Responding to emotional distress, expressions of anger, and excessive walking
When a person is showing signs of agitation such as hitting out at others or walking around continuously it is important to consider this as a form of communication or a response to unmet needs.
Check through a number of factors:
- What is the environment like? Is this distressing the person? Has something significant changed/been moved (for example a photo or a piece of furniture)?
- What is going on physically for the person? (for example is the person walking in response to the need for exercise)?
- Is the person in pain?
- Are they communicating with you? Think about what they may have done in the past, for example the job they had and what it involved, what they did with their family such as walking their children home from school. Does this help you understand their behaviour better?
Most importantly consider what is happening within the interaction?
Is the person being,
- ignored
- shouted at
- blamed
- belittled
- spoken to as a child
- ridiculed, or
- handled insensitively?
Any of these responses will result in a loss of dignity and an increased sense of distress for the person with dementia.
Be mindful of the experience of the person.
What to do:
- Think if there is anything you are doing which is making the situation worse.
- Stay calm.
- Give the person space and back away if necessary.
- Speak slowly and gently.
- Refer back to workbook 1 and look at the work you have already done on improving communication.
Mr Salter has a mixed dementia and was diagnosed three years ago. He was being cared for by his wife Sybil at home who recently has been admitted to hospital for a heart operation. Mr Salter is now in a care home. Since being at the care home he has been reluctant to sit down with the other residents to eat and drink. In the evenings he has been continuously walking around the care home and approaches people both staff and residents saying such things as ‘I’ve done it all now I’m going’, or ‘I need to get back now’.
This is becoming an increasingly distressing situation as Mr Salter is getting angry when the staff are preventing him from leaving.
His daughter has said that her father was one of eight children. He had a troubled childhood and spent some time in a home she describes as being ‘for naughty boys’.
1. What needs do you think Mr Salter might have?
In your notebook list any possible physical or psychological needs.
2. How might you approach Mr Salter?
In your notebook write down how you might approach Mr Salter. Think about your non verbal communication as well as what you might say.
Further learning
For further information see Step 3 of these workbooks on the South West Dementia Partnership website on ‘How to manage behaviours that challenge us’.