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Dealing with Challenging Alzheimer’s Behavior

Caring for a loved one with Alzheimer’s disease can be a profoundly loving yet emotionally taxing experience. As the disease progresses, behavioral changes often occur, presenting unique challenges for caregivers. Understanding these behaviors and learning effective strategies to manage them can help caregivers provide compassionate care while maintaining their own well-being. The following are some of behaviors seen in people with Alzheimer’s or other dementia:

Agitation and aggression: This may manifest as irritability, verbal outbursts, physical aggression, or even attempts to harm themselves or others. Such behavior often stems from confusion, fear, or environmental triggers.

Wandering: Individuals with Alzheimer’s might wander away from home, often driven by an underlying purpose or need, such as looking for something or someone.

Repetition: Repetitive speech or actions are common, which can be frustrating for caregivers. This behavior is usually a result of stress, anxiety, or an attempt to express a need.

Suspicion and delusions: Misplacing belongings can lead to accusations of theft, and memory loss might cause the individual to fabricate explanations or become suspicious of those around them.

Sleep disturbances: Changes in the brain can disrupt sleep patterns, leading to restlessness or wandering at night, which in turn can disrupt the caregiver’s sleep.

These behaviors can be challenging for both family and professional caregivers. The first thing to understand is that not all changes in behavior may be caused by dementia, so don’t immediately write off those behavioral changes. Make a note to bring these changes to the attention of your loved one’s healthcare provider. No matter what the cause of the challenging behavior, the following are ways you can help your loved one feel safe and secure.

Create a calm environment: Keep the environment peaceful and avoid overstimulation. Use soothing music and soft lighting, and remove excess clutter. Consistency in routine also provides a sense of stability and security.

Ensure safety: To manage wandering, secure the home with locks that require a key and use devices that alert you when a door is opened. Location-tracking devices can also be worn by the person with Alzheimer’s.

Redirect and distract: When agitation occurs, try to redirect the person’s attention to a different activity. It could be as simple as going for a walk or moving to another room.

Validate feelings: Instead of correcting, acknowledge the emotions behind the behavior. Saying “I see that this is upsetting you, let’s try doing something you enjoy” can be more effective than rational explanations.

Promote restful sleep: Establish a nightly routine that promotes relaxation, such as listening to soft music or reading together. Make the sleeping environment comfortable and use night lights to reduce confusion.

Use “therapeutic fibs”: In cases of delusions or false beliefs, sometimes agreeing with or redirecting the belief can be more beneficial than confronting it. This approach, known as therapeutic fibbing, can reduce distress. Of course, lying to a loved one can cause distress in the caregiver and raise ethical dilemmas. Caregivers can view this act as one of kindness and love. If a loved one asks where her deceased father is, telling her “He’s not here right now” helps avoid the repeated heartbreak of hearing that her dad is dead.

Get support for yourself: It’s essential for caregivers to seek support and respite care to manage their own health. Local support groups, Alzheimer’s associations, and professional counseling can provide valuable resources and emotional support. Remember, taking care of yourself is just as important as caring for your loved one.

By understanding and strategically managing the challenging behaviors associated with Alzheimer’s, caregivers can improve the quality of care and make the journey a little easier for both themselves and their loved ones.

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