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.
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:
- Feelings such as sadness, fear, stress, confusion, or anxiety
- Health-related problems, including illness, pain, new medications, or lack of sleep
- Other physical issues like infections, constipation, hunger or thirst, or problems seeing or hearing
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 hallucinations. Medications are available to treat some behavioral symptoms.
Source: Managing Personality and Behavior Changes in Alzheimer’s
I Don’t Understand
“What do you mean?” and” I don’t understand “… As a caregiver for a person living with Alzheimer’s, these phrases can be frustrating. Something that seems simple to us, such as, saying ” Let’s go this way”, then just walking away …..Can make the PLWA feel abandoned and frustrated. The words must sound more like Whant, Whant, Whant and Blah, Blah, Blah than an actual request or suggestion. Instead of just saying something to them, take the person by the hand or make a forwarding gesture as you say “Let’s go this way”.
What about after your sixth try to assist your loved one to the restroom. You finally get them to the restroom, give their pants a tug and say “Ok, now pull your pants down”. Just for them to look at you like you are crazy and cling to their pants with clenched fists. They probably feel vulnerable and afraid which may lead to anger. This anger may lead to aggression. Wow…… this situation just got bad in a hurry. But why? You have a request and made a simple gesture…Think about the intimacy involved in using the restroom and the trust the PLWA has to have with the person assisting them. Does their reaction make sense now? Use step by step instructions with non-invasive gestures. Take your cues from them….. They will let you assist them when they feel comfortable and safe with you.
It takes lots of patience.
It takes patience, lots of patience. Sometimes it will be a success and sometimes it won’t. Trial and error…… Keep trying. What works today may not work tomorrow. Remember, you are not the only struggling caregiver. With support from others like us. You can hold our caregiving head up high and say, “I Can Do This!!!!”
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.
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.
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.
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.
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
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.
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:
- Pain, depression, or stress
- Too little rest or sleep
- 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 and 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.
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
2I just finished updating the header photos on the website. These pictures will randomly load when someone visits the website. I chose pictures that may help explain what my wife is experiencing today. The day started off good better than most days have started off here lately.
That was followed by her wanting to go somewhere. The where was not important, she just wanted to go see some ‘peeples’. She starves for social interaction so she will ask several times a day where are the ‘peeples’. However, she was not dressed. I attempted to explain that she needed to get dressed first then we would go out somewhere. Like I said the where is not important.
She had shown very little interest in eating so she had not eaten very much. Her agitation level is somewhat proportional to her hunger level. She has never been one who could go long without eating breakfast. Or going very long without eating. After eating a couple of breakfast bars and drinking some ice tea. Her anxiety started to ease. We always keep plates and bowls of food out for her to eat. Fresh fruit, cheese, vegetables cut up into bite-size pieces, small bites of some form of protein.
For those who have followed me on Facebook, you should know I employ music therapy, as an emotional regulator. Soon after she had got up this morning. I put on some music that she finds soothing. About 30 – 45 minutes after eating she was dancing to the music. Her anxiety and agitation levels were now as calm as a glassy lake.
This calm lasted a couple of hours before restlessness returned, but we are still not fully dressed. This time the anxiety was brought on by the need for a bowel movement. She is not able to fully communicate what it is that is bothering her. So we a left to guess and make educated decisions. We only get so many attempts before anger sets in. And she will pop off with a remark like ‘whats wrong with you are you stupid’. Rule number 1 never argue. A typical reply at least for me is. Maybe, can you help me?
Failure to determine what is causing agitation will lead to all kinds of other issues that will have to be resolved. These issues will wreak havoc on everyone involved.
What has not happened so far today is we have not hit a wall. However, the day is not over and sometimes those walls come at night when she refuses to lay down.
Thanks for visiting