Updated January 29, 2024
Problem Behaviors in Alzheimer's Disease
What this section covers:
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Why problem behaviors occur in Alzheimer’s disease
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Prevention of problem behaviors
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What to do when problem behaviors develop: initial troubleshooting
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Managing psychiatric issues
Apathy and social withdrawal
Anxiety
Depression
Sexual problems Insomnia
Paranoia and other delusions Hallucinations
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Managing issues regarding activities of daily living
Unsafe driving
Bathing problems
Dressing problems
Feeding problems
Incontinence and toileting
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Managing specific problem behaviors
Repeating the question
Clinging and following
Hiding things
Rummaging and hoarding Wandering
Disruptive vocalizations
Agitation and sundowning
Aggression
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​Key Points
Why problem behaviors occur in Alzheimer’s Disease (AD)
As discussed in the section on Dementia, people with AD lack insight into their declining abilities, even in the early stages. What this means in practical terms is that many will try to continue functioning as they always have, except that they lack the cognitive skills to do so. They may insist on driving the car, not remembering that their license has been revoked because of accidents. They may misplace personal items and then blame others, or start to hide things to protect their belongings from imagined thieves. Brain function deteriorates further, and other abilities like communication and self-regulation decline, so that they have increasing difficulty meeting social and functional expectations, and this is frustrating for everyone. In later stages of the disease, they may confuse past and present and wrongly identify people living in their own home.
As AD progresses, the world becomes less familiar and may seem more threatening to your loved one.
It is up to family, friends, and caregivers to figure out ways to reduce stress for those affected by AD. When the condition is managed well, the quality of life can be greatly improved, not only for the patient, but for everyone involved.
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To this end, there is one overriding principle that needs to be acknowledged right up front:
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If the brain doesn't work, no amount of argument or scolding will make it work.
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It’s a mistake to think that your loved one (the patient) will be able to correct their own bad behaviors. That job — for better or for worse — falls to the primary caregiver, family, and others. This will require changes, both in the attitudes of caregivers and in the home environment.
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Accepting that this is true goes a long way towards making the situation better.
What this section will try to convey to you is that you can do this! Armed with information and tips described here, you can master the problems and issues that arise, and even become an expert yourself.
Prevention of Problem Behaviors
The first order of business in the prevention of problem behaviors is to consider the following question: what is daily life like for your loved one? Think about the home environment, about how communication works between the patient and caregivers, and about activities. Is the environment contributing to confusion? Is it safe? Is there anything happening that interests the patient? Does he or she have events to look forward to?
The environment
Those experienced in the care of persons with AD have shared lots of advice and practical tips on how to make the home environment safe and non-threatening for your loved one. Some should be implemented early, and others later, as the disease progresses. A selected list is shown below.
These are tried-and- true interventions that will end up saving you a load of grief later, as decline continues. ​
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Reduce clutter around the house. Make things as simple as possible.
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Reduce background noise as far as possible.
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Open the curtains during the daytime, and use indoor lights on cloudy days.
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Consider removing mirrors from the patient’s living areas; mirrors can induce delusions (false beliefs) in later disease stages.
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Use night lights to reduce confusion at night and to light the way to the bathroom.
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Avoid spotlights and motion-activated lights; these are disorienting and may cause falls.
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Remove obstacles on the floor and walkway. Get rid of flimsy area rugs, which tend to wrinkle or bunch up and cause falls.
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Clearly mark raised thresholds that must be stepped over.
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Provide a simplified telephone with large buttons and photos.
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Consider getting a locking microwave oven.
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Install “off” switches on the electric stove and oven.
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For gas appliances, contact the gas company for recommendations.
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Install a locking cover on the thermostat.
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Install cabinet and drawer locks for contents posing a danger (guns, knives).
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Tack pictures to cabinets and drawers showing contents to help in locating things and prevent rummaging. Many helpful labeling options are available on Etsy.
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Make sure that all stairs have handrails and that showers and toilets have grab bars.
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Consider safety gates for stairs.
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Consider installing a room monitor so you can keep track of your loved one while doing your own chores.
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Consider buying a watch or other device with a GPS locator. This will be of high value in the case of wandering in later stages of AD.
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Use sturdy chairs with arms.
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Consider installing locks on exterior doors to prevent unsupervised walks. These locks should be placed high up on the door, out of easy reach.
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Ensure the adequacy of yard fencing (at least 6 feet high).
If all of this sounds overwhelming, there are resources available to help. Your Area Agency on Aging can supply referrals for occupational and physical therapists to assist you with these modifications. In addition, the National Association of Home Builders can help you locate a Certified Aging in Place Specialist for more extensive changes. The Alzheimer's Association also has a lengthy list of valuable resources. These resources can be found on the home page of this website.
