Dementia Related Behaviors: Lost and Found

Some people collect items that have meaning to them over time and they can amass a great deal of items. Compulsive hoarders are not able to throw away any thing and over time, their living space becomes unsafe. The compulsive hoarding can lead to health risks and financial demands.

A person with dementia may exhibit hoarding behavior in the early to middle stages. They may be seen frequently searching or runnaging for something they believe is missing.

What is Causing this Behavior??

• Physical changes within the brain, impaired judgement, memory loss, and/or confusion
• Loss of control over behaviors
• Inability to remember taking items or where the items were placed

There are other theories why individuals with dementia hoard, hide or rummage through things:

1. They may hoard for fear they may need the item one day
2. They may hide items because they no longer recognize the people around them
3. They may rummage through things because seeing and touching the items provides them with comfort and let’s them know that the items are there

Other theories suggest that these individuals may experience environmental reasons why they hoard, rummage and/or hide things:

• Fear of being robbed or losing items they may hide or hoard to keep the items safe
• Lack of awareness to know what should be kept or thrown away
• Boredom, lack of stimulation or difficulty stimulating new activities

If we go with the theory, or premise, that hoarding provides comfort and a sense of security, then it would not be in the best interest of the individual to remove everything that a person hoards. This can cause the individual severe emotional distress. However, removing clutter if it is causing a safety or health hazard is recommended. You can leave as much ‘safe” clutter and organize it in large bins or decorative baskets. If you find that you need to remove or discard items, have diversion activities planned and be ready to divert the person’s attention as you remove the items. Best practice? If the clutter is not posing a safety or health hazard, then just leave it be.

 

Hallucinations and Paranoia

Paranoia in persons with Alzheimer’s is thought to be as a result of the memory loss. For instance, if any individual forgets where they put an item, they may begin to believe that somebody is taking their things. Other examples may be as simple as forgetting who the caregiver is and not trusting the caregiver that they now view as a stranger. Paranoia is an emotion that is rooted in fear. If they don’t know who you are, they may not trust you and think you mean them harm.

Hallucinations, by definition, is experiencing something (involving the senses) that is not there. Hallucinations can be visual, auditory (hearing), tactile (feeling) or olfactory (smell). It is woth mentioning that hallucinations are not always upsetting or distrubing to the individual having the hallucinations…and not all hallucinations or delusions are paranoid in nature. However, it is important to consult with your healthcare provider regardless because there could be physical causes for the problem.

 

Sundown Syndrome

Sundowning is not a disease but rather a symptom that affects those with Alzheimer’s or related dementias. Its cause is unknown but is believed to be triggered by sleep disturbances. A disruption in the normal routine can trigger sundowning symptoms of increased confusion, difficulty sleeping, agitation and pacing, that starts when the sun goes down. Sundowning is common in persons who are hospitalized because they are in an unfamiliar place. In addition to the symptoms mentioned earlier, these people may closely follow their caregiver wherever they go in the home. An event known as shadowing.

Sundowning starts in the middle to late stages of Alzheimer’s disease and can last each afternoon/evening once it has begun. Each episode can last for a few hours or throughout the night. Unfortunately, there is no treatment for sundowner’s syndrome but there are ways to minimize its occurrence:

1. Get a Routine: A routine can eliminate fear and anxiety
2. No Naps! If possible, discourage naps during the day. Remember sleep disturbances is thought to trigger sundowner’s
3. Cut the Sugar and Caffeine: Foods containing caffeine and sugar should be avoided late in the day because they can interrupt sleep patterns
4. LET THER BE LIGHT…Keep rooms properly lit to minimize any shadows which can cause confusion. Light therapy lights strategically placed have been proven to minimize the effects of sundowners, dementia, and depression