Understanding and Responding to Unpredictable Behavior Related to Alzheimer's Disease

Posted by Donna Mae Scheib on December 06, 2017

Understanding and Responding to Unpredictable Behavior Related to Alzheimer’s Disease

Frustration, exhaustion and anger are common emotions when experiencing the behaviors of a loved one suffering from Alzheimer’s. As the disease progresses, much of the individual’s ability to communicate deteriorates, leaving caregivers guessing at and often misinterpreting needs.

A good place to start when interacting with a loved one who has Alzheimer’s is to remember that while it can be frustrating for you at times, it’s likely even more frustrating for your loved one who may regularly struggle to communicate their desires accurately, directly and effectively.

One of the best resources to turn to in these moments is the Alzheimer’s Association. This nonprofit offers excellent guidance in identifying behaviors related to dementia so that caregivers can better understand communication signals and respond more appropriately. Below are paraphrased highlights from the association’s list of dementia-related behaviors and responses.

First Things First—Evaluate the Unpredictable Behavior

Ask yourself the following questions before responding to the behavior.

• What happened? What did the behavior include?
• Did something specific trigger the behavior?
• Is the person in physical pain?
• Are there any new medications that could be contributing to this behavior?

Next, Consider Common but Unpredictable Behaviors and Assess How to Respond

Does the behavior fall into one of the following categories? If yes, read on to see some suggested ways to react.

Aggression

A sudden verbal or physical act that can include throwing objects, shouting, and hitting.

Response:
Respond calmly and redirect the focus to a different activity. Make sure your loved one is not in any pain. Try to discover the feelings behind the verbal or physical actions rather than focusing on the words themselves.

Anxiety/Agitation

Uneasiness or nervous excitement.

Response:
Think about if your loved one’s normal routine may have been disrupted or if anything currently around them is especially noisy or distracting. Certain environments or times of day may put them on edge. Listen to your loved one to see if you can discover what’s making them agitated and address the situation. Failing that, try adjusting their focus to a relaxing activity like listening to comforting music or working on an art project.

Confusion

When your loved one fails to remember where they are, who they are talking to and/or your name and the names of other family members.

Response:
Be concise with explanations and don’t overwhelm or confuse your loved one even more by scolding them or becoming angry. Try not to take their confusion personally. Consider using labeled photographs to help them recognize family members.

Repetition

The repeating of a word, question or performed action over and over again in search of comfort or security.

Response:
Write down the answer to their question and calmly repeat the answer a few times to help reassure them. Make the repetitive actions into an activity; for example, if they are drumming their fingers on the table, have them sit down at a piano to play a few keys.

Suspicion

When a loved one becomes paranoid, perceiving certain people—sometimes even loved ones—as strangers. They may not remember if it is a family member or a nurse visiting them and may express concern that someone is taking money or a possession away from them or that a perceived stranger is out to harm them.

Response:
Stay calm and briefly explain what’s going on. Try to focus their attention on a different activity in a different location. If they consistently lose a certain item—like a purse or watch—or think it is stolen, have multiples of the same item on hand to provide reassurance.

Wandering/Getting Lost

When a loved one tries to engage in familiar (and often no longer appropriate) routines—going home, going to school, going to work—but instead ends up wandering; loved ones who wander require increased supervision.

Response:
Make sure their home is secured with deadbolts or a security device that notifies you if an exterior door is opened. Keep the person occupied throughout the day with various household activities like folding laundry, cooking or washing dishes; tasks like these can provide purpose and potentially decrease restlessness that leads to wandering.

Trouble Sleeping

A common side effect of dementia and Alzheimer’s; the reasons for sleep pattern disruption are often unknown.

Response:
Have your loved one avoid consuming coffee, alcohol and other stimulants that could impact sleep. Encourage them to stick to a routine that includes a variety of activities—simple exercises, timely meals and shorter naps—to help them sleep well and avoid restlessness at night.

Conclusion

Identifying behaviors and responding appropriately can help you communicate with a loved one dealing with dementia and Alzheimer’s. Keep in mind you may not always be successful, even when equipped with potential ways to respond. Try different approaches until the behavior subsides or is no longer harmful to the caregiver or loved one.

It's never a bad idea to consult a dementia care specialist, whether a mental health professional or a physician (especially in the case of physical pain or discomfort, which may be the side effect of your loved one’s medications). As a caregiver, do not be afraid to reach out for help from other family members and friends. When extra help is needed, we at Senior Living Link can direct you to professional care units located in memory care facilities and nursing homes that specialize in easing the burden of caring for a loved one with Alzheimer’s disease.