Coping with Challenging Behaviors

Posted by Mary Baum, Program Director, Concord Park Memory Support on 2 July 2008 | 0 Comments

Tags: Alzheimer's disease, grandchildren, visiting tips, family support

As Alzheimer's disease progresses and different areas of the brain are affected, an individual can exhibit new and often challenging behaviors. The disease causes cell death and diffuse tissue changes, so control of certain functions, such as perception, begin to change. Information that was once readily perceived, interpreted, understood and acted upon now becomes unreliable.

It is important to know that the person with Alzheimer's or dementia has an altered state of reality and may show signs of aggression, paranoia, hallucinations, irritability or anxiety.

People with Alzheimer's and related memory disorders have a lower threshold to stress and stimulation. Maintaining structure, consistency and daily rituals are vital in maintaining a balance of activity and success in navigating the day to day. The first line of defense in managing challenging behaviors is the non-pharmaceutical or behavioral approach.

Here are some tips to help you cope with the negative effects of Alzheimer's disease:

Prevent frustration. Watch for signs of over-stimulation or confusion. Avoid loud noises and clutter. Turn off the television if you want to have a conversation and try to phrase questions so they may be answered simply. Distraction can be a very effective approach to managing challenges. If a person is having trouble putting on a sweater, simply do something else and then try again in a little while.

Avoid confrontation. Do not argue or try to reason if presented with a challenging behavior. Even if your family member is yelling or criticizing you, avoid expressing anger or impatience in return. Try softening or quieting your tone. Fatigue is the most common denominator in outbursts - for the person with Alzheimer's and the family caregivers!

Be positive. Use positive expressions and humor when appropriate to diffuse tense situations. Remain calm. Use a gentle touch to reassure (if the person is willing to accept it). Build in periods of relaxation into the daily routine, such as sitting in a rocking chair or favorite recliner with a cup of tea.

Don't take the behavior personally. Remember that this is part of the illness. It can be stressful to relate to a family member who is combative even when you understand the source of the behavior.

Dealing with hallucinations. If your family member is hallucinating that they had a conversation with a deceased family member and this was a pleasant experience for them, go along with their reality. However, if the hallucination (or any behavior) causes fear and distress it is vital to request a medical evaluation. Difficult behaviors that persist or have the potential to cause harm need to be attended to by a skilled and knowledgeable physician. The behavior may be rooted in a physical cause such as pain or side-effects of prescriptions. Pharmaceutical interventions may be warranted to reduce and manage anxiety, hallucinations and paranoid behavior.

Online Resources:

Behaviors
Alzheimer's care: Practical tips