What does Behavioral Change Look Like in the Elderly?
Behavioral changes can be common in seniors experiencing neurological and/or medical conditions. These behaviors can present as outbursts of anger, repeating demands, aggressiveness, dysfunctional sleep patterns, or even hoarding. Oftentimes outbursts or signs of aggression fall on caregivers and it becomes their job to decipher the cause of the change. New behaviors and personality changes can indicate underlying challenges in an elder’s health such as a progressing neurocognitive disorder, depression, or a UTI.
Common Changes in Behavior
Below are some recurrent behavior changes as well as appropriate coping skills provided by Aging Care. The actions that older adults exhibit can be labeled as “scary” or “bad” to those who do not know them or what they are going through, but the root of the problem validates that these personality changes are common in many seniors’ lives.
A senior who has a pre-existing mental health condition may present their behavior changes in a form of more severe symptoms relating to their mental illness. Saving tissues, worrying if it’s time to take their medications, and picking at their skin are types of OCD behaviors that can disrupt the daily lives of seniors and their caregivers. Hoarding, refusing the bathe, and lethargy that become worse over time may be related to depression. Similarly, hallucinations and paranoia might be related to a mood disorder, personality disorder like Borderline, or signs of a form of a neurocognitive disorder. In these situations it is important to remember that their mental illness is not their nor the caregiver’s fault and can be helped by talking to their doctor about treatment plans.
Aggressiveness or abuse:
Occasionally, seniors will lash out at the person who is making the biggest effort to ensure their happiness and well-being. The anger and frustration may become so severe that it results in abuse of the caregiver. Try explaining how their behavior makes you feel. If the abuse is verbal try stepping back for a while. If your loved one requires supervision and assistance to ensure their safety, then bring in outside help to take over your duties. If you are experiencing physical abuse seek help by calling the police, Adult Protective Services, or visiting this Domestic Abuse Hotline.
Refusing to shower or bathe:
Changes in hygienic behavior is very common among seniors who are experiencing depression, grief, or have a neurocognitive disorder. Declining senses of sight and smell may also be the cause. The first step is to determine why an elder has stopped bathing. If depression is the cause, speak with their doctor about solutions like therapy and antidepressant medication. If the senior doesn’t want a family member helping them bathe, have a conversation with them about professional assistance. Lastly, if your loved one is struggling with remembering the time of day or when they last bathed, be gentle and take small steps to achieving a hygiene routine.
Excessive swearing or inappropriateness:
When this behavior is out of character for an elder, the start of Alzheimer’s disease or another form of a neurocognitive disorder may be the cause. If the onset is quite sudden, a urinary tract infection is another common culprit. UTIs present very differently in seniors than in younger individuals, and symptoms often include behavioral changes like agitation. A technique to stop an uncomfortable tantrum is to distract them with a new subject. Seniors love to reminisce, so sharing stories or looking at old photos may be a good way to get their mind off of things.
UTIs and Behavior
It’s common to hear people caution caregivers about the negative aspects of UTIs, but how do they relate to such sudden changes in a senior’s personality? For most people, the key symptoms of a UTI include the need to urinate frequently or urgently and a burning sensation while urinating. However, these symptoms are often missing in older adults or they are unable to articulate them. Seniors may suffer from unexplained fatigue or sudden changes in their behavior and mental status.
Psychological UTI Symptoms
Delirium is a common side effect of an elder experiencing a UTI. This makes it even harder to decipher the cause of shifts in personality in patients with neurocognitive disorders. In order to stay on top of this infection, here is a list of symptoms provided by Aging Care:
- Any sudden change in mental status
- Memory loss
- Trouble concentrating
- Restlessness or agitation
- Violent behavior, swearing, or yelling
- Changing levels of consciousness
Neurocognitive Disorders and Behavior Change:
Elders with Alzheimer’s or dementia exhibit behavior changes that make it seem like they are not who they once were. This is especially hard on caregivers, friends, and family members who no longer see them as “their old self.” Since memory disorders alter how one responds to their environment, this prompts new behaviors such aggression, refusal of outside help, hygienic changes, or cognitive changes like hallucinations or lack of awareness. Below is a list of what caregivers can do to best support their seniors showing signs of these behaviors.
How to Support Your Loved with Alzheimer’s or Dementia:
- Turn the negative behavior into a source of communication: If your loved one acts out in an aggressive way, it might be a way of telling others that they are overwhelmed, in pain, confused, or frightened.
- Contact their Doctor: Sudden changes could be a sign of an infection, pain, or side effect of a medication.
- Check their medication: Some medicines can also cause negative side effects and actually make things worse.
- Weigh the risks: An example of risky and hazardous behavior could be when the person gets angry and tries to walk out of the house. If their behavior is unsafe, respond in an active way.
- Find support and time for you: Consider a support group of other caregivers, take breaks when needed, and count to ten during intense situations or outbursts.
- Identify the cause: Was there a trigger or something that happened right beforehand?
How Psych360 Can Support You
Psych360 provides comprehensive mental health solutions for long-term care communities. We deliver a hybrid of both on-site and telehealth psychiatric and psychological services for your residents. Connect with us at psych360.org or give us a call at (330) 536-3746 for more information.