Managing Personality and Behavior Changes in Alzheimer’s

Managing Personality and Behavior Changes in Alzheimer’s

Alzheimer’s disease causes brain cells to die, so the brain works less well over time. This changes how a person acts. This article has suggestions that may help you understand and cope with changes in personality and behavior in a person with Alzheimer’s disease.

Mother with Alzheimer's and daughter interacting

Common Changes in Personality and Behavior

Common personality and behavior changes you may see include:

You also may notice that the person stops caring about how he or she looks, stops bathing, and wants to wear the same clothes every day.

Other Factors That Can Affect Behavior

In addition to changes in the brain, other things may affect how people with Alzheimer’s behave:

Other problems in their surroundings may affect behavior for a person with Alzheimer’s disease. Too much noise, such as TV, radio, or many people talking at once can cause frustration and confusion. Stepping from one type of flooring to another or the way the floor looks may make the person think he or she needs to take a step down. Mirrors may make them think that a mirror image is another person in the room. For tips on creating an Alzheimer’s-safe home, visit Home Safety and Alzheimer’s Disease.

If you don’t know what is causing the problem, call the doctor. It could be caused by a physical or medical issue.

Keep Things Simple…and Other Tips

Caregivers cannot stop Alzheimer’s-related changes in personality and behavior, but they can learn to cope with them. Here are some tips:

  • Keep things simple. Ask or say one thing at a time.
  • Have a daily routine, so the person knows when certain things will happen.
  • Reassure the person that he or she is safe and you are there to help.
  • Focus on his or her feelings rather than words. For example, say, “You seem worried.”
  • Don’t argue or try to reason with the person.
  • Try not to show your frustration or anger. If you get upset, take deep breaths and count to 10. If it’s safe, leave the room for a few minutes.
  • Use humor when you can.
  • Give people who pace a lot a safe place to walk. Provide comfortable, sturdy shoes. Give them light snacks to eat as they walk, so they don’t lose too much weight and make sure they have enough to drink.
  • Try using music, singing, or dancing to distract the person.
  • Ask for help. For instance, say, “Let’s set the table” or “I need help folding the clothes.”

Talk with the person’s doctor about problems like hitting, biting, depression, or hallucinationsMedications are available to treat some behavioral symptoms.

Source: Managing Personality and Behavior Changes in Alzheimer’s

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Morning Confusion

 

Basic Needs

I have never been a morning person. You can ask my husband or my children and they would all agree….. coffee first…. conversation later. How do you feel in the morning? If you’re anything like me…. your head is foggy, your joints are stiff and your tongue feels like sandpaper. If you were a person living with Alzheimer’s, add the confusion of not knowing where you are or who is in the room with you or why are you cold and wet? I don’t know about you but I’d be afraid, probably very afraid.

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Now this strange person is saying something about clothes and a bath….. you don’t understand…The person reaches for you and you say “No” and pull away from them and try to get through the doorway. You’re still cold, a little unsteady and that person is still following you saying words you don’t understand and reaching for you. Sounds pretty terrifying to me. You might start swearing, crying or even hitting this strange person.

A Smile and a Soft Gentle Voice

Wow ….. I thought my mornings were tough. How can we as caregivers make mornings less stressful for everyone? A smile and a soft gentle voice may help. How about a familiar tune to set the mind at ease. Remember, if we were lucky enough to sleep for six or more hours we’re probably thirsty and hungry. Try offering a favorite drink or food. Is there a favorite robe or stuffed animal that brings them comfort. Most of all be patient. It may take fifteen minutes or maybe hours to regain their trust.

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Remember every day is a new day. So turn on a tune, enjoy a cup of coffee and be patient with yourself. It’s gonna be a good morning.

Tips for Coping with Sundowning

Tips for Coping with Sundowning

Late afternoon and early evening can be difficult for some people with Alzheimer’s disease. They may experience sundowning—restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade—often just when tired caregivers need a break.Woman with Alzheimer's experiencing sundowning

Sundowning can continue into the night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.

Possible Causes

The causes of sundowning are not well understood. One possibility is that Alzheimer’s-related brain changes can affect a person’s “biological clock,” leading to confused sleep-wake cycles. This may result in agitation and other sundowning behaviors.

Other possible causes of sundowning include:

Coping with Sundowning

Look for signs of sundowning in the late afternoon and early evening. These signs may include increased confusion or anxiety and behaviors such as pacing, wandering, or yelling. If you can, try to find the cause of the person’s behavior.

If the person with Alzheimer’s becomes agitated, listen calmly to his or her concerns and frustrations. Try to reassure the person that everything is OK and distract him or her from stressful or upsetting events.

You can also try these tips:

  • Reduce noise, clutter, or the number of people in the room.
  • Try to distract the person with a favorite snack, object, or activity. For example, offer a drink, suggest a simple task like folding towels, or turn on a familiar TV show (but not the news or other shows that might be upsetting).
  • Make the early evening a quiet time of day. You might play soothing music, read, or go for a walk. You could also have a family member or friend call during this time.
  • Close the curtains or blinds at dusk to minimize shadows and the confusion they may cause. Turn on lights to help minimize shadows.

Preventing Sundowning

Being too tired can increase late-afternoon and early-evening restlessness. Try to avoid this situation by helping the person:

Avoid things that seem to make sundowning worse:

  • Do not serve coffee, cola, or other drinks with caffeine late in the day.
  • Do not serve alcoholic drinks. They may add to confusion and anxiety.
  • Do not plan too many activities during the day. A full schedule can be tiring.

If Problems Persist

If sundowning continues to be a problem, seek medical advice. A medical exam may identify the cause of sundowning, such as pain, a sleep disorder or other illness, or a medication side effect.

