Dementia – the side effects
I’ve already been through some of the loss of memory and loss of functionality of a person with dementia, with their loss of ability to plan (the executive function). So as well as loss of brain ability, they can also have a personality change and sometimes they don’t.
We are all individuals, we are all different. I’ve met some clients with similar traits, but I’ve never yet met anyone who is exactly the same as someone else. So like all individuals, people with dementia have their own presentation and journey through the condition.
I would stress once again, that I am not a clinician, but I am an elderly client solicitor with a lot of experience of dealing with people with dementia at all stages of the condition.
One of the most common side effects (if they are going to get any) is aggression. This can be very upsetting for families to see their loved one who was always delightful come out with language they never knew they knew or hitting others.
Aggression is a spectrum presentation and can be anything from a cross word and a stern stare to punching, kicking & biting with all their strength and everything in between. Some people with aggression may only be aggression (to whatever extent they are) some of the time and sometimes it is all the time. I had one client who punched someone so hard, she broke her own arm!
An aggressive presentation is more common in the moderate stages and as the dementia progresses their aggression can wane, but this is not always the case, as already said – we are all individuals. It is suggested by clinicians that this is a fear response, and as the dementia progresses and they don’t know that they don’t know, they become calmer. I have had clients that were described as “internally agitated”, it is a more unusual presentation, but even in very late stage dementia, they can seem agitated, sometimes tearful and aggressive.
Aggression can take the form of abusive language, without physical aggression. This is when families hear colourful language! Or it can be threatening language without the swear words, spoken pointedly towards their loved ones.
There can also be a presentation of paranoia, but this tends to be in the mild to moderate stages, again it is assumed to be a fear response.
I’ve also seen the side effect of hyper sexuality, which is more unusual. This is when the person with dementia is overtly sexual. It can create a very difficult situation if the look like their parents, as the parent will look at their child and think it is their spouse in the earlier years, which may be where their world exists at that time. Therefore when the parent makes overtures to their child, the child will of course rebut them, but the parent feels let down by their spouse, not having realised this was their child. Even without this situation in families, the person with dementia is being constantly turned down and it is very hard for them, although they may not remember how many times they have been turned down (a small blessing).
There is lots of guess work in respect of people with dementia, as their condition develops and they lose the ability to communicate, no-one knows for sure what they think or how they feel, because they cannot communicate it.
Caring for someone with these side effects takes a great deal of empathy and skill to keep all parties safe and the person with dementia in the optimal health possible.