Tips for Dealing with Behavior Problems in Alzheimer's Patients

Alzheimer's patients exhibit a wide array of behavioral and psychiatric problems separate from the memory loss and thinking difficulties commonly associated with Alzheimer's. These problems are not only very distressing for caregivers but also may compel caregivers to seek nursing home care for their loved ones. When patients begin to exhibit Alzheimer's behavior problems, there are a few steps caregivers can take to both alleviate and control the disturbing behaviors, which may run the gamut from emotional distress and psychosis to acting out and aggression.

First, caregivers must seek alternative explanations for the Alzheimer's behavior problems. The disease process taking place in the brain of an Alzheimer's patient offers only one explanation for the disturbing behaviors. Other preventable or controllable reasons include unrelated health difficulties, medication complications, or environmental disturbances. For example, problems may arise from physical pain that patients are unable to verbalize. A thorough medical examination with a physician who can assess pain using nonverbal clues can determine whether an Alzheimer's patient has unrelated health problems, such as a urinary tract infection or skin irritation. Also, any time an Alzheimer's patient is taking multiple medications, there exists the possibility that the drugs could interact with each other, causing physical or mental symptoms, such as psychosis. A physician can assess the possibility of medication complications. Finally, changes in environment, such as being moved to a nursing home, having relatives drop by for a visit, or becoming accustomed to a new primary caregiver, can be disorienting or frightening to a patient, leading to preventable or controllable behavior problems.

Once physicians and caregivers decide on an explanation for the Alzheimer's behavior problems, they can take two different routes toward alleviating the problem. The first route, which should always be taken first, if possible, involves modifying the environment to eliminate or control the behavior. When Alzheimer's patients are acting out, caregivers can try to distract them, talk to them calmly, offer assistance or encouragement, or allow them to make decisions about what they may need to do or change in their environment. Caregivers should not become agitated themselves, act aggressive or defensive, or try to argue with the patients. In addition to these common sense conflict resolution tools, caregivers can also try to identify and eliminate environmental triggers, such as a poorly lit hallway or loud noise from a television. The environment should be free of weapons or other dangers with safety locks on doors and windows to prevent patients from wandering. If triggers can not be eliminated, patients can still be encouraged to rest and follow a comforting daily routine.

If altering the environment does not work, medication may be a viable option. A physician can prescribe drugs that alleviate depression, anxiety, or psychosis. When taking new medications, however, there is always the danger of drug interactions or side effects, which could cause more Alzheimer's behavior problems, so patients should always be carefully monitored when beginning a new medication. In the end, it is important for caregivers to remember that behavioral and psychiatric problems are not always caused by Alzheimer's disease itself, and alternative explanations should be sought to improve the quality of life for both patients and caregivers.


*****