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Alzheimer's disease: Behaviour changes

A person with Alzheimer's disease may experience behaviour changes as the condition progresses.

These can range from mild irritation to behavioural outbursts and aggression.

Coping with the behaviour of a person with Alzheimer’s disease can pose many challenges for a carer, particularly as the disease progresses and the ability to communicate with the person becomes more difficult.

The changes in the brain associated with Alzheimer's disease can lead to unusual and unpredictable thinking and behaviour. For example, the person with Alzheimer’s may become anxious around family members, neighbours, or friends who he or she may not recognise, or in situations that differ from his or her normal routine.

The person with Alzheimer's disease may also become suspicious and suffer from delusions - false ideas that a person firmly believes and strongly maintains in spite of contradictory evidence. He or she may also begin to withdraw from social interaction, wander, become aggressive, and/or become angry and irritable.

Managing unpredictable behaviour in Alzheimer's patients

Here are some tips to help you, as a carer, manage the changes in thinking and behaviour that often accompany Alzheimer's disease:

  • Maintain. Work to preserve the abilities of the person affected by the disease, particularly those concerning his or her dignity (such as eating and using the toilet) rather than try to teach new skills.
  • Preserve consistency. Try to minimise any changes in the surroundings or to the person’s daily routine.
  • Keep it simple. Follow simple routines and avoid situations that require the person with Alzheimer's disease to make decisions. Having to make choices can be very frustrating and cause anxiety for a person with Alzheimer's disease.
  • Use simple language. It may help to simplify, or re-word your statements or requests if the person with Alzheimer's disease doesn't seem to understand. Try to be patient and supportive, especially if the person you are caring for is confused and/or anxious.
  • Gently remind. Help the person maintain his or her orientation by naming events for the day, reminding him or her of the date, day, time, place, etc, and repeating the names of the people with whom he or she has contact.
  • Reassure. Reassure the person you’re caring for every day, even if he or she does not respond. Use a quiet voice, be protective, and affectionate. If he or she has delusions, be reassuring rather than defensive.
  • Be calming. If your loved one becomes agitated or aggressive, try playing music or a film that he or she used to enjoy. Reminisce with him or her about the family, or activities he or she once enjoyed.
  • Communicate. Try to understand the words and gestures the person uses to communicate. Adapt to his or her way of communicating - don't force the person with Alzheimer’s to try to understand your way of communicating.
  • Keep an eye on medication. Be sure the person with Alzheimer’s gets the right medication and at the right time. Watch for reactions and possible side effects of medication, such as depression or agitation. Talk with your GP before using any over-the-counter medicines - they may interact with prescription medications and cause serious side effects.
  • Provide a good diet. Because the effects of dementia can be worsened by poor nutrition, be sure to provide the person affected by the disease with a nutritious diet and plenty of healthy fluids, such as water or fruit juice.
  • Identify triggers. Try to identify any actions, words or situations that may "trigger" inappropriate or dangerous behaviour. Make a note of any episodes of such behaviour so you can try to avoid the triggers in the future.
  • Adapt the environment. To minimise confusion and anxiety, adapt the environment where the person with Alzheimer’s lives to match his or her capabilities. Make adjustments as his or her abilities decline. If your loved one tends to wander, you may need to lock the doors, especially at night.
  • Be honest. Recognise when the person's behaviour is more than you can handle. Safety - your own and the person you care for - must be considered at all times.

In some cases behavioural problems - especially physical aggression and delusions - may require treatment with medications, such as anti-anxiety or anti-psychotic drugs. However, these drugs can have negative side effects, including drowsiness and depression, and can further affect memory.

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on June 12, 2017

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