of life.
**Interviewer:** It sounds like a proactive and compassionate strategy. Alongside understanding and communication, what other methods can caregivers employ to support individuals with dementia?
**Dr. Chin:** Caregivers can enhance the mood and well-being of their loved ones by ensuring regular exposure to natural light, which has been linked to better sleep quality. Keeping the environment engaging through various activities is essential too. Boredom can lead to more challenging behaviors, so maintaining an active routine is important.
**Interviewer:** Those are practical suggestions. Before we wrap up, what final advice would you give to caregivers grappling with the emotional rollercoaster of dementia care?
**Dr. Chin:** Remember to take care of yourselves, too. Caring for someone with dementia is incredibly taxing. Connecting with support groups or educational resources can really help. It’s important to build a network where you can share experiences and strategies with others in similar situations. Caring for your own mental health is as crucial as caring for your loved ones.
**Interviewer:** Thank you, Dr. Chin, for your valuable insights and practical advice. It’s been a pleasure speaking with you.
**Dr. Chin:** Thank you for having me! Awareness and empathy go a long way in this journey.
