Understanding and Responding to Challenging Behaviors in Alzheimer’s Disease

cont. from

Trailing and Checking and Alzheimer's

We know that, for many people, the experience of living with dementia makes them feel extremely insecure and anxious. A person with dementia may therefore constantly follow you or call out to check where you are. Memory loss and confusion about time means that a few moments may seem like hours to a person with dementia and they may only feel safe if you are nearby. This behavior can be very difficult to cope with.

• Try not to speak sharply. If you do it will only increase the person’s anxiety.
• Provide something absorbing for the person to do if you are busy with something else – perhaps a pet or a familiar cuddly toy or doll.
• It may be reassuring for the person to hear you hum or sing. Or, if you are in another room, perhaps put the radio on.
• Try to make sure that you have some time to yourself.

Shouting and screaming and Alzheimer's

The person may continually call out for someone or shout the same word or scream or wail over and over again. There are several possible reasons for this behavior.

• They may be in pain or ill or they may be experiencing hallucinations. If any of these possibilities seem likely, consult the GP.
• They may be lonely or distressed. If they shout out at night, a night light in the bedroom may be reassuring.
• They may be anxious about their failing memory. Try to reassure or distract them. If they are calling out for someone from their past, then talking to them about the past may be helpful.
• They may be bored. Everyone needs to be occupied, including people with dementia. Listening to music together or giving the person a gentle hand massage are just some of the things that people have found helpful.
• There may be too much noise and bustle. They may need a quieter environment.
• It may be the result of brain damage due to dementia. Ask your GP to refer the person to a specialist if you think that this is the case.

Laughing and crying and Alzheimer's

The person may laugh or cry uncontrollably for no apparent reason.

• This may be associated with hallucinations or delusions (seeing or hearing people or things that are not there, or believing things that are not true). If you think that this may be the case consult the GP.
• This may be due to the effects of brain damage. It is more common among people who have vascular dementia. It does not necessarily mean that the person is very sad or very happy. They may prefer you to ignore these episodes. On the other hand they may respond to reassurance.

Lack of inhibition and Alzheimer's

The person may behave in a way that other people find embarrassing due to their failing memory and general confusion. In a few cases it may be due to specific damage to the brain. Try to react calmly.

• Undressing or appearing naked in public may simply indicate that the person has forgotten when and where it is appropriate to remove their clothes. Take them somewhere private and check whether they are too hot or are uncomfortable or whether they want to use the toilet.
• Lifting a skirt or fiddling with flies may be a sign that the person wants to use the toilet.
• If a person starts to stroke their genitals in public, discourage them tactfully and try to distract their attention. If such behavior is frequent or persistent, consult the GP.
• If the person behaves rudely – for example, by insulting people or swearing or spitting – do not attempt to argue or correct them. Try to distract their attention. You can explain to other people later that their behavior is due to the dementia and is not directed at them personally.

continue: Pacing, Fidgeting, Suspicion

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Reviewed: 03/2006