Communication
Some variants of Alzheimer’s disease are associated with a significant language problem from early stages, and all variants have language affected in later stages. Clear communication requires several strategies on the part of caregivers. Let’s look at some examples to make this point.
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The woman at right is having physical therapy.
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What the therapist said: “I need you to pick your feet up.”
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What the patient “heard”: “I’m… peet… up.”
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The first rule of clear communication is to use short sentences.
The therapist could say instead, “Pick up your feet!”
At the same time, she could demonstrate with her own feet.
This one requires more skill.
What the patient said: "You ban tip roger that.”
What the patient meant: "You look like my daughter.”
In this case — fortunately — the aide was tuned into his facial expression, and knew him well enough that she could tell he was trying to say something meaningful to her. Instead of telling him she couldn’t understand, she went with the feeling he was trying to convey. The encounter was thereby changed from a frustrating one to a bonding experience.
Many caregivers have reported that their loved one begins to develop his own language, substituting nonsense words for what they want to say. For example, one patient started using the word “mish” for “food.” He used “mish” consistently, so the caregiver just added it to her vocabulary. Problem solved.
How to talk to the patient with Alzheimer’s disease
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Approach from the front so he can see you coming.
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Use short, simple sentences.
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Use gestures and demonstrate what you mean.
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Allow the patient time to respond.
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Get to know that person’s “language.”
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Watch non-verbal communications:
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What is the emotion?
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How is the patient looking at you?
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What does his body language say?
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Life enrichment
The principles of Brain Fitness apply to those with Alzheimer’s disease just as they do to everyone else. A variety of stimuli and activities will help preserve brain functions not yet affected by the disease. It’s a big mistake to assume that because someone is known to have dementia, it’s okay to let them sit with nothing to do.
In early stages of the disease, activities will likely be the same as usual, provided memory and language are not overly challenged. It’s important to demonstrate competency wherever it exists, and to praise where appropriate.
As the disease progresses, activities will change accordingly. It’s still important for the person affected to interact socially with family and friends, to listen to preferred music, to exercise, to attend church services, and to have outdoor activities such as walks and picnics. Even a trip to the grocery or hardware store can provide needed stimulation.
In later disease stages, these activities will necessarily be more supervised. Consider enrolling your loved one in a day program, where staff are experienced in providing stage-appropriate events. These kinds of programs vary greatly in cost and among geographic regions, so contacting your local Area Agency on Aging may be able to help you sort this out. See the home page of this website.
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Putting together a daily schedule in writing can help you and your loved one by identifying when activities are needed and when rest is indicated (for both of you).
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Looking at the schedule can show your loved one that the day ahead will not just be a wasteland of inactivity, and give him or her something to look forward to. This can also help with the frequent question of “What am I supposed to be doing?” When asked, you can remind them to look at the schedule.
Empathy (entering your loved one’s world)
Douglas B. Was an 86-year-old male with later-stage Alzheimer’s disease living in a care home who began to disrupt the unit routine by insisting on standing just inside the entry door. This was a locked facility, and his presence there represented an elopement risk. He was encouraged again and again to stay away from the door, without success. Finally, an aide asked him what he was doing.
“I’m waiting for my mother,” he said.
The aide wisely played along.
“Is she bringing something in for you?”
“My shoes,” he said. “I need them for the dance.”
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Let’s pause for a moment to ask: How would you approach this? Would you try to reorient Douglas B.? Would you break the news that his mother is no longer alive? Is there any harm in playing along? If you put yourself in Douglas B.’s shoes, what would you like to hear?
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The aide talked to Douglas B. about the dance and who he was going to see there. They went to his room to find another pair of shoes, which he put on, and they did a few twirls. She told him she would let him know as soon as his mom arrived, but in the meantime, he might consider practicing with the shoes he had.
What to do when problem behaviors develop: initial troubleshooting
When behavioral issues arise in later disease stages, your loved one may not be able to tell you if something is wrong. It may be up to you to figure that out.
Arthur N. Was a 92-year-old male with late-stage Alzheimer’s disease who decided to start using another patient’s walker. The other patient was not pleased, and the two nearly came to blows. Arthur was seen to be moaning and grimacing, but he would not sit down, and he would not give up the walker.
How would you deal with this? In troubleshooting, there are a few standard questions that should be addressed first:
Question 1: is the patient in pain?
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Sudden change in physical status (walking, speaking, eating).
