Alzheimer`s disease (AD) is an incurable brain disease that can cause troublesome changes in behavior. Some of the most common behavior problems associated with AD are wandering; inappropriate behaviors (sexually inappropriate behavior, aggressive and assaultive behavior, pestering, repetitive vocalizations); hallucinations and delusions; and sundowning.
What is wandering?
People with Alzheimer’s often wander like walking aimlessly. Wandering may occur at any time of the day or night and poses the risk of injury to the wanderer as well as privacy problems for others. The problem affects more than 75% of people with AD at some time during the course of their disease.
What causes inappropriate behaviors?
As Alzheimer’s progresses, more and more brain functions are lost. This includes loss of impulse control, which results in the inability to remember which actions are acceptable and which are not. Sense of time is lost and the person may not be able to handle delays. The experiences of pain, pleasure, and discomfort remain. When needs are not met, the person may become angry or insulting or begin cursing.
The person with AD cannot control his or her behavior. Many of these behaviors are directed toward getting attention or affection. Giving attention or affection, such as with a pat or a hug, can often prevent disruptive behavior.
How to deal with inappropriate behaviors?
Always remember, the disease is causing the behavior, not the person. Some ways to handle difficult situations include:
- Remain calm, even in the presence of the most offensive situations. Don`t raise your voice. Don`t act surprised or angry.
- Maintain a sense of humor. Laughter is a great outlet.
- Avoid drawing attention to the person. Try to divert the attention of others from the person with the inappropriate behavior.
- Distract the person to another activity or another area.
- Validate the emotional content of what the person says.
- Do not scold or shame. It makes the situation worse.
- Be sure the person`s physical needs are met. Hunger, pain, thirst, stress, or even an infection may cause behavior changes.
- Avoid situations that the person might believe are dangerous. When faced with a perceived danger, a person with AD will strike out in self-defense.
- Speak in simple, short sentences.
- Limit choices to two. More than two choices or open options will frustrate the person.
- Break large tasks into small ones to avoid frustration.
Alzheimer’s – Hallucinations and Delusions
Hallucinations
Hallucinations are perceptions that are not based on reality, such as seeing or hearing things that are not there. Many hallucinations are related to the need to feel safe. For example, to make up for feeling unsafe, a person makes up an imaginary companion who provides the needed security.
Delusions
Delusions are false beliefs held despite definite evidence to the contrary. For example, a person prepares, waits, and plans activities for a visit from a relative who is dead. It is thought that people develop delusions to avoid depression and self-blame, and to maintain good feelings about themselves and a sense of control.
How to deal with hallucinations and delusions?
It is more important to listen and respond to what the person is saying than to try to get him or her to face reality.
Always remain calm and friendly. Speak slowly and clearly to make yourself heard. Look directly at the person when speaking. These techniques show your interest in what is being said and may decrease the person`s anxiety. Establish a trusting relationship that is not demanding and identify and build on strengths of the person. Feeling safe, trusted, and respected can decrease the need for protective delusions.