7.07.2016 Mary Yamin-Garone, Changing Behavior
Good afternoon. Welcome to Demystifying Alzheimer’s. I’m your hostess Mary Yamin-Garone.
Today’s topic is “Changing Behavior and Alzheimer’s.”
An individual in the middle or moderate stages of Alzheimer’s loses their memory functioning, independence and sense of self. Communicating becomes difficult because they have trouble following what’s said to them and making themselves clear. Some may become restless or agitated while others can become fearful, suspicious, swear, scream, throw things, even hit, kick or bite. It’s impossible to control the disease that causes these behaviors but you may be able to soothe or calm some of its effects.
Behavior is a response to what’s happening inside and around you. If you’re not feeling well or you’re overtired, you probably don’t think as clearly as you normally do. You might become disoriented, feel like things are out of your control or get frustrated or angry. Those are normal human responses that typically go away once you’re feeling better. Alzheimer’s sufferers, however, don’t feel better. Instead, they become more fatigued and confused and less able to take care of themselves.
No question about it. It’s difficult to deal with the hostile, uncooperative and difficult behavior of someone with Alzheimer’s, especially if you’ve been working hard to provide the best possible care and comfort. It’s important to remember that their behavior isn’t stubbornness or mean-spirited. It’s a response to a devastating illness.
This disease progresses steadily but it affects your brain unevenly. That’s why your mother may remember specifics about her wedding day but forgets celebrating her 50th wedding anniversary last fall.
Alzheimer’s destroys your brain’s ability to learn from your mistakes. Don’t argue, threaten or punish your loved one for something they can’t control and may not remember. That frustrating behavior may be their response to their basic human need to be busy and productive. Try to find a task for them, such as folding clothes, that helps satisfy that need.
These relatively mild symptoms occur because AD damages your brain’s ability to remember, learn and reason. Your mother doesn’t recall emptying the dishwasher yesterday or you asking here not to do it. She can’t learn from her mistake because Alzheimer’s afflicts her once sound judgment. Because she’s confused and disoriented, she can’t tell that the dishes are dirty. All she knows is that they belong in the cupboard.
When an individual with Alzheimer’s bursts into tears or makes an angry accusation, it doesn’t happen in a vacuum. Somebody may have said something to upset them. They might be bothered by activity in the house, loud noises or glaring light. They may have an upset stomach or they may not have slept well. All behavior is triggered. As a caregiver, one way you can change behavior is to change the patterns that lead to that behavior.
Identifying causes and patterns of disturbing behavior allows you to modify their environment and the manner in which you approach someone who’s confused. Sometimes, simplifying a situation or decision works wonders. For example, if your loved one becomes combative when trying to decide what to eat or wear, you can limit the choices available. Rather than suggesting, “Why don’t you get dressed?” lay out clothing and say, “Why don’t you put these clothes on?” That’s what my father did with my mother and it made things easier.
If you’re angry, upset or puzzled by your loved one stop and take a breath. Ask yourself if one of you is hungry, angry, lonely or tired. If so, do whatever you can to change the situation.
Take away the triggers. Someone with a brain disease often becomes extremely upset, angry or moody in certain situations. Going to a restaurant, spending the weekend at a relative’s house or being in a crowded room can be so overwhelming and scary to your loved one that they might overreact if they lose sight of you in a crowd or are asked a question they don’t understand. They may get angry, nasty or burst into tears.
To avoid those responses, you have to recognize that these behaviors are a response to feelings of frustration your loved one can’t control. The best way to manage catastrophic reactions is to avoid things that upset them. Everyone responds differently but certain situations trigger extreme reactions in many people. They include:
- Situations in which they have to think about—and accomplish—several tasks at once, like bathing
- Situations in which they are attempting to do relatively simple tasks they can no longer manage on their own, like putting the dishes away or calling their grandchildren
- Being cared for by someone who’s rude or rushed
- Feeling inadequate because they can’t follow a conversation or understand a doctor’s questions
- Not understanding what they’re asked to do
- Feeling tired
- Feeling frustrated
- Being treated like a child
Agitation describes a range of behaviors that are common among Alzheimer’s sufferers, such as irritability, insomnia, verbal outbursts and physical aggression. Mild agitation or irritation often comes and goes during the early stages of the disease and then becomes more frequent and disruptive along with the other symptoms. Occasional irritability can easily turn into frequent anger or hostility.
Physical, environmental and emotional triggers also can make your loved one agitated. According to Alzheimer’s experts, this most frequently occurs when someone with Alzheimer’s feels they’re being forced to relinquish control over what they eat, the clothes they wear, where they live or who’s taking care of them.
Acknowledge a confused person’s anger over losing control of their life. Tell them you understand their frustration. Here are some other suggestions for soothing agitation.
- Try to reduce their caffeine, sugar and junk food intake.
- Reduce noise, clutter or activity.
- Be sure they’re surrounded by familiar, reassuring objects, like furniture and pictures.
- Pat their hand, rub their neck and play soothing music.
- Speak in a reassuring voice.
- Don’t attempt to restrain them when they’re agitated.
- Keep dangerous objects out of reach.
Don’t forget, confronting a confused person may increase their anxiety.
That’s all for today. Thanks for listening. I hope this information was helpful.
I’ll be back at 1 pm on Monday when I’ll talk more about changing behavior and Alzheimer’s.