Alzheimer’s disease, a form of dementia, is a progressive disorder that affects memory, behavior, and cognitive abilities.

As a caregiver, it can be challenging to cope with the changes in your loved one’s behavior, especially if they begin to exhibit problem behaviors that can be disruptive, even dangerous. But understanding these behaviors and developing strategies to address them can help you and your loved one maintain a better quality of life, manage the disease, and preserve your relationship.

Aggression and agitation

Alzheimer’s can cause your loved one to feel agitated or aggressive, especially if they are confused, frustrated, or scared. These behaviors can include hitting, kicking, pushing, or throwing things. To manage these behaviors, it may help to:.

Identify and address triggers: What is causing your loved one’s agitated or aggressive behavior? It could be a specific noise, activity, or situation. Once you understand what triggers these behaviors, you can help avoid or minimize them.
Redirect their attention: If your loved one is agitated or aggressive, try changing the subject or redirecting their attention to something else, like a familiar activity or task.
Remain calm: Avoid escalating the situation by speaking calmly and reassuringly. Avoid arguing or trying to reason with your loved one, as this will likely make them more agitated.
Modify the environment: Sometimes, making changes to the environment can help reduce agitation and aggression. For example, adjusting the lighting or reducing noise levels may help.

Wandering and getting lost

People with Alzheimer’s disease may wander and get lost, which can be dangerous. To prevent this, you can:.

Ensure your home is secure: Install locks, alarms, or other safety features to prevent your loved one from wandering outside the house without supervision.
Create a routine: Establish a routine for your loved one, including regular meals, activities, and rest periods, to help them feel more secure and less likely to wander out of boredom or confusion.
Use GPS tracking devices: Consider using a GPS tracking device or bracelet that can help you locate your loved one if they wander away from home.
Inform neighbors and law enforcement: Alert neighbors and local law enforcement of your loved one’s tendency to wander and provide them with your contact information in case your loved one is found.

Hoarding or hiding possessions

People with Alzheimer’s disease may hoard or hide possessions, which can be frustrating for caregivers who need to provide care for them. To manage this problem behavior, you can:.

Provide a “safe” space: Set up an area in your home where your loved one can keep their possessions safely, like a chest or cabinet that can be locked.
Remove hazardous objects: If your loved one is hoarding dangerous or potentially harmful items, like cleaning products or sharp objects, make sure to remove them from the home.
Compromise: Negotiate with your loved one to find a solution that balances their desire to keep their possessions with the need for a safe and clean living space.
Ask for help: If hoarding or hiding becomes unmanageable, seek help from a professional caregiver or therapist for advice on how to manage the behavior.

Incontinence and hygiene issues

Alzheimer’s can cause incontinence and other hygiene-related issues, which can be unpleasant for both the caregiver and the person with Alzheimer’s. To manage these issues, you can:.

Create a routine: Establish a regular schedule for meals, bathroom breaks, and bathing to help your loved one get into a routine that can reduce the likelihood of accidents.
Consider using incontinence products: Use absorbent products, like adult diapers or pads, to help manage incontinence and maintain hygiene.
Provide reminders: If your loved one forgets to use the bathroom or maintain hygiene, provide gentle reminders or prompts to help them remember.
Talk openly: Communicate with your loved one about the importance of maintaining hygiene and provide regular encouragement and praise for their efforts. This can help them feel more confident and less embarrassed about accident.

Poor appetite and refusal to eat

Alzheimer’s can affect appetite and increase the risk of malnutrition, which can further worsen neurological and cognitive symptoms. To manage this problem, you can:.

Serve small, frequent meals: Instead of large, infrequent meals, serve small, nutrient-dense meals throughout the day to help your loved one get enough food and nutrients.
Find familiar foods: Serve foods that are familiar and easy to eat, like finger foods or soups.
Consider supplements: If your loved one is having trouble getting enough nutrition, consider giving them a multivitamin or supplement.
Be patient: Refusal to eat or loss of appetite can be frustrating, but try to remain patient and calm. Avoid forcing food and instead provide comfort and support to your loved one as they navigate this difficult behavior.

Sleep disturbances

Alzheimer’s can cause sleep disturbances, making it difficult for your loved one to sleep through the night. This can also disrupt your own sleep schedule as a caregiver. To manage this problem, you can:.

Establish a routine: Create a nightly routine that includes calming and relaxing activities, such as reading, listening to soft music or meditation, or a warm bath.
Limit daytime naps: Avoid letting your loved one nap during the day to help them feel more tired at night.
Avoid caffeine: Limit your loved one’s intake of caffeine, which can make it harder to sleep.
Consider medications: Consult with a healthcare provider to determine whether medication could help your loved one sleep better at night.

Sundowning

Sundowning is a behavior common among people with Alzheimer’s disease. It is characterized by increased confusion, restlessness, and agitation in the evening hours. To manage this behavior, you can:.

Create a soothing environment: Dimming the lights, playing calming music, or using aromatherapy techniques like lavender can help create a calming environment.
Follow a schedule: Establishing a set evening routine can help your loved one feel more calm and secure.
Minimize stimulation: Reduce the amount of activity and stimulation in the evening, such as limiting visitors or television programs that may agitate your loved one.
Provide reassurance: Speak calmly and reassure your loved one that they are safe and secure.

Communication difficulties

Alzheimer’s can cause communication difficulties, making it hard for your loved one to express their needs and emotions. To manage this difficulty, you can:.

Use simple language: Speak in short sentences and use simple, easy-to-understand language to help your loved one stay engaged in the conversation.
Use visual aids: Use visual cues, like pointing or hand gestures, to help your loved one understand what you are trying to convey.
Be patient: Allow your loved one time to process and respond to what you are saying. Avoid interrupting or finishing their sentences for them.
Encourage nonverbal communication: If your loved one is having trouble speaking, encourage them to communicate nonverbally, like through hand gestures or facial expressions.

Legal and financial issues

As Alzheimer’s progresses, your loved one may begin to have difficulty managing legal and financial matters, like making decisions about their medical care or managing their finances. To manage these issues, you can:.

Consult with a lawyer: Seek advice from a legal professional to help you and your loved one navigate legal matters, like estate planning or power of attorney.
Communicate openly: Communicate with your loved one about their wishes and desires while they are still able to make decisions. Make sure their legal and financial documents are in order, and that someone is named who can make financial decisions on their behalf if necessary.
Seek help: If your loved one requires more extensive financial management, consider hiring a professional financial manager, or consulting with a geriatric care manager who can provide expertise in managing Alzheimer’s-related issues.

Caring for Yourself

As a caregiver, it is important to take care of your own well-being as well. You may find it helpful to:.

Seek support: Join a support group or seek counseling to help you manage the stress and emotional burden of caring for a loved one with Alzheimer’s.
Take care of your health: Make sure you are getting enough rest, eating healthy, and engaging in regular exercise to maintain your own physical and emotional health.
Take breaks: Take regular breaks from caregiving to avoid burnout and maintain your own sense of well-being.
Ask for help: Don’t be afraid to ask family members or friends for help with caregiving duties, or consider hiring professional caregivers if necessary.

Conclusion

Managing problem behaviors in a loved one with Alzheimer’s disease can be challenging, but understanding the behaviors and developing strategies to address them can help improve your loved one’s quality of life and your own well-being as a caregiver. By communicating openly, establishing routines, and seeking help when necessary, you can provide the care and support your loved one needs while also managing the stress and emotional burden of caregiving.