What’s going on with Mom?
A person with Alzheimer’s disease may eventually show changes in behavior and personality. Some of these changes can prove alarming to loved ones as well as their caregivers. In some cases, an individual with Alzheimer’s may become aggressive, belligerent, and quite vocal about their wishes and demands, or exhibit unacceptable behaviors such as pinching, hitting, and pushing.
A woman who has never said a bad word in her life may suddenly spout cuss word like a sailor. A confident, formerly stalwart and retired ex-firefighter is suddenly unable to do more than one thing at a time, and when he does, it’s with hesitance and some confusion. Oh, and yes, he snaps at you too. What’s up with that? What’s going on with mom or dad? It’s alarming. It’s scary. It takes your breath away.
Learning how to identify and deal with such behaviors is essential not only for family and friends of loved ones diagnosed with the disease but for the caregivers taking care of these individuals.
Why Behaviors Occur
It’s not understood exactly why behaviors and personalities in an individual diagnosed with Alzheimer’s – or other forms of dementia – may change. Some people advance through the stages of Alzheimer’s with a calm, serene demeanor, while others become angry, belligerent, and behave in ways they never did prior to the diagnosis. The behaviors we’re talking about here are not early stage behaviors such as moodiness or depression. The behaviors we’re discussing now occur during the later stages of the disease process.
Loved ones, friends and most especially the caregivers need to understand that many of these reactions lead to emotional turmoil, misunderstandings, sadness, and frustration. It’s difficult enough to watch a person slowly forget a daughter’s name or a son’s face without watching that very same person become aggressive or belligerent.
Anyone offering support and care for an individual diagnosed with Alzheimer’s should understand some of the causes of behaviors, not limited to:
- An inability to communicate
- Inability to understand what someone is telling them
- New Environments
- Loud noises or noisy environments
- Complicated activities or tasks
- Unfamiliar surroundings
- Discomfort or pain
An individual with Alzheimer’s may be in pain or uncomfortable and unable to express that discomfort in a calm and normal manner. Mom may be bothered by the intense activity going on around her during holiday preparation or more easily startled by loud noises outside. Dad may become frustrated, agitated and difficult if he’s in a new environment and unable to recognize familiar objects that he’s used to. Mom may find it more than frustrating to not be able to express herself to her loved ones or to receive comfort from them.
When dealing with any type of uncommon behavior, loved ones and caregivers should:
- Try to identify what has triggered the behavior
- Create possible solutions to avoid such triggers and to deal with the behavior in a calm and safe manner
- If one solution doesn’t help, try something else
What works for one person may not work for another. We’ll give you a few ideas on how to respond to three common behavior changes in those experiencing moderate to later stages of Alzheimer’s: aggression, anxiety, and confusion. While these suggestions are by no means perfect, they offer family and friends as well as caregivers possible solutions to dealing with unexpected behavior from their loved ones.
Mom may never have raised her hand in anger to anyone in her life, but all of a sudden, she wants to pinch everyone within reach. While the pinches may not hurt (or maybe they do), they can be extremely startling and disturbing to loved ones and caregivers. Dad may suddenly decide that hitting is the only way he can express his anger and frustration. How do you deal with such situations? Try following these steps:
- What caused the reaction or the behavior? Was Mom startled? Was Dad unable to find his favorite shirt? Try to determine what happened immediately before the agitated behavior that might have caused the individual to become aggressive.
- Attempt to determine how the person is feeling. Are they expressing anger or frustration? This isn’t always easy, but individuals familiar with their loved ones or caregivers taking care of a familiar patient will often be able to interpret their emotions.
- Avoid reacting with anger. Always keep your voice calm and speaks softly and slowly. Don’t patronize the individual, but realize that their behaviors are not directed at you in a personal manner.
- If you see behaviors accelerating or worsening, try to guide the individual into a quieter, calmer environment. For example, if Mom seems to grow agitated every morning at breakfast while the kids are eating at the table or getting ready for school, asking where clothes are and you’re making their lunches, try adapting Mom’s schedule. Don’t get Mom up and ready for breakfast until the kids have left for school.
- Try to distract your loved one and promote relaxation. Put on their favorite music or turn the television on low. Ask your loved one if they want to go for a short walk in the backyard or, if you have one, set them in front of a fish tank or a birdcage. This often will have a calming effect.
Anxiety can be caused by a number of incidents or triggers. Many individuals diagnosed with Alzheimer’s become increasingly restless. Their sleep schedules are interrupted, they’ll sleep during the day and be awake at night, or they may pace in circles or from one room of the house to another, over and over and over again. If Mom is content to wander from one room of the house to another, let her do so, but make sure that each environment is a safe one.
However, if you see Mom or Dad growing increasingly agitated or anxious and fearful, try to determine the cause of the anxiety. Talk to the individual in a calm and soothing manner and let them know that you’re there to help. Let them know they’re okay. They’re safe. Encourage the individual to perform some type of activity or task that will help distract them. Folding clothes, sorting objects, or light cleaning chores may be beneficial.
Whenever possible, decrease the number of distractions or noises in the environment. If the TV is turned on at the time, try turning it off or turn down the volume. Relocate the loved one in another area of the home. Try to think of activities or other alternatives that will help reduce the level of anxiety and get the loved one involved in doing something.
Confusion, uncertainty, and memory loss have a definite and severe impact on someone with Alzheimer’s. As a loved one or a caregiver, you should not be surprised if they eventually forget how to properly use a fork or a knife. They may forget how to put their pajamas on, or why, or how to brush their teeth.
If you give a person with Alzheimer’s a task, no matter how simple, and they experience confusion or frustration, be patient and explain what you would like them to do. Strive for a calm manner. This is especially important if you’re taking care of Mom or Dad and they forget who you are. They may demand to know who you are, why you’re in their home, and threaten to call the police.
Such situations are common and extremely difficult for loved ones. Again, do your best to remain calm and maintain your cool when in the presence of such an individual. Tell them who you are, where they are, and attempt to soothe them. This is a very painful situation, but try not to express or show your pain in front of your loved one, because chances are they’re not going to know why you’re upset and your behavior will further agitate or confuse them. You may have to step out of the room or the home for a moment. Then, return a moment later and try again. They may have already forgotten the episode.
Such situations are extremely draining on the emotions and mental fortitude of loved ones and caretakers. However, compassion, understanding and a gentle, calm reaction to confusion may help alleviate a large number of situations. Offer corrections or suggestions for what you want your parent to do, without patronizing. While a loved one may forget your name, they will still understand kindness, understanding, and support.
Regardless of the type of behavior a loved one expresses, resist the temptation to take it personally. Your loved one isn’t trying to hurt you. Never argue or try to convince a person with Alzheimer’s that they’re wrong, or that something isn’t what they sincerely believe it to be. You’ll never win, and you may end up creating a potentially aggressive situation.
Dealing with behaviors is one of the most difficult aspects of providing care for an individual diagnosed with Alzheimer’s. Whether your loved one, a family friend, a relative or the caregiver hired from a home healthcare agency is taking care of someone with dementia in any form, it’s an extremely challenging and physically and mentally demanding endeavor. It can also be one of the most rewarding experiences in your life.