How to handle Alzheimer’s disease’s erratic behavior
Alzheimer’s disease can be to patients like gamma radiation to Dr. David Bruce Banner; if triggered, it’s all “you won’t like me when I’m angry” or anxious, or aggressive, or frustrated, or confused. It is up to the caregiver to identify and address these negative behaviors before anyone gets hurt.
What as the behavior?
Was the behavior harmful?
What may have triggered it?
What transpired next?
Are the patient’s needs being met?
Can adapting the environment soothe the patient?
How can your reaction change?
The Alzheimer patient may be acting up on one or more of the following:
· Pain caused by illness, medication, hunger, or thirst.
· Overstimulation from loud noises or a busy environment.
· An unfamiliar environment.
· Difficult tasks.
· Inability to communicate.
Since several different factors may be behind the erratic behavior, it’s important to keep trying different and new approaches.
A person with Alzheimer’s disease may be verbally or physically aggressive. While an outburst may occur seemingly out of nowhere, many a time there is something else behind it.
Responding to aggression
· Discard pain as the cause.
· Remembering what happened right before the behavior may help you identify the trigger.
· Focus on the feelings behind the words or actions.
· Keep your cool, remain positive, speak in a calm tone.
· Limit distractions in the patient’s surroundings.
· Perform a relaxing activity such as playing music, exercising, or giving a massage.
· In general, try to switch to a different activity.
· Whenever it is safe to do it, walk away from the patient and be alone for a while.
· Ensure the safety of the patient, as well as that of others and your own. If necessary, ask for help – including 911.
As with aggressiveness, many things can make a patient with Alzheimer anxious or agitated.
Responding to anxiety/agitation
· Check for pain.
· Listen to frustration.
· Offer reassurance with calming words.
· Have the patient participate in a distracting or relaxing activity.
· Either adapt the patient’s surroundings to reduce noise and distractions, or move the person to a different setting.
· Go for a walk or a car ride in order to allow the person to blow off some energy.
Given the nature of the condition, people with Alzheimer’s disease may experience confusion even in familiar places or surrounded by familiar faces.
Responding to confusion
· Remain calm even if you are hurt by the patient’s lack of recognition; remember that it’s nothing personal by the effect of the disease.
· Provide a brief explanation – a long exposition might confuse the person further.
· Use visual aids such as photographs and other objects.
Repetition is the bane of many a caregiver’s existence, since it is perhaps the most stressful – albeit the least harmful – of Alzheimer’s disease-related behaviors.
Responding to repetition
· Remain calm and reassure the patient.
· Look for a reason, cause or trigger.
· When a word has been repeated to the point it has no meaning anymore, look for the emotion behind it.
· In case of a repetitive gesture, such as rubbing hands across a table, try to put it to use by giving the person a cloth to dust with.
· Generally speaking, a distracting activity may curtail the cycle of repetition.
· Provide an answer and repeat it as many times as the patient repeats the question.
· Use notes, clocks, calendars, or photos as memory aids and reminders.
Loss of memory and confusion can lead the person to paranoia.
Responding to suspicion
· Do not be offended.
· Do not argue with the person but acknowledge their opinions.
· Offer your opinion as well, but in a simple manner.
· Redirect the person by engaging them in an activity of chore.
· Keep duplicate items in case the person accuses you or others or stealing their belongings.
The patient’s train of thought is not the only thing that can trail off; their own person can wander and get lost as well.
Responding to wandering
· Keep the person busy and engaged in a specific activity that reduces restlessness, for example doing dishes, folding laundry or preparing dinner.
· Try outdoor activities like gardening or walking during which the person is being supervised at all times.
· Let friends, relatives, and neighbors know that you provide care for an Alzheimer patient who may wander around.
· Consider deadbolts or slide-bolt locks on doors.
· Sign up for MedicAlert ® + Alzheimer's Association Safe Return.
Finally, dementia patients may experience sleep issues that may contribute to their erratic behaviors.
Responding to sleep problems
· Make the person’s sleeping area as comfortable as possible.
· Stick to a regular schedule of meals, waking up, and going to sleep.
· Limit daytime naps if necessary.
· Have the person exercise during the day, if they are physically able to do so.
· Limit or take away alcohol, caffeine and nicotine.
· Talk to a physician about the person’s sleep problems.