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Pain behaviors: rubbing a sore leg, grimacing, moaning, limping.
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Make a tentative diagnosis with the help of the primary care doctor.
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Treat the cause, if possible.
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Trial of acetaminophen (Tylenol) or other medication around the clock.
Question 2: is the patient delirious?
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Acute confusion, agitation, hallucinations.
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Needs medical attention!
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Poor outcome when not treated.
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These issues are covered in detail in the section on Delirium.
Question 3: could this be akathisia?
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A medication side effect.
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Agitation, usually in the form of pacing.
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Patient feels like jumping out of his own skin.
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Stop the drug or lower the dose.
Question 4: Could there be some other medical or physical problem?
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Constipation
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Dehydration (see skin check at right)
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Urinary tract infection (especially women)
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Side effect of medication(s)
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Heart or kidney problems
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Clinical depression, anxiety
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Nicotine withdrawal
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Alcohol withdrawal
A visit to your loved one’s primary care physician could help sort this out. If this doesn’t get results, consider psychiatric issues, as discussed below.
In the case of Arthur N., pain was an issue, and pain made him agitated. When the pain was treated, he calmed down sufficiently that he could listen to staff, and was able to accept and start using his own walker.
Managing psychiatric issues
Apathy and social withdrawal
Apathy — loss of interest and motivation — is the most common psychiatric problem that can emerge in the course of Alzheimer’s disease. It is not only distressing for the caregiver, but significantly reduces the quality of life for the patient. Apathy overlaps with depression, but it is not the same, as it does not involve feelings of hopelessness, sadness, or guilt. The two may occur together, however, and if depression is present, it should be treated as usual.
Other interventions that may be helpful in treating apathy:
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Aerobic exercise
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Music
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Art therapy
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Cognitive stimulation games and exercises
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Sensory stimulation
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Cholinesterase inhibitors (e.g., donepezil)
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Stimulant medications (e.g., methylphenidate)
Anxiety
This is common in all stages of Alzheimer’s disease, and when persistent, can negatively affect all aspects of life. Depression also frequently accompanies anxiety, so an evaluation for depression is needed. Newly developing anxiety can sometimes signal the presence of a physical illness such as pneumonia or hyperthyroidism.
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Symptoms of anxiety are worsened by loss or change. Individuals suffering from Alzheimer’s disease can be very sensitive to the emotional state of caregivers and others in the household, so the first thing to do is take a step back and calm yourself. Ask the patient if they are worried, and take time to let them respond. Provide reassurance in a matter-of-fact way. As far as possible, remove stressors to ensure a calm environment. Medication may be useful, as discussed in the lecture on Anxiety Disorders.
Depression
This is a brain disorder that cannot be “willed away,” as discussed in the lecture on Depression. Symptoms include irritability, worry, refusal of care, social withdrawal, loss of pleasure, guilty feelings, and changes in functions such as eating, sleeping, and walking. Memory problems can get acutely worse. It’s important to note that the depressed patient might not report sadness, so avoid using that as an indicator.
A visit to the primary care clinician should be scheduled. In the meantime, make your own assessment as to whether there is a risk of suicide; this will be assessed again at the clinician appointment. Watch oral intake to make sure dehydration and/or constipation don’t develop. Medication may be prescribed, with SSRI antidepressants being the drugs of choice. Depression in this context might be difficult to treat; more than one antidepressant might be needed.
Sexual problems
It might surprise you how often sexual problems arise in patients with Alzheimer’s disease, particularly in middle to late stages. Caregivers may find that their loved one has a new and unremitting desire for sex that is not welcome. Alternatively, patients may lose all interest in sex.
Behaviors such as exhibitionism, public masturbation, and inappropriate touching of others are not uncommon. Continual requests for sex can be dealt with by providing distracting activities. For exhibitionism and public masturbation, sweatpants that are not easily untied can be used. Inappropriate touching can be managed by educating caregivers, changing caregivers (e.g., from female to male), behavior modification, and/or medication. Consultation with an experienced clinician is advised.
Insomnia
In middle to late disease stages, nighttime restlessness is common. The patient may wander, rummage, or even decide to start cooking. It’s important to ensure that the environment is free of safety hazards, as discussed above. Sleep hygiene measures should be used, as detailed in the lecture on Insomnia. The patient should be kept active during the day, and daytime napping should be avoided. As a last resort, sleep medications could be used.
Paranoia and other delusions
False beliefs may drive behavior to a significant degree in later disease stages. When beliefs are benign — for example, “My mother is coming to drop off my shoes” — distraction is indicated.
