Dementia Fact or Fiction:  Unmet Needs

Fact or fiction: People living with dementia are often aggressive and assaultive. In the past, some of us might have answered “fact!”   

Some of us remember visiting grandma in the nursing home and how she would yell. My big brother remembers taking our grandma’s roommate for wheelchair rides in the hall because my grandma refused to let him stay in her room when we visited.

Those childhood memories—and visual imprints—have great power over how we as adults perceive dementia. I can still see my 10-year-old brother pushing grandma’s roommate in the wheelchair!

The problem is that as strong as those memories are, they often do not reflect the reality of dementia. Once we begin to learn how the brain changes with dementia, we realize that there are reasons why that person does what they do.

Let’s focus on one big area: unmet needs. On any given day, we human beings have needs that must be met. Physical needs include eating and drinking and needing to go to the bathroom. If those needs aren’t met, we experience hunger, thirst, and constipation. If you’ve ever been on a long road trip with no rest area in sight, you understand acutely the discomfort that occurs!

Most of us are able to voice those needs. “Honey, there’s a rest stop in 10 miles. Can we please stop?!” And we’re often able to meet them. We drink when we’re thirsty. We eat when we’re hungry.

People living with dementia may not be able to communicate those needs, and the need goes unmet. Pain can be a common one, especially if that person is older and has additional diagnoses such as arthritis. So, someone living with continuing pain who is not able to communicate verbally is more than likely going to communicate that distress in other ways.

As we approach and care for people living with dementia, we sometimes need to put on our detective caps and try to figure out the cause of their distress.

Rosemary Apol-Hoezee, RN, MPH, CPRHM
Dementia Specialist