“There’s always a reason behind the behaviour.” Our job as caregivers is to ask “why?” What is causing someone’s sudden change in behaviour – e.g., wandering, anxiety, anger, inappropriate behaviour or even aggression? Knowing the cause of the behaviour guides us in coming up with solutions to manage the behaviour and treat whatever underlying conditions that precipitate such behaviour.
Is Doris showing signs of early dementia?
“Doris” has been residing in independent living for a few years. She is coping and living well in her environment until recently, her family noticed a change in Doris’ behaviour. They feared that it could be symptoms of early dementia. Some of the behavioural changes they have observed in Doris included:
- asking the same questions repeatedly to staff members
- wandering the halls at night
- paranoid behaviour including accusing staff of stealing her things
Doris’ family was concerned that they may need to move Doris out of assisted living.
The cause of Doris’ sudden change in behaviour
The family then decided to reach out to me. Having seen similar behaviour in my other clients, I suggested that they bring Doris to her family physician to see if she has an infection such as a urinary tract infection (UTI).
The result came back and it showed that Doris had UTI. Therefore, she was in fact, at the time, experiencing delirium.
She was treated for UTI and Doris was fine for a little while. However, it wasn’t long until Doris started showing the same unusual behaviour. This time, it wasn’t UTI.
A family member thought of giving Doris a banana and noticed that whenever they give Doris a banana, she would be back to her “usual” self. Further testing showed that Doris’ potassium levels were low and that her sudden change in behaviour could very well be related to her low potassium levels.
Low potassium levels and behavioural changes
Hypokalemia, that is, low potassium levels are known to be associated with neurological symptoms. Hypokalemia can cause muscle weakness, cardiac symptoms such as arrhythmia and neurological symptoms including lethargy, fatigue, apathy, memory impairment, disorientation and confusion, to name a few (Hypokalemia and Psychosis: A Forgotten Association. American Journal of Psychiatry. 2017).
This could explain the sudden onset of Doris’ unusual behaviour. Doris wasn’t showing signs of early dementia; she was experiencing delirium triggered by her susceptibility to low potassium levels.
Why we need to ask “why”
As a Dementia Consultant and Educator for over 25 years, I advocate and educate others that it’s important to dig deeper, investigate further and identify what is causing the behaviour. It’s not always dementia. In Doris’ case, the first clue was that her changed behaviour was acute or “sudden onset” in nature. Before jumping to the conclusion that she could have early dementia, it was prudent to ask if Doris was in pain or experiencing some sort of discomfort.
“Early diagnosis and treatment,” starts with having the correct diagnosis so we can provide the appropriate treatment. Prescribing Doris with anti-psychotic medications may manage the symptoms, but her UTI and hypokalemia will remain untreated and she will continue to be in discomfort and in pain.
Asking “why” is compassionate care and ensures we are providing the best quality of care to the person under our care that would allow them to enjoy a good quality of life.
If you are struggling with a challenge in your caregiving role and could benefit from an outsider to offer you helpful solutions for your situation, please reach out and our Dementia Care Advisors will be happy to support you.
DISCLAIMER:
The contents of this blog are provided for information purposes only. They are not intended to replace clinical diagnosis or medical advice from a health professional.
