Alzheimer's: Dealing with Difficult Behavior
By J B Buckley
As if it weren’t enough to deal with forgetfulness and confusion while caring for your loved-one with Alzheimer’s, but aggressiveness, wandering and paranoia can really put you over the edge. Managing your loved-one’s difficult behavior is your true testament of love and devotion. You know it isn’t their fault, it is their disease that is making them scream, cry or yell terrible things out at you. Who ever said patience is a virtue, didn’t care for a loved-one with Alzheimer’s or dementia. Perhaps a caregiver’s only defense is to understand how to react to difficult behaviors and be ready for them.
Difficult behaviors can be broken down into the following categories: Wandering, Sleeping and Eating Problems, Agitation, Paranoia and difficulty with personal tasks. This is not to say these categories are the only forms of behavioral problems displayed by people living with Alzheimer’s, but their remedies may intersect other problems.
Wandering is not an uncommon hallmark of Alzheimer’s disease or dementia. Stress in the variety of noise, clutter or crowding can cause your loved-one to wander. The best idea is to reduce excess stress. A person living with Alzheimer’s disease should be settled in a quiet, clean, and spacious environment. This will eliminate many of the unwanted stressors, which could cause your loved-one to wander. Other reasons why your loved-one may wander include: Feelings of being lost, boredom, need to use the restroom or medication side effects.
In order to prevent your loved-one from feeling lost or foreign to his or her environment, provide them with familiar objects and reassure them quite frequently that they are at home or in a safe place. Maybe a family photo or an award he or she has won always jogs their memory so keep it close by. If your loved-one displays signs of boredom, give them a task of limited difficulty. This will keep them entertained but won’t frustrate them. Folding laundry is a great activity for people living with Alzheimer’s or dementia.
It is possible that your loved-one is wandering because they need to use the bathroom. In which case, place elaborate signs or pictures on bathroom doors to help guide them. Also, it is a good idea for you to implement regular toilet times. This will keep both of you on schedule. If your loved-one is wandering due to medication side effects, contact their physician to initiate a change in prescription or to lower the dosage. Wandering can be a dangerous behavior. Caregivers should contact their local Alzheimer’s Association to obtain information about ‘The Wanderers Program’ in their area.
People living with Alzheimer’s or dementia often experience sleeping and eating problems. Common causes for these problems include: discomfort, medication, pain, dehydration, depression and excessive sleeping or eating.
Feeling discomfort can sometimes not be conveyed by your loved-one depending upon the severity of the disease but it can cause eating and sleeping disturbances. Frequently monitor your loved-one’s room temperature, lighting, noise level, and chair or bed position. If you think your loved-one’s medications could be curbing his or her appetite or ability to sleep, speak to their doctor about changing or eliminating prescriptions.
Pain can be a factor in eating or sleeping disturbances. Again, sometimes a person with Alzheimer’s or dementia cannot express their feelings; if you sense a change in appetite or sleeping pattern has suddenly occurred without due cause, set an appointment for a medical examination. Dehydration is a known factor of sleeping and eating disturbances. Make sure your loved-one is drinking plenty of water. Place a pitcher filled with water near your loved-one at all times. Remind them it is there frequently and check to make sure it remains somewhat full. Too full can result in another problem- slip and falls.
If you feel your loved-one is showing signs of depression, have him or her evaluated by their physician. Anti-depressants or bedtime sedatives may be a productive treatment option. Depression can also cause excessive sleeping or eating. In which case, increase their exposure to light and reduce or eliminate nap time or snack time.
Defined:
Behavioral problems are defined as patient responses, which are considered noxious to staff, other patients, the patient himself, or family (Burgio, Jones, Butler, & Engel, l988). Behavioral problems have a profound impact on quality of care, staff, morale and the day-to-day operation of the long-term care institution
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