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As if it weren’t enough to deal
with forgetfulness and confusion while caring for your loved-one
with Alzheimer’s, but aggressiveness, wandering and paranoia can
really put you over the edge. Managing your loved-one’s difficult
behavior is your true testament of love and devotion. You know it
isn’t their fault, it is their disease that is making them scream,
cry or yell terrible things out at you. Who ever said patience is a
virtue, didn’t care for a loved-one with Alzheimer’s or dementia.
Perhaps a caregiver’s only defense is to understand how to react to
difficult behaviors and be ready for them.
Difficult behaviors can be broken down
into the following categories: Wandering, Sleeping and Eating Problems,
Agitation, Paranoia and difficulty with personal tasks. This is not to
say these categories are the only forms of behavioral problems displayed
by people living with Alzheimer’s, but their remedies may intersect
other problems.
Wandering is not an uncommon hallmark
of Alzheimer’s disease or dementia. Stress in the variety of noise,
clutter or crowding can cause your loved-one to wander. The best idea is
to reduce excess stress. A person living with Alzheimer’s disease should
be settled in a quiet, clean, and spacious environment. This will
eliminate many of the unwanted stressors, which could cause your
loved-one to wander. Other reasons why your loved-one may wander
include: Feelings of being lost, boredom, need to use the restroom or
medication side effects.
In order to prevent your loved-one
from feeling lost or foreign to his or her environment, provide them
with familiar objects and reassure them quite frequently that they are
at home or in a safe place. Maybe a family photo or an award he or she
has won always jogs their memory so keep it close by. If your loved-one
displays signs of boredom, give them a task of limited difficulty. This
will keep them entertained but won’t frustrate them. Folding laundry is
a great activity for people living with Alzheimer’s or dementia.
It is possible that your loved-one is
wandering because they need to use the bathroom. In which case, place
elaborate signs or pictures on bathroom doors to help guide them. Also,
it is a good idea for you to implement regular toilet times. This will
keep both of you on schedule. If your loved-one is wandering due to
medication side effects, contact their physician to initiate a change in
prescription or to lower the dosage. Wandering can be a dangerous
behavior. Caregivers should contact their local Alzheimer’s Association
to obtain information about ‘The Wanderers Program’ in their area.
People living with Alzheimer’s or
dementia often experience sleeping and eating problems. Common causes
for these problems include: discomfort, medication, pain, dehydration,
depression and excessive sleeping or eating.
Feeling discomfort can sometimes not
be conveyed by your loved-one depending upon the severity of the disease
but it can cause eating and sleeping disturbances. Frequently monitor
your loved-one’s room temperature, lighting, noise level, and chair or
bed position. If you think your loved-one’s medications could be curbing
his or her appetite or ability to sleep, speak to their doctor about
changing or eliminating prescriptions.
Pain can be a factor in eating or
sleeping disturbances. Again, sometimes a person with Alzheimer’s or
dementia cannot express their feelings; if you sense a change in
appetite or sleeping pattern has suddenly occurred without due cause,
set an appointment for a medical examination. Dehydration is a known
factor of sleeping and eating disturbances. Make sure your loved-one is
drinking plenty of water. Place a pitcher filled with water near your
loved-one at all times. Remind them it is there frequently and check to
make sure it remains somewhat full. Too full can result in another
problem- slip and falls.
If you feel your loved-one is showing
signs of depression, have him or her evaluated by their physician.
Anti-depressants or bedtime sedatives may be a productive treatment
option. Depression can also cause excessive sleeping or eating. In which
case, increase their exposure to light and reduce or eliminate nap time
or snack time.
Defined:
Behavioral problems are defined as patient responses, which are considered
noxious to staff, other patients, the patient himself, or family (Burgio,
Jones, Butler, & Engel, l988). Behavioral problems have a profound
impact on quality of care, staff, morale and the day-to-day operation of
the long-term care institution
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