Caring for Alzheimer’s Seniors: Dealing with Difficult Behaviors

Chris Hawkins Written by Chris Hawkins
SeniorLiving.Org Expert on Senior Care & Assisted Living

The behaviors of seniors with Alzheimer’s are often unpredictable. You may have already experienced a wide swing in your loved one from withdrawn to aggressive. Dealing with these behaviors is never easy, especially as they sometimes come out of the blue. But that’s Alzheimer’s.

Difficult Behaviors & Alzheimer’s

We’ll look at some common behaviors and ways you can respond to limit your frustration and to increase the wellness of your loved one.

3 Stages of Alzheimer’s Disease

Let’s take a quick look at the three stages and their behaviors of Alzheimer’s as described by the American Health Assistance Foundation.

Stage 1 (Mild): This stage occurs in the first 2 to 4 years. It's characterized by energy loss, mood swings, anger and frustration. Some common behaviors include getting lost, difficulty managing household affairs (bills and money management), poor judgment, losing things, repetitive questions, changes in mood and personality.

Stage 2 (Moderate): This the longest stage can last from 2 to 10 years and is where the individual clearly becomes disabled. An individual can perform simple tasks but need help with activities that are more complex. Common behaviors include depression, loss of control, irritability, restlessness, apathy and withdrawal. More severe behaviors include paranoia and physical violence.

Stage 3 (Severe): Lasting from 1 to 3 years, in this final stage, the individual may lose the ability to speak, to recognize people, lose bodily functions and the ability to feed themselves. Memory is almost non-existent. Constant care is usually required.

Common Behaviors and How to React

Confusion is a common behavior starting in Stage 1. The person may call you by a different name, forget their address, a phone number or forget what their toothbrush is for. It’s easy to get frustrated with this behavior, especially if it happens day after day.

  • Stay calm and remember that it’s part of the disease. Some days may be better than others.
  • Give a brief explanation but don’t overwhelm with a lot of information. Keep it simple.
  • Try to jog their memory with pictures of important places and relationships.

Sundowning is late-day confusion caused by a number of factors: mental and physical exhaustion; disturbed internal body clock; reduced lighting and increased shadows; less need for sleep.

  • Keep the person busy throughout the day with both mental and physical activities.
  • Limit caffeine and sweets and only serve them in the morning.
  • Serve dinner early
  • Keep their bedroom partially lit to lessen confusion by the dark surroundings.

Aggression—in addition to the effects by the disease—can be caused by several other factors: poor communication, physical discomfort and their environment.

  • Being tired because of poor sleep
  • Side effects from medication
  • Being in pain and unable to let you know
  • Feeling overstimulated or overwhelmed by an environment because of loud noises, clutter, or lighting (glare, too dark/too light, flashing lights of TV)
  • Feeling lost
  • The caregiver’s poor communication such as hard to follow instructions, asking too many questions, being negative and/or critical.

Agitation often occurs when the person is in an unpleasant environment, a new environment and their frustration trying to remember things.

  • Be aware of the same reasons above that can prompt aggression.
  • Modify the environment; get to a known comfortable environment like their bedroom.
  • Ask them what’s causing the agitation.
  • Go for walk to take their mind off the agitation
  • Don’t become agitated yourself; they’ll recognize this.

Suspicion is caused by the brain perceiving things in new, sometimes unusual ways, leading them to make accusations of friends, spouses and caregivers.

  • Listen and find out what’s bothering them.
  • Don’t argue
  • Offer a simple explanation
  • Engage them in an activity to change their focus..

Hallucinations can be terrifying for the individual or they can simply be non-threatening images from their past. Causes of hallucinations in addition to Alzheimer’s include: schizophrenia, dehydration, intense pain, alcohol/drug abuse, medications and eyesight/hearing problems.

  • Be supportive and respond in a calm manner.
  • Ask them to take a walk into another room, preferably one that is better lit.
  • Re-focus their attention with their favorite activity.
  • Make sure the environment doesn’t have distracting lights, shadows or noises that can be misinterpreted.

If you are an Alzheimer’s caregiver, consider getting help from outside sources that provide respite care and home health care. The Seniorliving.org database has one of the most complete listings on the web.

For further reading on Alzheimer’s:

“An Introduction to Alzheimer’s”

“Causes of Alzheimer’s”

“Caring for Alzheimer’s Seniors: Part 1”

“Caring for Alzheimer’s Seniors: Part 2: Incontinence.”

“Caring for Alzheimer’s Seniors: Part 3: Safety"

“Caring for Alzheimer’s Seniors: Part 4: Depression"

“How to Approach a Person with Alzheimer’s”

Updated: May 21, 2012

Comments

[1] Comment.
Patt Devitt On Sep 18, 2012
I appriciate my daughter sending me this site. These are things I knew when dealing with my mother 25 years ago! Thank you for jogging my memory now that I need them for my husband. He is just starting this path; now I am starting it with him. Thank you for your help.