July 2019, Volume 31
As individuals get older, sometimes we see changes in their behaviors. We often assume that aging itself is the reason, but it is important that we look into what may be causing the behavior change so that an important, even urgent, medical issue does not go unaddressed. According to Dr. Julie Gentile, doctor and professor at Wright State University, the most common causes of behavioral changes are:
Behavioral Changes in the Elderly
85% of individuals with disabilities have untreated, under-treated, or undiagnosed medical problems. This is frequently because people with disabilities do not receive the preventative screening and lab work which is common for the typical population. The first thing to do when behavioral issues arise is to rule out medical issues and organic reasons as causes before looking for possible psychiatric issues. Medical conditions that are commonly missed include: constipation, allergies, dysphagia, seizure disorders, pain, pulmonary conditions, autoimmune disorders, reflux (GERD) and other GI issues, sleep apnea, and vitamin deficiencies.
- Pain (emotional and physical)
- Medication side effects
- Sleep disorders
- Psychiatric illnesses, including the after-effects of trauma
Sometimes elderly people begin exhibiting new and strange behaviors. Aggression can be a way of expressing frustration, but other possibilities to rule out as causes are physical pain and acute medical conditions. Aggression can also signal an acute psychiatric problem. Regression can also result from stress, pain, change in routine, or novelty.
Dr. Gentile has compiled the following list of behaviors that could indicate an underlying condition:
Fist jammed in mouth - can be a sign of GERD (reflux); teeth erupting; asthma; rumination; nausea; anxiety; pain in hands; gout
Biting side of hand - can be a sign of sinus problems; ear problems; wisdom tooth eruption; other dental problems; pain; hand paresthesia (tingling, chilling burning, or numbness)
Biting thumb or object with front teeth - can be a sign of sinus problems; problems with the Eustachian tube in the ear; finger pain or paresthesias; or gout
Refusing to sit evenly - can be a sign of hip pain, genital or rectal discomfort; a movement disorder called akathisia. Can also be a clue that the individual has been abused in the past or that abuse is ongoing.
Won't sit - can be a sign of akathisia; anxiety; depression; pain (back or elsewhere); or sleep deprivation
Suddenly sitting down - can be a sign of heart problems; syncope/orthostasis (meaning fainting due to a severe drop in blood pressure); medication side effects; vertigo; otitis (ear infections); atlantoaxial subluxation (misalignment of cervical vertibrae); seizures; trauma; panic
Waving fingers in front of eyes - can be a sign of migraine; corneal scarring (scarring of the eye); cataracts; seizures; glaucoma; medication side effects
Walking on toes - can be a sign of arthritis in hips, ankles, or knees; sensory integration issues; tight heel cords, proprioception (which means a sense of awareness of the body's movement)
Whipping head forward: can be a sign of dental problems; headaches; or misalignment of cervical vertibrae (in those with Down Syndrome or other conditions that produce joint laxity)
Banging Head: Please note that this is not normal for anyone - can be a sign of trauma/depression; headache; dental issues; seizure; ear inflammation; sinus problem; tinea capitis (infection of the scalp)
Intense rocking (when not "normal" for the individual) - can be a sign of visceral pain; headache; depression; anxiety; or medication side effects
The above examples are just possible reasons for behavioral changes. Any sudden change of behavior should be investigated to determine the reason. We can support people who are aging by noticing red flags, following up with next steps, and advocating for appropriate and timely medical care.
JULY ACTIVITY TIP
4TH OF July Pretzel Sparklers
- One bag of pretzel rods.
- One can of white frosting.
- Red, white, and blue candy sprinkles.
- Wax paper.
- Paper plates
- Plastic spoons and knives
Put wax paper on top of paper plates. Frost the top of each pretzel rod using a spoon or knife. On a separate paper plate, add the candy sprinkles. Roll the frosted pretzel rod in the sprinkles to cover the pretzels. If you want to make several and store them for later use, place the pretzels on wax paper and air dry for about 5-10 minutes before placing in a covered container.