Thus, they may lash out at a nurse whom they perceive as a threat. They cannot express their needs clearly or at all. Thus, they may yell when in pain or short of breath, wander when lonely or frightened, or urinate in public when the bladder feels full. Persons with dementia, who commonly cannot control their frustrations or conform to rules and routines, often adapt poorly to this regimentation. For many elderly persons with dementia, behavior disorders develop or worsen after they are moved to a more restrictive environment.
Physical illness can exacerbate behavior disorders.
Pain, shortness of breath, urinary retention, constipation, other physical problems, or physical abuse may cause a change in the pattern or intensity of a behavior disorder. However, using a term that has so many meanings does not help in planning a management strategy. Keeping such a record makes planning a management strategy easier and helps identify changes in pattern or intensity of a behavior. If a change is observed, a physical examination should be performed to exclude physical disorders and physical abuse. Identifying psychotic behavior is essential because management differs when psychosis is present.