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Why Do Dementia Patients Cry?

Introduction

One of the biggest changes in my Dad’s behavior is how much more emotional he has become. I have unfortunately seen him cry more in the last two years than in the whole previous forty years!

You too will no doubt witness uncharacteristically emotional behavior from your loved ones suffering from dementia. This can often be upsetting for you, the caregiver, or family, as much as it is for the dementia sufferer themselves.

Dementia is a condition that needs a great deal of care and support as it carries a large spectrum of psychological and physical issues to deal with. All of these problems need to be dealt with separately but with an interlinked approach.

The mental issues associated with dementia are often either not physically evident, or when they are they may manifest as extreme emotions that don’t seem to relate to their cause.

One of the reasons for this is since the sufferer is not able to express themselves verbally, the mental symptoms get overlooked.

The symptoms, when becoming more pronounced, can be exhibited by the patient screaming, yelling or crying. As a carer, it can be difficult to deal with this especially when you are not able to determine the exact cause for these signs.

There can be a lot of reasons for the patient crying. Generally, we associate crying with sadness or pain, but in dementia patients, that is not always the case.

Here are some of the common reasons for a dementia sufferer having crying spells, followed by some ideas for possible solutions.

Reasons for Dementia Patients Crying

Physical causes

One of the most common causes of crying is physical pain or discomfort. The patient can be in pain if they are hungry, need water or unable to pass urine/stool when they are bed-bound. They may have a minor ailment such as foot cramp or an ingrowing toenail but lack the ability to tell you.

Psychological Causes

Since dementia occurs mostly in old age, and old age has a strong association with depression and mental issues i.e. stress anxiety, hallucinations, etc. which can cause a person to cry.

A buildup of Anger and Frustration

In the early stages of dementia, my Dad found it very frustrating as he had enough awareness to know he wasn’t well, but not enough to understand what was wrong.

When you are not able to comprehend simple or even complex tasks as you used to do earlier, it leads to the buildup of frustration and anger. The expression of this is usually in the form of cry.

Environmental Causes

An unfriendly living environment can also contribute to crying. Factors such as room temperature or poor environmental/room hygiene can be uncomfortable causing stress and to eventually cry.

Associated Comorbid

Comorbid means associated health problems. The dementia sufferer may be suffering from any associated medical condition that needs attention such as arthritis or diabetes causing complications. These diseases can cause pain or any associated complication which may be expressed in the form of crying.

Sleep Disturbance

Many times, dementia sufferers are not able to have a sound and relaxing sleep. They may wake up in the night confused. They may need to go to the bathroom often which interrupts sleep.

My own Dad has complained about getting harrowing nightmares and vivid dreams about past events since he was diagnosed with dementia. Together, these symptoms make it hard for dementia sufferers to get a good night’s sleep which can quickly build up stress and can cause them to cry.

How to Prevent a Dementia Sufferer from Crying

These are some common causes that can cause a person to cry. Dealing with it can be challenging but with some techniques discussed below, it can be managed.

Evaluation for Psychological Illness

One of the most renowned causes for crying in dementia is a psychological illness especially depression. In many cases, after evaluation by the expert, the case of crying was found to be depression and was treated with medications with very good results.

When my Dad was put on anti-depressant medication it made a hugely positive change in his temperament and emotional state.

Calming Techniques

One of the most effective methods is the application of calming techniques such as meditation which includes deep breathing, yoga or listening to calm and relaxing music.

Depending on their outlook, many elderly people may be skeptical of these techniques, so it may be best to introduce them as just listening to music rather than going straight in with ‘Let’s do some Yoga’.

Family and Social Support

Dementia is a disease that has a multidisciplinary approach to treatment. Apart from the medical team’s support, family and social support are also essential. Simple steps such as eating together with family have shown to relieve stress in most of the cases. Even a reassuring touch by family members is very supporting and reassuring. 

Physical Activity

By being physically active you can manage a lot of side effects of dementia. Studies have shown that people who exercise had a decrease in cognitive function progression besides the pronounced health effects of doing an exercise.

Exercise doesn’t have to mean high exertion. Just a short, slow walk makes a huge difference. If your loved one can’t manage that, then simple in chair exercise are possible too.

Improving Their Sleeping Pattern

Making the patients follow a specific sleeping pattern has shown to improve the symptoms of dementia. It has to born in mind that both extremes i.e. sleeplessness and sleeping more, are also hazardous and a study shows that these increases the risk of dementia.

Breaking Down Tasks for Them

Breaking a complex task into easy to achieve milestones can help the patient’s mind to work on a straightforward goal rather than dealing with complex information that can make them overwhelmed and eventually being angry and frustrated.

Lifestyle Modification

A total lifestyle change for dementia patients can be very challenging. But steps like quitting smoking, changing sleep patterns, etc. have very pronounced effects in managing this condition.

Removing temptation is one of the key steps to a lifestyle change.

For example, my Dad started to gain a lot of weight when he got dementia and he was diagnosed with pre-diabetes. This was because his physical activity reduced so much and he started comfort eating candy and chocolate, something he had never done previously.

Because all our relatives wanted to be nice to him, whenever they visited, they would bring him candy and chocolates.

I had to tell everyone in my family how much I appreciated their gifts but that it was important that they stopped bringing unhealthy food to him.

It didn’t take long for him to forget about the candy, and within about a year his weight went back to a more healthy level which also enabled him to go out and walk more.

Dementia Journal

Documenting each episode may help you identify the cause and trigger of crying. It can also be helpful when seeking professional help as they can identify the intensity of crying and whether to start administering medications or not.

Consult Your Physician

If you cannot figure out the cause of crying then it’s better to get a professional opinion. A doctor will be in a better position to identify and treat the problem which many of us tend to miss, such as a neurological cause of pain.

Support Groups

Dementia support groups are quite helpful in learning different ways to deal with these crying spells. These support groups also have carers who share their ideas as to how they deal with this problem, something that can help you choose the best way for your loved one.

Conclusion

In conclusion, dementia can be associated with crying which can be quite normal but as a patient or a caregiver, it can be very difficult to deal with it regularly. Also, it can be quite frustrating when there is no evident cause of this symptom. By applying the above strategies, the chances of dealing with this problem are quite high. One should also not shy away from asking a consultation from a medical expert in case the reason is not evident.

References:

• Davenhill, R. (2018). Looking into later life: A psychoanalytic approach to depression and dementia in old age. Routledge.
• Kouloutbani, K., Karteroliotis, K., & Politis, A. (2019). The effect of physical activity on dementia. Psychiatrike= Psychiatriki, 30(2), 142-155.
• Larsson, S. C., & Wolk, A. (2018). The role of lifestyle factors and sleep duration for late-onset dementia: A cohort study. Journal of Alzheimer’s Disease, (Preprint), 1-8.
• Sindi, S., Kåreholt, I., Johansson, L., Skoog, J., Sjöberg, L., Wang, H. X., … & Skoog, I. (2018). Sleep disturbances and dementia risk: A multicenter study. Alzheimer’s & Dementia, 14(10), 1235-1242.