If medication is prescribed to help the person relax and sleep better at night, be sure to find out about possible side effects. Some medications can increase the chances of dizziness, falls, and confusion. Doctors recommend using them only for short periods of time.

Source: Tips for Coping with Sundowning

Alzheimer’s and Hallucinations, Delusions, and Paranoia

Alzheimer’s and Hallucinations, Delusions, and Paranoia

Due to complex changes occurring in the brain, people with Alzheimer’s disease may see or hear things that have no basis in reality.

 

  • Hallucinations involve hearing, seeing, smelling, or feeling things that are not really there. For example, a person with Alzheimer’s may see children playing in the living room when no children exist.
  • Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.
  • Paranoia is a type of delusion in which a person may believe—without a good reason—that others are mean, lying, unfair, or “out to get me.” He or she may become suspicious, fearful, or jealous of people.

If a person with Alzheimer’s has ongoing disturbing hallucinations or delusions, seek medical help. An illness or medication may cause these behaviors. Medicines are available to treat these behaviors but must be used with caution. The following tips may also help you cope with these behaviors.

Hallucinations and Delusions

Here are some tips for coping with hallucinations and delusions:

  • Discuss with the doctor any illnesses the person with Alzheimer’s has and medicines he or she is taking. Sometimes an illness or medicine may cause hallucinations or delusions.
  • Try not to argue with the person about what he or she sees or hears. Comfort the person if he or she is afraid.
  • Distract the person. Sometimes moving to another room or going outside for a walk helps.
  • Turn off the TV when violent or upsetting programs are on. Someone with Alzheimer’s may think these events are happening in the room.
  • Make sure the person is safe and can’t reach anything that could be used to hurt anyone or himself or herself.

Paranoia

In a person with Alzheimer’s disease, paranoia often is linked to memory loss. It can become worse as memory loss gets worse. For example, the person may become paranoid if he or she forgets:

  • Where he or she put something. The person may believe that someone is taking his or her things.
  • That you are the person’s caregiver. Someone with Alzheimer’s might not trust you if he or she thinks you are a stranger.
  • People to whom the person has been introduced. He or she may believe that strangers will be harmful.
  • Directions you just gave. The person may think you are trying to trick him or her.

Paranoia may be the person’s way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.

Here are some tips for coping with paranoia:

  • Try not to react if the person blames you for something.
  • Don’t argue with the person.
  • Let the person know that he or she is safe.
  • Use gentle touching or hugging to show you care.
  • Explain to others that the person is acting this way because he or she has Alzheimer’s disease.
  • Search for things to distract the person, then talk about what you found. For example, talk about a photograph or keepsake.

Also, keep in mind that someone with Alzheimer’s disease may have a good reason for acting a certain way. He or she may not be paranoid. There are people who take advantage of weak and elderly people. Find out if someone is trying to abuse or steal from the person with Alzheimer’s. For more information, visit Elder Abuse.

Source: Alzheimer’s and Hallucinations, Delusions, and Paranoia

Coping with Agitation and Aggression in Alzheimer’s Disease

Coping with Agitation and Aggression in Alzheimer’s Disease

People with Alzheimer’s disease may become agitated or aggressive as the disease gets worse. Agitation means that a person is restless or worried. He or she doesn’t seem to be able to settle down. Agitation may cause pacing, sleeplessness, or aggression, which is when a person lashes out verbally or tries to hit or hurt someone.Older man in a wheelchair with a nurse

Causes of Agitation and Aggression

Most of the time, agitation and aggression happen for a reason. When they happen, try to find the cause. If you deal with the causes, the behavior may stop. For example, the person may have:

  • Paindepression, or stress
  • Too little rest or sleep
  • Constipation
  • Soiled underwear or diaper
  • Sudden change in a well-known place, routine, or person
  • A feeling of loss—for example, the person may miss the freedom to drive
  • Too much noise or confusion or too many people in the room
  • Being pushed by others to do something—for example, to bathe or to remember events or people—when Alzheimer’s has made the activity very hard or impossible
  • Feeling lonely and not having enough contact with other people
  • Interaction of medicines

Look for early signs of agitation or aggression. If you see the signs, you can deal with the cause before problem behaviors start. Try not to ignore the problem. Doing nothing can make things worse.

A doctor may be able to help. He or she can give the person a medical exam to find any problems that may cause agitation and aggression. Also, ask the doctor if a medicine is needed to prevent or reduce agitation or aggression.

Tips for Coping with Agitation or Aggression

Here are some ways you can cope with agitation or aggression:

  • Reassure the person. Speak calmly. Listen to his or her concerns analzheimers-rummaging-hiding-things-metad frustrations. Try to show that you understand if the person is angry or fearful.
  • Allow the person to keep as much control over his or her life as possible.
  • Try to keep a routine, such as bathing, dressing, and eating at the same time each day.
  • Build quiet times into the day, along with activities.
  • Keep well-loved objects and photographs around the house to help the person feel more secure.
  • Try gentle touching, soothing music, reading, or walks.
  • Reduce noise, clutter, or the number of people in the room.
  • Try to distract the person with a favorite snack, object, or activity.
  • Limit the amount of caffeine, sugar, and “junk food” the person drinks and eats.

Here are some things you can do:

  • Slow down and try to relax if you think your own worries may be affecting the person with Alzheimer’s.
  • Try to find a way to take a break from caregiving.

Safety Concerns

When the person is aggressive, protect yourself and others. If you have to, stay at a safe distance from the person until the behavior stops. Also, try to protect the person from hurting himself or herself.

Source: Coping with Agitation and Aggression in Alzheimer’s Disease