Alzheimer’s Difficult Behaviors/Distract & Redirect
Do you sometimes feel mistreated by the person in your care? Nothing feels more frustrating than working hard to care for someone who argues, refuses to follow directions, and is even verbally abusive. Sometimes these are the behaviors that accompany diseases such as Alzheimer’s disease (AD). Other times, the person is frustrated by feeling sick or without control over many aspects of his life, and takes these frustrations out on those around him, especially the caregiver.
Handling Angry Outbursts or Uncooperative Behavior
First, try to diffuse the anger. There are several ways to do this. You will have to experiment to see what works best with the person in your care. You can try:
- Humor—Making light of the situation, but not the person.
- Empathy —“I see how upset you are and I understand.”
- Changing the Subject—Address what he is saying briefly and then move on to a different topic.
- Take a Break—Tell the person you have a task to take care of in another room and that you’ll discuss the issue in a little while. This will give him time to cool down and you a chance to take some deep breaths to get centered again.
When the Person Refuses to Cooperate
First, make sure he understands what you are asking. He may be confused, especially in cases of dementia, or he may be feeling ill and simply unable to respond quickly.
- Make sure he is comfortable and not sick—He may be confused, over-stimulated, or in physical pain.
- Be a listener—Take time to ask the person in your care how he is doing. Sometimes combative behavior is a symptom of a deeper issue. For example, a person may refuse to be bathed because he is feeling modest. Or he may refuse to eat in response to a sense of loss of control. In these cases, giving the person choices can make him more likely to cooperate.
- Be patient—Your schedule may be overwhelming, but the person in your care is on his own schedule. Allow more time than usual for simple tasks. Too many activities at once can provoke a reaction because the person feels overwhelmed.
- Remain calm. Seeing you calm may help calm him down.
- When the person is upset, delay the personal care if possible. Ask yourself if the task you are attempting can be put off until the person is calmer.
- Do not contradict his reality. If he believes something to be true, do not disagree unless it poses a physical threat.
- Track the behavior. Keep notes on times of day, frequency, or type of behavior problem.
Tips on Changing What you Do
You may not be able to control the other person’s behavior, but you can control your own. Here’s how to appear less confrontational to the person who is agitated:
- Stand to the side of him or at eye level rather than towering over him—especially if there are several people tending to him at once.
- Don’t expect an immediate answer or response. Give him extra time.
- Keep the room calm. Turn off the TV and radio.
- Speak clearly and slowly.
- Don’t take it personally. Sometimes a person’s abusive behavior is a symptom of Alzheimer’s or dementia and not his true nature. Remember, he may not be able to control his behavior or even be aware of it because of his disease.
At some point in the course of the disease, people with Alzheimer’s may become physically aggressive, although this does not occur as often as people think. They may sometimes throw things, hit, kick, bite, or pinch the caregiver or others they come into contact with. They may not know why they are doing this, and they may not even realize that they are doing it. These displays of behavior can be very frightening. Try to remember that these behaviors are probably an indication that the person with AD is very upset about something.
When it looks like he is getting upset, and may seem to be spoiling for a fight, perhaps using threatening language, you may feel frightened and tempted to fight back. Try to stay calm, use a reassuring tone, and distract the person.
There is no “magic pill” for troubling behaviors, although medications can sometimes help. Take the person to the doctor to see if there is a physical reason for the upset, such as pain, constipation, infection, depression, or anxiety. These kinds of problems can be treated.
The most important thing caregivers can do when dealing with a person who is upset is to stay calm! By creating a peaceful environment in the home, caregivers can help prevent and limit aggressive and agitated behavior. Usually, the person with Alzheimer’s disease will calm down in a few minutes if you do not bother him.
Taking Care of Yourself – Laughter for Good Health
Laughter clubs offer laughter yoga, which is a combination of yogic breathing and laughter, as a mind-body approach to wellness. Laughing is a natural cleansing process. You don’t have to be genuinely happy to reap the physical and psychological benefits of laughter. Even in the saddest situations, it will enable the body to deal with emotional pain better because unexpressed emotions are released, rather than keeping it bottled up inside. Its core premise is that your body can and knows how to laugh, regardless of what your mind has to say. Because it follows a body-mind approach to laughter, participants do not need to have a sense of humor, know jokes, or even be happy. The invitation is to “laugh for no reason”, faking it until it becomes real. Laughing is an easy way to strengthen immune functions, bring more oxygen to the body and brain, foster positive feelings and improve interpersonal skills. Visit, www.laughteryoga.org.
Memory Care-Agitation
What used to irritate the person in your care probably still will. While agitation may be a symptom of the illness, remember that you may have done something to offend the person that would have been distressing even before she became ill with Alzheimer’s. If you realize you did something that upset her, apologize. She may not understand the words, but she will understand the tone.
Safety Tips — Steps to Avoid Injury
What seems like violent behavior may be the way the person with AD is responding to changes in his brain or to events that he interprets as dangerous in some way. These might be an unfamiliar person entering the room, attempts to take something away from him, fear of being hurt, an exaggerated response to something happening. As a caregiver, it is easy to forget that what you think is a normal way to behave may seem frightening or threatening to a confused person with dementia.
Do not try to restrain the person. This could cause serious injury to both of you.
- Get out of striking distance. Step away so that he cannot reach you.
- Call for help if you need it. You can call a friend, family member, or neighbor to help you get the person calmed down. If necessary, call 911.
- Avoid creating a situation in which the person feels threatened because this can make him more upset.