Loss of decorum is a phenomenon that occurs in various forms of dementia such as Parkinson’s disease, Creutzfeldt-Jakob disease, Alzheimer’s or vascular dementia. The connection between nerve cells slowly breaks down. This causes various symptoms, loss of decorum being one of them. Loss of decorum also occurs with psychological disorders or brain damage. Undesirable and inappropriate behavior occurs, such as arguing, looking unkempt, farting and burping in public, swearing, foul language and uncouth eating. It is important to learn to deal with this in a good way.
What is loss of decorum?
Loss of decorum means: exhibiting behavior that does not fit in with the environment. Loss of decorum therefore falls under psychiatry. The patient exhibits undesirable behavior.
Causes
Loss of decorum often occurs in dementia. Dementia is not one disease but is a syndrome that occurs in more than 50 diseases. For example, we distinguish between Alzheimer’s disease, Parkinson’s disease, Creutzfeldt-Jakob disease, vascular dementia and Lewy Body dementia. In addition, there are many other forms of dementia. Dementia causes a decline in mental health. The processing that takes place in the brain no longer works as it should. The nerve cells or connections between these nerve cells break down. The process is often slow and bystanders notice increasing deterioration in the patient.
Loss of decorum is an important phenomenon that occurs in dementia. Most patients will have to deal with this sooner or later. In addition, loss of decorum also occurs temporarily in people with a psychological disorder or condition, trauma, manic depression and sometimes after a serious infection.
With frontal brain damage, which refers to damage to the front of the brain, loss of decorum also sometimes occurs. In addition, other symptoms often arise such as apathy, emotional flattening, being very focused on oneself (egocentric) and being easily distracted.
Symptoms
The patient exhibits behavior that is not normal for the environment he or she is in. For example, the patient may show signs of touching, make sexual innuendos, be noisy in company and interrupt others. Sometimes the patient appears to be rude or ill-mannered. This can also appear that way to outsiders.
Common symptoms include burping, farting, undressing in public, urinating in public or in inappropriate places, throwing food or eating in an uncouth manner, swearing, using foul language, arguing with others in an inappropriate manner and looking unkempt. .
Will it pass?
Loss of decorum, i.e. displaying undesirable behavior that does not fit with the environment or the situation one is in at that moment, does not simply go away in most cases. In various forms of dementia, the decline is gradual but not reversible.
In other cases, loss of decorum can also be temporary, such as with a mental disorder. If this disorder is treated properly, the symptoms will reduce or disappear. Without treatment, loss of decorum can persist. In case of brain injury, loss of decorum can be temporary or permanent. This depends on the severity of the injury and the recovery capacity of the brain.
Dealing with this phenomenon
Undesirable or inappropriate behavior often causes misunderstanding for outsiders, because they do not know where this behavior comes from. In public places, painful situations can sometimes arise due to a patient with loss of decorum. It is therefore better for caregivers and family/friends to assess a situation in advance. This makes it possible to temporarily keep the patient away from an important occasion. Sometimes it is better not to take the patient at all. Care must be taken to avoid patient isolation: it is often the easiest way to leave the patient at home. This will cause the patient to become lonely.
Sometimes dangerous situations arise. When bystanders know what is going on with the patient, they can also intervene earlier to prevent possible accidents. Often the environment can be more understanding of the entire situation.
Do medications help?
Unfortunately, loss of decorum cannot be treated with medication. However, there are certain medications that can prevent deterioration of memory, especially in dementia. This slows down the process of dementia. Some medications can even cause a (slight) loss of decorum. In this case it is sometimes better to switch to other medications.
A fixed daily rhythm is important for patients with dementia. A quieter environment ensures better concentration but also less unwanted behavior. It is important for the partner to accept that loss of decorum is one of the symptoms that occurs with certain diseases. By accepting it, it can be dealt with better. The undesirable behavior that results from loss of decorum is not exhibited intentionally, but is a consequence of brain deterioration.
