Alzheimer’s disease leads to progressive deterioration in the brain, which causes problems with memory and cognition. Even more heartbreaking, these changes to the brain can cause a range of behavioral issues. Caregivers of Alzheimer’s patients may find their loved ones acting in unfamiliar, even disturbing or violent ways. Sometimes the behavior is so severe that families place Alzheimer’s patients in nursing homes or dementia care facilities.
Fortunately, there are plenty of coping strategies available to help families develop an understanding of what their loved one is going through, as well as helping them manage the behavioral effects of dementia.
1. Angry Outbursts and Physical Aggression
Verbal or physical aggression, which can be quite alarming, is common in patients with Alzheimer’s. It is key for caregivers to remember that the disease is triggering these behaviors, and that the patient isn’t acting this way deliberately. Another important strategy is identifying whether there is an immediate cause for the behavior, such as physical discomfort or over stimulation.
2. Hand-wringing, Pacing and Rocking
Dementia makes it very difficult to process stimuli and new information, causing many people with Alzheimer’s disease to become anxious. This anxiety often manifests itself in the form of restlessness, pacing, hand-wringing, and rocking. The Alzheimer’s Association notes that anxiety is often triggered by very specific details in the environment, so try to identify what’s causing your loved one to become anxious and then divert his or her attention, for example by taking a short walk, listening to soft music or singing a song.
3. Accusing Loved Ones of Wrongdoing and Hallucinating
Caregivers may feel at a loss when an Alzheimer’s patient exhibits behavior that is clearly not grounded in reality: either hallucinations—perceiving something that isn’t really there—or delusions, which are false beliefs that can lead to paranoia. Sometimes simple distraction can help bring an Alzheimer’s person back to the present, but severe hallucinations or delusions should be brought to a doctor’s attention.
4. Repeating Stories and Leaving the House Unassisted
The memory problems caused by Alzheimer’s disease can lead to a range of distressing behaviors, including repetition of words or activities, disorientation even in familiar places, and, in severe cases, confusion about the passage of time. Most important, says the Alzheimer’s Association, is for caregivers to stay calm and be patient. Memory aids such as notes or photos may also help. Ann Napoletan, who was an Alzheimer’s caregiver for many years said, “My advice – first and foremost – do not argue or try to correct them when they repeat something over and over again. As hard as it is, it’s best if you can just smile and nod (even if you’re *really* just clenching your teeth!). You’ll have less regrets if you don’t let these moments turn into arguments.”
5. Sleep Problems and Sundowning
It’s not well understood why sleep disturbances occur in many Alzheimer’s patients, but it’s common for them to experience nighttime restlessness and changes to their sleep schedule. The symptoms, referred to as sundowning, can aggravate behavioral issues and create misery for caregiver and senior alike. The Family Caregiver Alliance suggests plenty of structured activity during the day and a healthy diet that limits sugar and caffeine intake. Experts also recommend that you make sure your loved one is not over-napping in the day, which can cause night-time over activity. Another tip is to close the curtains or shades just before dark and turn on as many interior lights as possible.
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We are grateful to Sarah J. Stevenson for this article.