General Guidelines for Responding to the Behaviour of a Person with Dementia
Understanding the 10 common symptoms of dementia — based on Alzheimer's Indonesia (ALZI) guidelines — and five core principles for responding to a person with dementia with empathy and dignity.
RUKUN Senior Living dementia care environment – caregiver with resident
General Guidelines for Responding to the Behaviour of a Person with Dementia
Recognising the Symptoms of Dementia
Before discussing guidelines for responding to the behaviour of a Person with Dementia (PWD), it is important to understand the 10 Common Symptoms of Dementia as outlined in the guidance from Alzheimer's Indonesia (ALZI). This guidance is provided to help the public identify the possible onset of dementia in a family member or someone in their community. These symptoms generally indicate the early onset of dementia (the early phase) — based on global statistics, someone in the world begins experiencing dementia every three seconds.
Although each individual may express these symptoms in their own unique way, they are common across all types of dementia — and understanding them can help explain the behaviour of a person with dementia in general.
1. Memory Impairment
- Frequently forgetting events that have just occurred.
- Difficulty recalling short-term information.
- Asking or doing the same thing repeatedly within a short period.
- Still able to recount things from the distant past, often in considerable detail.
2. Difficulty Concentrating
- Easily distracted; unable to concentrate.
- Difficulty carrying out daily activities and tasks.
- Unable to perform simple calculations.
- Takes longer than usual to complete tasks.
3. Difficulty with Familiar Activit
According to ALZI guidelines, the 10 common symptoms of dementia are: (1) memory impairment, (2) difficulty concentrating, (3) difficulty with familiar activities, (4) disorientation in time and place, (5) difficulty with visuospatial understanding, (6) communication difficulties, (7) misplacing objects, (8) poor judgement and decision-making, (9) withdrawal from social life, and (10) changes in behaviour and personality.
The Validation Method is an approach in which the caregiver acknowledges and validates the PWD's perceptions and feelings, so that interactions align with the reality as expressed by the PWD — rather than imposing actual reality. For example: if a PWD says they are waiting for their deceased husband to return from work, the conversation is conducted as though the husband is still alive, with sincerity and respect, rather than simply silencing their expression.
A PWD's behaviour generally occurs beyond the control of their rational mind — it is not the result of a conscious choice. Therefore, instructing them not to do something tends to be ineffective. A more successful approach is to redirect their attention to a different activity or topic, while first seeking to understand the root cause of the behaviour in question.
Yes. Although a PWD's thinking capacity and memory decline, their emotional sensibility continues to function long after. Emotions such as embarrassment, fear, sadness, happiness, and pride can still be felt and experienced fully by a PWD. This is why maintaining dignity and treating them with respect in every interaction remains critically important.
Activities such as bathing or mealtimes often need to follow the rhythm of the PWD's mood and cannot be imposed through a rigid schedule. Although this may sometimes be less than ideal for the caregiver, accommodating the PWD's needs is generally more effective at preventing conflict and creating a more peaceful situation for everyone involved.