Alzheimer’s disease affects how people think, feel, and how they act. As Alzheimer’s disease progresses, alterations in mood and behavior become common.  Many behaviors are a result of inability to remember things, to problem solve and to reason with others. These behaviors are the result of impairment in communication between cells. We need to remember that these behaviors are the way the person with Alzheimer’s is communicating.

Behaviors can be related to physical discomfort, illness such as a UTI, or medication reaction, loud noises, a very busy environment, unfamiliar surroundings, new places, inability to communicate or make needs known. There are a number of behaviors that are challenging to caregivers and can include, aggression, agitation, hallucinations, resisting care, suspiciousness, wandering, insomnia,

Some questions to ask yourself are what happened before the behavior, could the person be in pain, do they need to go to the bathroom, is it noisy, are they frustrated because they do not understand what is being said or done to them. Remember behavior is communication.

Aggression/agitation: try not to take it personally. Speak in a very soothing and soft tone of voice. Be positive and reassuring. Provide structured routine with simple tasks and provided step-by-step instruction. Acknowledge the feelings the person is experiencing.  Try to distract them with a favorite snack or activity like walking or soothing music.  If this is a recurring behavior keep a log when the incidents occur and see if you can identify any patterns or situations that may precipitate the incident. Check for physical discomfort, sleep deprivation or even medication side effects.

Wandering/restlessness: There are many causes for wandering, including boredom, physical discomfort, a loud noisy environment,  looking for spouse or children, looking to go home because they do not recognize their environment or because their hungry or need toileting. Again watch for patterns to see if it occurs during a specific time of day. To address this try to turn behavior into something productive, purposeful exercise, physical tasks such as sweeping, raking, cleaning. Attend to physical needs and reduce noise level or any confusion in their environment. Hide items that they may always take with them when they go out.  Put up pictures of a toilet or bedroom. Lock doors to dangerous stairwells, secure external doors. Always have a recent photo of the person, sign them up with the safe return program and medic alert with the Alzheimers association and local police department

Sleep disturbance: Disrupted sleep patterns are common in people with Alzheimer’s disease. They can be caused by the progressiveness of the dementia, medications, illness or the environment, fear of the dark, overstimulation or sleeping during the day. Some interventions to use would be to maintain a regular routine at bedtime. Make sure the bed is comfortable, reduce noise and light, and play soothing music. Indicate to them that you are sleepy, you can even yawn and stretch. Increase physical activity during the day and monitor napping. Avoid giving the person alcohol or caffeine, especially late in the day. Keep a night light on. Be careful if you of sleep medications, they can increase confusion.

Hallucinations: A hallucination is seeing or hearing something that’s not there. This can be the result of failing senses or as a result of medications or an illness. Hallucinations are very real for the person who experiences it. Do not try to convince them that it does not exist. Discuss their emotions relative to what they see. Violent movies, television or mirrors can contribute to the hallucination, if they do cover or removed them. Make sure rooms are well lit to reduce glare and resulting hallucination. Remember some times medications can contribute to the. Sometimes they can misinterpret objects they see. For example they could see a coat rack with a coat on it and think it is a person. Reassure them, it does look like that but it is just a coat rack.

Resisting care: People with Alzheimer oftentimes do not realize that they need help with care. Bathing and dressing involve many different tasks and can be frustrating or overwhelming for the person with dementia. Before you begin to provide care talk first and connect with them. Approach them with its time for your shower, lets get dressed not “do you want to”. Simplify each task and lay their clothing out in the way they would be put one. If they refuse to do something, back off and go back in a while using aa gentle positive approach. Offer positive reinforcement after your bath we’ll go for a walk, or have a cup of tea etc..

Remember these quick tips: remain calm and patient; respond to the emotion not the behaviors, Don’t argue or say “no”, memory aides may be helpful, look for causes that trigger the behavior, try not to take the behavior personally, acknowledge their feelings. Try to maintain a structured routine.  Consult a physician when necessary.

Citation: Devereaux, Pat. “Coping with Common Alzheimer’s Behaviors.” The Concord Journal. http://www.wickedlocal.com/concord/news/lifestyle/health/x1831583317/Coping-with-common-Alzheimers-behaviors