Alzheimer’s disease affects the brain and its function. As Alzheimer’s disease progresses behavior problems become more common. It is important for family members and caregivers to understand these common behavioral problems in order to become better equipped to handle them if or when the Alzheimer’s patient begins to exhibit them.

1. Agitation – An Alzheimer’s patient may feel anxiety or agitation which can cause restlessness or pacing. The patient may exhibit agitation related to specific triggers, such as certain places, topics, or people. It is important for caregivers to first try to identify what is causing the agitation and rule out physical pain or discomfort. Once these things are ruled out, the caregiver should try to remain calm and identify the trigger. If the trigger can be removed that is the best option. However, if the trigger cannot be removed, the caregiver should try to speak calmly and create a calm environment. Changing the subject or providing a distraction can also be helpful when the Alzheimer’s patient becomes agitated. Physical activity has so many benefits and in the case of agitation exercise, like taking a walk, can provide a necessary distraction to remove the patient from the environment where the agitation is occurring. Caregivers should always remember to remain patient in these situations.

2. Aggression – Becoming aggressive is another behavioral problem of an Alzheimer’s patient. The patient may become verbally or physically aggressive toward family members or caregivers. This could include cursing, insulting, screaming, throwing things, hitting, or pushing. These behaviors can be very difficult to handle as they come suddenly and often without warning. Just as with agitation, the caregiver must first rule out pain or physical discomfort as a cause. If these are the cause, the caregiver must give attention to the pain and find out how it needs to be dealt with. If physical pain is not the trigger, it may be environmental, it may stem from frustration, feeling lost, or being unable to communicate. The caregiver must remain patient and calm. Try to learn possible triggers. Never argue or add to the confusion the Alzheimer’s patient may be feeling. Many sources recommend focusing on the past which can be calming since Alzheimer’s disease affects short-term memory. It can help to remember it is the disease causing these behaviors not the person.

3. Sleep Issues and Sundowning – Alzheimer’s patients often experience problems with sleep and suffer from a condition called sundowning. Sundowning is when an Alzheimer’s patient displays more behavior problems as the sun goes down. The patient may have more aggression, agitation, or anxiety during this time. Many Alzheimer’s patients experience sleep issues causing them to be restless and wander more at night. Caregivers can help these issues by making sure the Alzheimer’s patient is not napping too much during the day. It helps to maintain a schedule and keep the patient active without overstimulating them. Avoiding stimulants and creating a calm atmosphere in the evening hours are ways to help with these issues.

4. Hallucinations and Delusions – Alzheimer’s patients may experience hallucinations, seeing things that are not there, or delusions, believing things that are not true. These behaviors are more common in late stage Alzheimer’s patients and are very difficult for the caregiver. As with all behavioral problems, it is very important for caregivers to be patient. These behaviors often come from fear the Alzheimer’s patient feels. Assess the situation to be sure that hallucinations are not a danger to the patient or you. Never argue with the patient. Instead try distractions or removing the patient from the environment. It may also be necessary to alter the environment to help hallucinations. When an Alzheimer’s patient experiences delusions, they may accuse family members or caregivers of things such as stealing or infidelity. The best way to cope with these behaviors is to remain calm, don’t argue, and don’t take offense. Distracting the Alzheimer’s patient with something else can help. If the accusation is theft, the caregiver can produce the item in question. This can be difficult and hurtful for family and caregivers, but remember it is the disease talking.

These are four of the common behavioral problems Alzheimer’s patients may exhibit, but the disease is different for everyone. Caregivers can be more prepared for these problems by educating themselves about the problem and coping strategies.

If you have any questions about something you have read or would like additional information, please feel free to contact us at 760-642-7072.

Yvonne Amrine   

191 Calle Magdalena, Suite 270, Encinitas, CA 92024