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When beliefs are not so benign, as when the patient develops the idea that he or she is being held captive, consultation with an experienced clinician may be needed. Antipsychotic medication, while effective, is associated with a high rate of side effects and even mortality in elders.
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Remember this rule: never try to argue with a delusional person.
Hallucinations
Visual and auditory hallucinations are common in dementia with Lewy bodies and in later stages of Alzheimer’s disease, as noted in the section on Dementia. It’s important to reassure the patient about these frightening experiences. You might tell them, “I don’t see what you’re seeing, but I promise you I will
keep you safe.” Distraction and relocation to a more neutral place should be tried. A visit to the primary clinician is indicated. Antipsychotic medication may be needed if the hallucinations are affecting the patient’s quality of life.
Managing issues regarding activities of daily living
Unsafe driving
For many individuals suffering from Alzheimer’s disease and their families, this is the single most difficult challenge faced. Driving is a complex skill involving a variety of cognitive and motor functions, and the onset of Alzheimer’s disease symptoms should raise a big red flag in this area. But because driving represents freedom and independence to so many people, taking away the right to drive is a very big step.
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Significant impairment in driving may be seen early in the disease, when the patient denies any problems, and is still able to get around efforts to keep them from driving. It’s important for family members and caregivers to observe driving early and consistently.
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The Alzheimer’s Association lists the following signs of unsafe driving:
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Forgetting how to locate familiar places
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Failing to observe traffic signs
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Making slow or poor decisions in traffic
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Driving at an inappropriate speed
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Becoming angry or confused while driving
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Hitting curbs
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Using poor lane control
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Making errors at intersections
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Confusing the brake and gas pedals
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Returning from a routine drive later than usual
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Forgetting the destination during the trip
This issue often divides families. If you find yourself in the position in which one family member disagrees that driving should stop, ask that person whether he or she would be comfortable having their own child or grandchild ride in the car with the patient. Sometimes this helps them to understand the risk the patient poses to others out on the road.
It may be necessary to involve the primary care clinician in the decision as to when driving should stop. Often, the doctor can be the “bad guy” who insists that the car keys be surrendered. If this doesn’t work, the patient should undergo a formal driving evaluation. This can be arranged through the Alzheimer’s Association’s Dementia and Driving program. When keys are surrendered, the patient will likely need extra moral support. In addition, it is imperative that other means of transportation be provided so the patient’s quality of life does not deteriorate.
Other interventions to keep the patient from driving include relocating or selling the car, or disabling the car (e.g., by disconnecting the battery). Experience suggests that these interventions can be so adversarial that some family members give up and decide to let the patient drive, but this is one issue for which “giving in” to the patient is not reasonable. If the argument that this endangers the lives of other people is not enough, consider what the legal consequences might be of driving with a documented diagnosis of dementia, should an accident occur.
Bathing Problems
Bathing can become a battle for patients who have forgotten their usual routines, become apathetic, and/or lost their sense of smell. If resistance to bathing is continually confronted, a “standoff” might be reached, with lasting difficulties.
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It may be possible to avoid this problem through careful planning and involving your loved one in the decision-making. It is certainly possible to make bath time more enjoyable for all involved. ​
Suggestions to consider include the following:
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Let the patient choose whether to have baths or showers.
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Prepare needed items before bringing the patient to the bathroom.
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Respect the patient’s privacy.
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Give instructions 1 step at a time.
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Hand them the washcloth & then the soap.
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Keep the bathroom and bathwater warm.
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Avoid water spray to the face.
Dressing Problems
As Alzheimer’s disease progresses, dressing may become bewildering and upsetting to the patient. This is also something that can be handled proactively, given suggestions such as the following from the Alzheimer’s Association:
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Simplify clothing choices. Clear out the patient’s closet except for a few outfits. Offer a choice of 2 outfits for the following day.
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Set out clothing in the order it will be put on.
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Choose simple, comfortable clothing that is easy-on and easy-off.
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Shoes should have non-slip soles.
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If the patient wants to wear the same outfit every day, buy duplicates if possible so that clothes can be kept clean.
Feeding Problems
In later stages of Alzheimer’s disease, significant weight loss is common, and the potential for undernutrition can’t be ignored. Meals can become another battleground, marked by high stress and catastrophic reactions. Loss of sense of taste and swallowing difficulties contribute to this problem, but an important factor that can be modified is how the meal is set up.
Suggestions to consider for meals:
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Ensure that the dining area is quiet and uncluttered.
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Set the table with one plate, one placemat, and one utensil.
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If the patient can’t cut his own food, cut it in the kitchen before bringing it to the table.
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Give one food at a time in a small portion.
