Dealing With Behaviors Common to Alzheimer's

 

Unfortunately, one of the challenges for Alzheimer's caregivers is dealing with the changing behaviors. Gradually, your family member doesn't act like he or she used to. He or she may not even recognize you at times.

How do you handle your family member when he or she gets unreasonably agitated? How do you deal with him or her when unacceptable behavior or behavior that is not in line with the situation occurs?

Much has been written on this subject. We offer you here tips from the Duke Family Support Program in their Tool Kit for Alzheimer's and Dementia Caregivers and links to fact sheets from the National Alzheimer's Association.

 

 

Behavior Basics

• Behavior changes are responses to a confusing world. These changes are often beyond the person’s control.
• People with dementia may not know why they are angry, frustrated or suspicious. Don’t take it personally.
• The caregiver is a symbol of security and safety in a shrinking and “scary” world. People with dementia want a family member close by. They are easily upset by a tense, angry or rushed caregiver.
• People with dementia are trying as hard as they can. Reasoning, pleading or punishing won’t change unwanted behavior.
• Most disruptive behaviors occur because the person is afraid, overwhelmed, forgets what is appropriate public behavior, loses control of impulses or is uncomfortable and unable to express pain, confusion or needs.
• Brain damage makes it more difficult to plan, start or switch activities. Tailor activities to fit the person’s capacities and energy level and help start the activity. People with dementia will try to avoid embarrassment by refusing to do things they perceive as too difficult or too childish.
• Use humor, flexibility, acceptance, reassurance and tolerance for best results.

 

 

Behavior Problem Solving

• Pick your battles. Which behavioral symptoms are most disruptive to family life at this point?
• Describe the behavior. Is it harmful to anyone? Can you accept it, change expectations or increase tolerance for it?
• Is there any pattern, trigger or time of day that sets it off? (Caffeine, alcohol)
• Does your reaction make it worse? Can you just repeat what is asked?
• Can you change your response to calm or reassure? (Apologize, sympathize or suggest a walk to a person who is restless or searching)
• Is the person hungry, tired, scared, overwhelmed, or in pain?
• Will a change in the environment help? (Turn off TV)
• Will distraction (ice cream), diversion (ride in the car) or reassurance with calm, relaxed approach, eye contact, gentle touch or soothing music, familiar pleasant activities or security objects help?
• Is the person cold, over-sedated, hungry, constipated, searching for the toilet, depressed or frustrated by uncomfortable clothing? Try comfort measures.
• Can routines be adapted to prevent future occurrences? (Frequent breaks, change time of bath)

 

 

What is Agitation?

• Irritability, frustration, excessive or uncharacteristic anger
• Restlessness, constant pacing, searching or rummaging through drawers
• Blow-ups out of proportion to the cause
• Constant demands for attention and reassurance
• Repetitive questions, requests or telephone calls
• Stubborn refusals to go somewhere or do something expected
• Insistence on going home immediately after leaving home
• Yelling, screaming, cursing, threats
• Hitting, kicking, biting, spitting

 

 

How to Talk to an Agitated Person with Alzheimer's

• May I help you?
• Do you have time to help me? You are safe here. I’ll check the locks for you.
• Everything is taken care of. It’s all squared away.
• I will get right on it.
• You can count on me.
• I apologize. (Even if you didn’t do it)
• I am sorry you are upset.
• I know this is hard.
• I will stay until you feel better.
• We’re in this together.

 

 

Unraveling Challenging Behaviors

Rethink Is the behavior harmful or scary to the individual or others, or can you accept it? Let forgetting work for the individual. Don’t remind, argue, scold, lecture, or confront someone after an outburst.   Redirect If the individual is pacing, agitated, or scared, provide a more positive activity, such as a walk, a dusting job, or a memory box to sort through. Distract the person; observe recurring behaviors and avoid situations that lead to problems; or let the person vent his frustration or anger in a controlled, secure place.   Restrict Stop the person from doing things that are harmful. Take dangerous objects from the room.   Reassure Say, “I know you’re upset. May I help you?” If the person is searching frantically, calmly join in her search while suggesting that you know you can find the lost item together. Let her know she is not alone and that you understand how important the missing item is to her. Nothing comforts better than standing by a person who is upset, offering sympathy, understanding, a shoulder to cry on, a tissue, or a knowing kind look. Do not ask a lot of questions.   Routines, Rituals, and Repetition Knowing what will happen next reassures people with Alzheimer’s. Rituals help, such as handing the person her favorite audiotape or cup of tea.   Security Objects can reassure and comfort.   Register The Person with the MedicAlert + Safe Return Program Through the Alzheimer’s Association MedicAlert + Safe Return is a national program to help identify people who wander and become lost and to provide critical medical information. Registered individuals receive a bracelet and clothing labels with a toll-free crisis number. This bracelet alerts others to an individual with a memory disorder who may need assistance. MedicAlert + Safe Return Program Remain Realistic Remain realistic about the person’s abilities. Concentrate on the person’s remaining skills, not deficits. Plan activities for best times of day. Help her/him compensate by doing for him/her what s/he can no longer do with ease.   Remain Objective About Your Own Strengths and Limitations Caregivers vary in their ability to cope with and manage a person who has Alzheimer’s. Know your limits as well as your strengths, and use support from others.

 

 

 

 

Alzheimer's Association Fact Sheets on Behaviors

The National Alzheimer's Association has published a number of fact sheets to help you. To follow are some related to behaviors.

 

 

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