Five classic behaviors that typically arise in someone who has Alzheimer’s disease or another type of dementia can be confusing and frustrating to caregivers.
Understanding what drives those behaviors may help.
“Most of the behaviors that become common when someone enters the middle stages of the disease are really just ways of communicating needs or discomforts or emotions,” says Whitney Hadley, a social worker at the Central New York Chapter of the Alzheimer’s Association.
Here’s a rundown from Hadley:
Behavior: Anxiety or agitation
Looks like: Restlessness and pacing, or over-reliance on a caregiver.
Explanation: If the person is feeling anxious or uncertain about something while losing control due to the disease, he or she is likely seeking out what’s most familiar, to feel safe.
Action: Recognize and act on any physical or emotional needs tied to their behavior. If they pace at dinnertime, make sure they wear shoes that fit well.
Behavior: Confusion or suspicion
Looks like: Accusation that a lost item was stolen.
Explanation: With dementia, people lose the ability to retrace their steps. If you are sitting near where they usually place their keys, and they cannot find their keys, they may logically believe you took them.
Action: Instead of arguing that you don’t have their keys, say, “Let me help you find your keys. That must be very stressful for you. Let’s look for them together.”
Looks like: Asking what time is lunch, over and over.
Explanation: They may want to engage and talk to someone, they may be having trouble processing information, or they may be forgetting that they have asked already.
Action: Consider whether they are hungry; did they eat a small breakfast several hours ago and now they need a snack? Are they thirsty? Answer the same way each time, and briefly. Say, “Lunch is at noon.” Then redirect with something such as, “Let’s go take a walk,” or “Let’s fold these towels.”
Behavior: Aggression or anger
Looks like: Sudden verbal or physical outburst.
Explanation: An aggressive episode is usually more scary than it is dangerous.
Action: After things have settled down, piece together what prompted the outburst for clues of how to prevent more. Consider what factors frustrated them. Are they in pain? Did the tone of your voice provoke them? Could they be overly tired? What about medication side effects?
Looks like: Becoming lost, from disorientation or confusion.
Explanation: About 60 percent of people with dementia will wander at some point, and usually without warning. It may be tied to boredom, the person trying to follow old habits, trying to find something or someone, or trying to get away from something unpleasant or stressful.
Action: Have safety precautions in place, including a list of places the person may wander to, such as previous job locations, former homes, places of worship or favorite restaurants. Also, the Alzheimer’s Association offers MedicAlert + Safe Return. Learn more at 800-272-3900.
A piece of advice
“Keep a notebook,” says Hadley.
“Taking notes is one of the best things a caregiver can do. It helps you identify a progression of symptoms, helps you to work through, if you start to see a behavior more frequently, what could be causing it.
“If you start to write these things down — What time of day is it happening? What’s going on that could be triggering it? — you’ll start to see patterns, and that will help you in the future.”