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  • Writer's pictureBy April Sage

Dementia’s Impact: Recognizing Signs and Managing Behaviors

landscape view of a sunset over the water and a grassy landscape

Nearly 70% of my clients have a cognitive decline, typically a form of Dementia. Whether this is Dementia with additional cognitive diagnoses, or perhaps the individual suffered a stroke that has wreaked havoc on the brain. Either way, this diagnosis brings challenges and changes that have a jarring effect on the entire family, drastically changing their daily living and hovering over their life as an umbrella of emotions.

Personally, last year my stepdad was cutting a cedar tree with a chainsaw in my front yard in July, and after a series of falls and incidences was diagnosed in November with severe white matter: Alzheimer’s. He has always been a quiet man; but his diagnosis caught us by surprise.

Dementia is a volatile cognitive disease that affects memory, language, reasoning, judgment, and thought processes. While there are more than 400 types of the disease, there are five primary types.

  • Alzheimer’s (60-80% diagnosed have this form)

  • Dementia with Lewy Bodies (10-15% diagnosed have this form)

  • Vascular Dementia (10% diagnosed have this form)

  • Mixed Dementia (a combination of Alzheimer’s + Vascular)

  • Frontotemporal Dementia (also referred to as Pick’s disease)

Parkinson’s disease and Huntington’s disease are usually combined in the Dementia category as the conditions that cause Dementia. For example, after approximately ten years, a patient with Parkinson’s often presents signs of Dementia.

Roughly 30% of the clients I support have drastic behavioral changes. There is nothing more upsetting or disruptive for their families than watching their loved one change before their eyes. One moment, they are lovingly reminiscing about their past, and without warning, striking others or cursing while throwing an object at the wall. I have seen clients curse out caregivers who never spoke a curse word in their lives or accused family and friends of stealing everything under their noses. Meanwhile, the item is misplaced in a shoe in the back of the closet. One client was too afraid to dine at meals because she believed the chef was her deceased husband’s reincarnate.

Many people experience what we call “behaviors” as a side effect of Dementia. These typically come from a place of frustration when the person cannot do something they have been able to do, such as find a word(s) or even find their purse that they set in the same spot in the home every day. When these behaviors happen, it can be hard to recognize your loved one as who they once were. It’s important to remember they are still real people. One of my favorite movies of all time is "The Notebook." The movie truly outlines the changes, the lucid moments, and the thief that Dementia is. It lovingly shows the sadness in the behaviors, the power of love, and the loss for the family who is left behind to figure it out. If you haven’t seen it, I strongly recommend this movie.

It’s believed the sooner a patient with cognitive decline has access to medication and programs, the sooner they can slow the progression and manage the effects and may extend the patient’s quality of life. Here are some common signs of confusion to look for:

  • Struggling to remember yesterday’s events or an inadequate account of activities.

  • Confusion about the current year, state, or even their address.

  • Trouble finding the right words, speaking generally, or forgetting how to write.

  • Showing poor judgment, lack of inhibition, or disregard for social norms.

  • Shifts in mood, personality, or extreme anxiety and/or depression.

  • Hallucinations of a long-lost relative can seem real to them.


While exercise can be the best medicine for stress, depression, or anxiety, not everyone loves to exercise, especially if they have restrictions. It is essential to understand your loved one’s limitations and know what makes them happy. It’s important to note this disease changes people. The best course of action is to provide quality of life. Maybe your loved one might have enjoyed roasted veggies three years ago, but now they only want ice cream. This behavior is expected. Try to roll with the punches and listen to your gut. If it’s ice cream, then let there be ice cream. They deserve everything that makes their heart happy, especially at this time.

If you need stimulating activities to manage behavior, or defuse anger or frustration, consider the following ideas:

  • Create a memory box. Organize pictures of people they love, fun trinkets, and special reminiscent activities, and watch them light up!

  • Cook simple meals. Help them smell and taste their favorite foods. Preparing a healthy meal from scratch from whole foods can improve mood and bring back cherished memories. It’s important to help them feel useful. Even if it’s not perfect, allow them to mix the greens for the salad, stir the cookie dough, and add in the chocolate chips. It is also important to note that taste changes, taste buds diminish, and their favorites can suddenly become undesirable. Be flexible, don’t argue, and introduce something else. Like with my stepdad, in about 2-3 weeks, he will like it again, and it will be his favorite.

  • Household chores. Engaging in small familiar activities can feel purposeful, needed, and keep physical activity up. Folding laundry, dusting, and sweeping can be very satisfying. These projects can take quite a while and are easy to return to when they forget they finished the load 10 minutes prior.

  • Gardening. For many, this traditional activity is therapeutic, soothing, and rewarding. It can redirect after a rough period, instill a need, and feel a connection to the outdoors. Let them plant the seed, and water the pot. Even if it’s over-watered and the seed is too deep, you can fix it later. The goal is to make them feel a part of the process. Just wheeling them out to spend time next to the space while you plant, water, and pot will be stimulating. Think about how to include them even in just observation. Ask them what they think about what to do next. Make it verbally interactive and it will give you something else to talk about.

Caregiving for others requires a heightened level of focus and knowledge of the various stages, unforeseen changes, and inevitable challenges. It’s vital to pre-plan a counterbalance to assist and prepare you for what’s to come for your loved ones. As your advocate, it is my mission to provide personalized, vetted solutions. You do not have to do this alone. Give me a call, and we can walk through your options together.

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