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Coping with unusual behavior

The onset of Alzheimer's disease begins with memory loss and trouble learning. As the disease worsens, a patient's behavior can become erratic and uncharacteristic. They may have trouble comprehending speech, they might undergo mood swings or they could be easily frustrated. This strange behavior can be triggered by several factors, such as physical discomfort or being in an unfamiliar place (an Alzheimer's patient may have trouble remembering his or her home).

The nonprofit Alzheimer's Association recommends a three-step process for identifying common behaviors and their causes:

1. Identify and examine the behavior: What was the behavior? Was it harmful to the individual or others? Did anything noticeable trigger the behavior? What happened after the outburst, and how did you react? (Call a doctor if you suspect the cause is related to a medicine or illness.)

2. Explore potential solutions: What does the patient need? Is there anything you can do right now to comfort the person? Can you change your reaction to the behavior to be more calm and soothing?

3. Try different responses: Did your reaction help the situation? What can you do differently next time this happens? Do you believe there are causes you haven't found yet?

Responding to unusual behavior

The erratic behavior of Alzheimer's patients often falls into one of the following categories. There are various ways to cope with various behavioral abnormalities and outbursts:

Aggression: Shouting, cornering, pushing, hitting or acting out in a threatening manner are common forms of aggression displayed by Alzheimer's patients.

How to respond: If a patient becomes aggressive, try to find and remove the cause of the aggressive behavior. Be reassuring, and focus on calming the patient's heightened emotions. Reduce other distractions in the room, and avoid making any potentially frightening songs or movements. You can also try redirecting the patient's attention with an activity he or she finds enjoyable.

Anxiety: Patients can develop increased anxiety as Alzheimer's worsens. Signs of anxiety include restlessness, dependency, worrying over details and being emotionally oversensitive.

How to respond: One of the best ways to calm someone who is experiencing anxiety is to listen. Hear out what is causing the anxiety or frustration, and then maybe you can correct the cause of the problem. Reducing noise or distractions in the person's environment can also help. Boredom can also contribute to anxiety.

Apathy: A person suffering from Alzheimer's may become listless or unwilling to do anything. This kind of apathetic behavior is problematic because it can lead to depression.

How to respond: Interact with the patient through conversation or fun activities. Help add color to the person's life.

Confusion: Alzheimer's patients may not recognize family or friends, and they might also forget about longtime relationships and surroundings. They might also forget how to use common objects. Patients may also become more confused in the afternoon and evenings, a phenomenon known as sundowning.

How to respond: Stay calm and remain positive. Try not to appear hurt if the patient does not remember something important. If you need to explain something to the patient, keep your responses as simple as possible. Also, be careful not to accidentally insult the patient. Using photographs or sentimental items might help the patient's memory. Also, you can help prevent sundowning by keeping the patient's afternoon and evening schedules simple and relaxed.

Hallucinations: People with Alzheimer's may believe they see, hear, smell or taste things that aren't real.

How to respond: Don't try to convince the patient that he or she is hallucinating. Instead, acknowledge the patient's feelings and offer your support. Perhaps redirect the patient's attention to a new activity. Also, determine whether the hallucination is harmful or beneficial. If the patient has imagined something that brings comfort, then the hallucination may not have been such a bad thing.

Suspicion: As confusion from Alzheimer's sets in, patients may become suspicious of others around them. They may even accuse others of theft or improper behavior.

How to respond: Don't take anything the patient says personally. Also, don't argue with the patient, even if he or she is obviously wrong. Instead, listen to what the patient says. When you reply, keep your explanation short and sweet. If possible, shift the person's attention to a new activity, such as helping you with a household chore.

Repetition: Alzheimer's patients may begin doing something over and over again, such as repeating a word, question or motion. This tends to happen when patients feel uncomfortable, estranged or insecure.

How to respond: Try to uncover any specific causes for the patient's repetitions. Ask if anything is bothering the patient, but do not criticize his or her behavior. Always answer the patient's repetitive questions, even if you must answer them several times. If the patient is repeating an action, try to give the patient a chore or task that mirrors the repetitive motions such as folding napkins if the patient's hands are fidgeting.