Dementia affects people in different ways and changes in the behaviour or emotional state of someone living with dementia are common.
Dementia can affect someone’s inhibitions. This means they may stop following the usual social rules about how to behave. Disinhibited behaviours can seem tactless, rude or offensive.
These behaviours can place enormous strain on families and carers. It can be particularly upsetting when someone who used to be private behaves in a disinhibited way.
Types of disinhibited behaviours
- Tactless or rude remarks. Making inappropriate comments about another person. It can seem like the person with dementia is trying to deliberately embarrass or harass the other person.
- Sexual comments. Flirting inappropriately with someone or making sexual comments.
- Undressing. Removal of clothing at inappropriate times or places.
- Touching themselves. Forgetting social rules, they may touch their genital area in public.
- Impulsiveness. Driving dangerously or make hurtful comments to their partner, family member or friend.
There are many reasons why behaviours change. Every person living with dementia reacts to circumstances in their own way.
Sometimes the behaviour may be related to changes in the brain. Or there may be something in the environment that triggers the behaviour. Other times, a task may be too complex, or the person may not be feeling well.
When disinhibited behaviours happen, it can feel distressing. Remember that these behaviours are related to how dementia affects the person and are not deliberate or intended to hurt or offend anyone.
Understanding possible causes of the behaviour changes can help you find ways to prevent it from happening again.
Dementia can cause confusion for someone about the identity of people around them. If they think their carer or child is their spouse, they may act inappropriately.
Some behaviours, such as undressing or touching themselves in public, may be caused by discomfort. For example, clothes may be removed if they are feeling too hot or if clothes are too tight. Urinary tract infections and itching can cause the person to touch their genital area.
Someone may have forgotten where they are, how to be discreet, how to dress or even the importance of clothing. They may need to go to the toilet, but have forgotten where the bathroom is or how to use it.
Dementia can cause confusion about the time of day or where they are. Disorientation may mean they start preparing for a bath or bed.
What to try
- Look for a reason behind the behaviour. Understanding why someone is behaving in a particular way will help you respond to it.
- Arrange a visit to the doctor. The doctor can check if physical illness, side effects of medication or discomfort are contributing to the behaviour. They can then provide advice.
- Respond with patience. Try not to overreact, even though the behaviour may be very embarrassing. Remember the behaviour is part of the condition.
- Appropriate physical touch. If appropriate, offer plenty of physical contact, such as stroking hair, hugging or arm rubbing. This is a loving way to ease anxiety and provide reassurance.
- Distract and redirect. If they are engaging in inappropriate sexual behaviours, gently remind the person that the behaviour is inappropriate. Lead them to a private place or try distraction with something else to do or fidget with.
- Adjust clothing. Consider buying pants without zippers or other clothing options that reduce the risk of inappropriate behaviours.
Support for families and carers
- Observing disinhibited behaviours can be very distressing for families and carers. The behaviours are symptoms of dementia and are not meant to upset you. Remember to look after yourself and take regular breaks.
- Discuss with the person’s doctor your concerns about changes in behaviour, and the impact on you and the person you are caring for.
- Call the National Dementia Helpline on 1800 100 500 to learn about support services and education programs, including carer support groups, counselling, and services and programs to assist you to understand and respond to changes and maintain your health and wellbeing.
- Call the Dementia Behaviour Management Advisory Service on 1800 699 799. They support people living with dementia who experience changes in behaviour that impact their care or the carer.