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 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.
- 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)
- 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
- 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.
Routines, Rituals, and Repetition
Register The Person with the
MedicAlert + Safe Return Program Through the Alzheimer’s
Remain Objective About Your Own
Strengths and Limitations
The National Alzheimer's Association has published a number of fact sheets to help you. To follow are some related to behaviors.
Behaviors - Causes & Responses
Complete List of Alzheimer's Association Fact Sheets
Sleep Changes in Alzheimer’s Disease
Wandering Behavior – Preparing for and Preventing It