Alzheimer’s – Steps to Avoid Injury
People with Alzheimer’s disease (AD) may get upset when somebody touches them. You may be trying to do something to help him, but he doesn’t understand what’s going on. He may be feeling uncomfortable, powerless, frightened, tired, in pain, or confused. He cannot say how he wants to be treated.
Your decisions will be easier to carry out if the person with dementia is aware of the diagnosis and understands that he will not be able to do things he did in the past. However, often the person denies the changes and resists your efforts to limit his activities—whether it be driving, using public transportation alone, using power tools or cooking. The doctor, family members, friends, or neighbors may be able to help you work around the problem. For example, friends or family may offer to drive you and him where you need to go or perform other activities without mentioning that it is because the person is no longer able to do them.
Physically Aggressive Behavior
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. This behavior can be frightening. These behaviors are probably an indication that the person with AD is upset about some need not being met, such as a physical need—comfort, pain, hunger or an emotional need such as boredom, fear or sadness.
Violent behavior may be the way this person is responding to changes in his brain or to events that he doesn’t understand and interprets as dangerous. 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 suddenly, not knowing how to express anger appropriately, or just an effort to avoid complying with a demand.
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. Usually, the person with Alzheimer’s will calm down in a few minutes if you do not fight back or you can redirect him.
Steps to Avoid Injury
Don’t try to restrain the person. This could cause serious injury to both of you.
1. Get out of striking distance. Step away so that he cannot reach you.
2. 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 you have to, you can also call 911 or your local emergency number.
3. Try to avoid creating a situation in which the person with AD will feel threatened because this will only make him more upset. When things have calmed down, figure out what has set the person off using the ABC method below.
The ABC Way to Understand Alzheimer’s Behavior
A person with Alzheimer’s disease may sometimes act in ways that are aggressive. He or she may hit, scratch, or fight with the caregiver. This does not always happen. If this does happen, it is likely to be when the person is in the middle stage of Alzheimer’s disease.
These actions can be upsetting and are often hard for caregivers to manage. It helps to have a plan. One that many people find easy to remember is called ABC. Here is what this means:
- A means Antecedent. This refers to events that happen just before an upsetting action.
- B is the Behavior. This means any upsetting or aggressive action done by the person who has Alzheimer’s disease.
- C refers to the Consequence. This includes events that happen after the behavior. Sometimes, these events can make the situation worse.
Source: The Comfort of Home for Alzheimer’s Disease: A Guide for Caregivers
NOTE
The most important thing to remember is to treat the person with dignity and respect. Avoid talking down to the person or talking to others as if he or she is not there. At all times be aware of your tone of voice and body language. Do not use the kind of high pitch that people sometimes use in speaking to children. Try to lower your pitch and sound and to be relaxed. Try not to be bossy or intimidating or stand over the person if he is sitting down. The person in your care may not understand your words, but he may nevertheless respond to the tone of your voice or your posture and will intuitively decide whether to respond to you as friend or foe.
Memory Care- Paranoia
Paranoia in people with AD appears as unrealistic beliefs, usually of someone seeking to do them harm. They may hoard or hide things because they believe someone is trying to take their possessions. These symptoms can be very distressing both for the person with AD and for you. Remember, what the person is experiencing is very real to him. It is best not to disagree. Try not to take it personally. In this situation it is best to offer to help the person to find the missing item. It will not be helpful to try to convince him that his explanation is wrong or based on his poor memory.
Taking Care of Yourself- Feeling Invisible
“Why doesn’t anyone ask how I am doing?” It is easy to feel invisible, as if no one can see you. Everyone’s attention is on the person with the illness, and they don’t seem to understand what the caregiver is going through. Many caregivers say that nobody even asks how they’re doing. Mental health experts say it’s not wise to let feelings of neglect build up. Caregivers need to speak up and tell other people what they need and how they feel. Support groups, religious or spiritual advisors, or mental health counselors can teach you new and positive ways to express your own need for help.
Safety Tips – Dementia and Gun Safety
Put a plan in place as soon as a diagnosis is made, just as you might plan to remove a driver’s license or a checkbook. A person with AD should not have access to guns. Depression is common among those with dementia and can increase the risk of suicide, especially if there is access to a firearm. Dementia affects one’s ability to control emotions, which can result in bursts of unpredictable anger. In the early stages of the disease, include the person in the conversation. If the person is too confused for a discussion, it may be time to just confiscate the gun.
- Don’t simply remove bullets or disable the gun. Police officers will not be aware that the firearm is disabled and they could injure anyone holding it.
- Remove holsters and other reminders of the gun.
Law enforcement and the doctor may provide advice. The Alzheimer’s Association has counselors available 24/7: 1-800-272-3900. It offers guidance on how to minimize risks associated with firearms in homes where a person has dementia. Visit www.alz.org and search Safety and the Right to Bear Arms.
May is Older Americans Month
This year’s theme, Flip the Script on Aging, celebrates the contributions of older adults and challenges outdated stereotypes. Join us in honoring the strength, resilience, and impact of older adults in our communities.
