Alzheimer’s disease and related dementias can cause a person to act in different and unpredictable ways. Anxious, repetitive, or aggressive actions can lead to misunderstanding, frustration, and tension between the person with dementia and the caregiver.
As a caregiver for a loved one with dementia, it is important to keep in mind that the person is not acting that way on purpose. Dealing with behaviors associated with dementia can be extremely challenging and upsetting experience. Although it’s not always easy to keep a cool head or cope with erratic outburst and strange behaviors, it’s a sign of a caregiver’s strength, love, and commitment.
By learning how to identify problems behavior for what they are—a result of the disease—and by making simply tweaks to the home environment and caring approach, you reduce stress, alleviate problem behaviors, and increase the quality of life for your loved one and yourself.
Here we address several dementia-related behaviors and the most effective ways to respond.
Aggressive behaviors may be verbal (shouting, name calling), physical (hitting, pinching). These behaviors can occur suddenly as an outburst or can result from a frustrating situation. Whatever the case, it is important to try to understand what is causing the person to become angry or upset and to create a calm, soothing environment.
1. Start by listening to the frustration. Though you may be taken aback or shocked by the angry outburst avoid getting anxious yourself. Try to identify the immediate cause and think about what preceded the outburst and that may have triggered it. The person may be cursing or screaming — Look for feelings behind the words.
2. Restore order. Try a relaxing activity like music or exercise to help soothe the person and provide an outlet for their energy.
3. Modify the environment. Find a quiet place and limit distractions. If you’re in a room with many people, move to another place where there is less noise.
A person with Alzheimer’s may fail to recognize familiar people, places, or things. He or she may forget important dates, call people by the wrong name, or lose track of where they are and how they got there. Such situations can be frustrating for caregivers and require a great deal of patience and understanding.
1. Stay calm. Although being called by a different name may upset you, do not make your hurt apparent. Remember Alzheimer’s causes people to forget, but your support and understanding will be appreciated.
2. Keep it short. Do not overwhelm the person with lengthy statements or logic. Instead, clarify with a short and simple explanation.
3. Avoid explanations that sound like scolding. Try to use statements that offer combine corrections and suggestions like “I thought it was a fork” or “I think he is your grandson John.”
Wandering may be irritating to you as a caregiver, but it can be potentially dangerous: leaving the house alone, walking into intersections, ending up miles away from home with no form of communication. Wandering occurs as a result of restlessness and disorientation which can be caused by hunger, thirst, constipation, stress, an uncomfortable environment, or lack of exercise.
1. Pay attention. Monitor the person’s behavior over time and carefully watch for pacing. Redirect restless behavior into productive activity or light exercise. Reassure and calm the person if they appear disoriented.
2. Have a plan. It’s a good idea to have a action plan in place if your loved one does wander. Notify your local police about your loved one’s condition and ask to be notified if they are found in the community alone. Another smart preventative measure is to sign up for the Alzheimer’s Association’s Safe Return Program in the U.S., an identification system to help rescue lost Alzheimer’s patients who have wandered away.
3. Encourage activity. Make sure your loved one gets plenty of regular physical exercise and movement to guard against the restlessness and boredom that causes wandering. If wandering tends to occur at a particular time of day, distract the person at that time.
4. Create a safe home environment. Install child-safety devices throughout the home to keep doors and windows secure.
5. Consult a doctor. Certain medications can cause disorientation. Ask you doctor to check if the person’s wandering could be a medication side-effects or drug interaction.
Paranoia and Suspicion:
Memory loss and confusion may cause the person with Alzheimer’s to perceive situations in unusual ways. Sometimes the person may misinterpret what he or she sees or hears or become paranoid that they are being watched or plotted against. A person with Alzheimer’s may become suspicious of those around them, even accusing caregivers or family of theft.
1. Do not take offense to the accusation. Listen to what is troubling the person and try to understand their reality. Offer reassurance that you are there to help them and let them know you care.
2. Don’t argue. Avoid trying to convince the person they are wrong. Allow them to express their opinion.
4. Redirect. Shift the person’s focus and engage them in an activity that promotes a healthy behavior, such as taking a walk.
5. Duplicate any lost items. If the person is often searching for a specific item, such as a hairbrush, have several available.