Better Health & Living

Issue: August 2007
Coping With Unexpected Behaviors
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Coping With Unexpected Behaviors

What do you do when your loved one begins acting unpredictably? Follow this sage advice.

by Linda Rao

Published in family •caregiving | 0 Comments, Talk about this article »

Question:

My mother was diagnosed with Alzheimer’s three years ago. Until recently, she’s behaved fairly normally. Lately she’s become aggressive and yells at my brother and me for no reason. What can I do?

Answer:

Most people think of Alzheimer’s disease as a memory-robbing illness, and although brain changes characteristic of the disease do steal a lifetime of memories, other symptoms often occur, too. Over time, the disease can cause loved ones to act in unusual and uncharacteristic ways that often create difficult—and sometimes painful—challenges for caregivers.

Alzheimer’s affects not only people’s ability to communicate effectively but also their perception of what they see and hear, says Peter Reed, PhD, senior director of programs for the Alzheimer’s Association. “As a result, she may become physically or verbally aggressive, seem anxious or agitated, repeat the same words or behaviors over and over, or start to wander. Unfortunately, there’s no single reason people with Alzheimer’s behave the way they do and often behaviors are a way to communicate some unmet need. Something ‘triggers the behavior’.”

Rooting Out the Cause
Triggers vary from person to person, so Dr. Reed suggests you look for “cues and clues” to what may be causing the behavior to determine and then limit them. “If you address a trigger, and it doesn’t stop the behavior, try something else. It’s about problem solving,” he suggests. Unusual behaviors can often be traced to underlying factors such as:

  • Physical discomfort
  • Overstimulation
  • Unfamiliar surroundings
  • Tasks or instructions that are too complicated
  • Negativity or stress
  • Boredom
  • Hunger or thirst
  • Loneliness

It helps to learn as much about Alzheimer’s disease as you can through educational and caregiver-training workshops and support group meetings where others share how they’ve dealt with the same issues.

On-the-Spot Help
Chances are, you need some ideas to help you communicate effectively with your loved one right now. Here’s a sample of some of the responses the Alzheimer’s Association suggests for a wide variety of situations.

Anxiety or agitation

  • Find out what could be causing the anxiety and try to understand.
  • Use calming phrases. Let your loved one know you’re there to help. Decrease noise and distractions that might be upsetting. If necessary, move to another room.
  • She may be looking for something to do. Take a walk or go for a ride in the car or use art or music activities to calm her down.

Confusion

  • Avoid scolding. It’s far more calming for your loved one to hear, “I think he’s your grandson, Peter,” than an exasperated, “Why don’t you know your own grandson?”
  • Keep explanations simple. People with Alzheimer’s often forget the purpose of common items like utensils. Say simply, “You use this to eat your meat. It’s a fork.”
  • Use photographs and other thought-provoking items as reminders of important relationships and places.

Physical or verbal aggression

  • Don’t get angry or upset. Try to understand what might be causing her emotions.
  • Use massage, soothing music, or exercise to calm her down, or find another outlet—a walk, a ride, a pleasurable activity—that distracts her and uses her energy.
  • Unless the situation is serious, avoid physically holding or restraining her. She could become more frustrated and unintentionally harm you or herself.

Repetition

  • Give your loved one the answer she’s looking for, even if you have to repeat it several times.
  • Rather than reacting to what she’s doing, think about how she’s feeling.
  • She may be bored and need something to do. Engage her in a pleasant activity.

You Have Needs

It’s easy to forget that you also need to take care of yourself. Eat well, get enough sleep, exercise every day, and ask for help from friends and family members, Dr. Reed says. “When you appropriately relieve your own stress, you’re better able to look at your loved one’s behaviors more objectively and determine the best course of action.”  BHL

Regular contributor Linda Rao writes about health, fitness, and caregiving for many national magazines.

 

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