It could be a trauma from the past
Researchers have found that problem behavior in dementia is often caused by post-traumatic stress disorder. And it is easily treatable, even in dementia.
A lady who keeps walking around the department and insistently ‘Help!’ keeps yelling until she becomes distraught herself. It is not only annoying for herself, but also causes a lot of nuisance for the other residents and the nurses. Until someone comes up with the idea to ask her life story. This shows that she had found her partner, very unexpectedly, dead in bed. She had then started drinking heavily and wandering around until she was admitted to the nursing home. In fact, this lady still suffers from this old sore.
Unprocessed trauma
Problem behavior in dementia causes a lot of headaches for caregivers and other people involved, not least for the resident himself. How do you handle it well? Often there appears to be an unprocessed trauma underlying the problem behaviour, according to researchers in the medical journal Medisch Contact. ‘Traumatic life events can result in serious psychological complaints, such as post-traumatic stress disorder (PTSD). PTSD is associated with vivid re-experiences, constant anxiety, and wakefulness. As people get older and develop problems such as dementia, the impact of the event resurfaces,” the researchers said.
Interview
But how do you find out whether the wandering or screaming is a symptom of dementia or of PTSD? People with memory disorders are no longer always able to tell their life history properly. The researchers have now developed a new method that allows them to make the distinction. People with dementia who exhibit problem behavior can be examined with this so-called TRADE interview (‘TRAuma And DEmentia’). The TRADE interview has been developed in the Meandergroep, Cicero-Zorggroep, Sevagram and Envida nursing homes, together with the Mondriaan mental health institution. The investigation into this is still ongoing.
Therapy
If someone is indeed found to have PTSD, it can be treated. For example, with the EMDR method, or with SSRI antidepressants, according to the researchers. It is not known how many people with dementia have PTSD. Among ordinary people over the age of 65, 3 percent have PTSD, but in dementia the percentage is probably higher, because PTSD itself increases the risk of dementia (20 to 70 percent). How that comes about is still unclear. Both conditions are associated with depression, alcohol abuse and cardiovascular disease.