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Watch to be sure the food is swallowed rather than held in the mouth.
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Use foods that can be picked up (“finger foods”) as much as possible.
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Between meals, have snacks and drinks in sight and within reach.
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Don’t ask your loved one if he is thirsty; just bring a drink every few hours and put it in his hands.
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If he refuses to take a bite of food that’s offered, try putting something sweet like honey on the tip of the spoon.
Incontinence and Toileting
In later stages of Alzheimer’s disease, loss of control of bladder and bowel is common, if not universal. “Accidents” can occur earlier, when the patient is distracted, can’t find the bathroom or manage complicated zippers, or doesn’t recognize the toilet and how to use it.
At some point, it will be necessary to establish a toileting routine (e.g., bring them to the toilet every 2-3 hours) to prevent incontinence. Other tips include simplifying clothing choices (e.g., pull-on pants without zippers), using pants liners like Depends, and planning ahead when you’re going to be away from home by limiting fluids and avoiding diuretics like caffeine.
Some caregivers have found it helpful to place a sign next to the toilet showing the steps of using the toilet, as shown in the picture at left.
Incontinence does not have to result in placement of the patient in a care facility, although for many caregivers, the change in quality of the home environment when incontinence develops does dictate the need for more assistance.
Managing specific problem behaviors
Repeating the question
This is a common behavior, even in the early stages of the disease. Many caregivers report that this behavior is the most bothersome – the one that drives them crazy. The patient may be feeling unsure, or be bored, and does not recall asking the question previously.
To deal with this behavior, try to read between the lines of what is being asked. In some cases, reassurance is in order. In others, distraction with other activities is needed. Consider writing the answer on a cue card and giving it to the patient to keep. Then when he or she asks again, you can suggest that they look at the cue card. A written schedule of that day’s activities can serve the same purpose, even when it only contains routine entries like “brush teeth.”
The caregiver who finds their temper growing short with repeated questioning should remember one of the cardinal rules of caregiving: respite (a rest) from caregiving duties is needed for a short time every day, and for a longer time (a whole day) every week. This is the minimum needed to prevent burnout.
Clinging and following
When the patient feels unsure, and believes that the caregiver is their only security, he or she might cling and follow that caregiver to an annoying degree.
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Distraction helps. Give the patient a task to perform on their own, like folding laundry. Recruit another family member or caregiver to engage the patient in an activity like a walk or helping in the kitchen.
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Childproof doorknobs can keep the patient out of the toilet area. Again, time away (respite time) helps greatly with tolerance for this behavior.
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Ear buds or headphones for the caregiver can restore private time to some extent.
Hiding things
This behavior arises mostly from absent-mindedness and forgetfulness, but can worsen if the patient becomes acutely confused. In some cases, when the items hidden are of value, it may be driven by paranoia about theft. Often, the patient will forget where something was hidden and report it stolen. Be careful not to accept a report like this in situations where outside caregivers are in the home. When something is missing, assume it hidden until proven otherwise.
There are several things that can be done to prevent and to manage this problem behavior:
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Clear away clutter to limit hiding places.
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Change the cleaning routine to include checking drawers and cabinets that are little used.
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Remove valuables to a safe place (home safe or safety deposit box).
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Make spare copies of important keys.
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Check wastebaskets before emptying them into the trash.
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Consider using remote control finders such as Tile or Key Finder.
Rummaging and hoarding
These are later-stage behaviors that involve persistent looking through and rearranging things (rummaging) or collecting things that are usually considered worthless (hoarding). Even people who have never had problems discarding unused things can develop hoarding behaviors as the disease progresses.
Rummaging becomes a particular problem in group living situations where the patient is going through things belonging to other people. In addition, valuable things can be lost in the rubble created.
One intervention that may be helpful is to create a small, safe area where rummaging and hoarding can be done without problems. This could be a closet or an alcove stocked with items that look interesting but are not valuable. It will still be necessary to check other hiding places routinely, and to provide other activities and stimulation for your loved one.
Wandering
If your loved one starts to wander outside the home, the risk of them getting lost or being injured means that urgent action is needed. It might be helpful to try to figure out why they are wandering. Are they bored? Are they looking for the bathroom? Do they have the idea that they’re supposed to meet someone? Often, you will find that wandering behavior is the result of a feeling that they have lost something (as they have), but they can’t articulate what they’ve lost.
Wandering is a serious problem for patients with later-stage Alzheimer’s disease who are unable to manage the problem of getting lost and finding their way home. The patient who starts to wander can no longer live alone.
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The following interventions may be helpful:
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Provide an ID bracelet that identifies the patient as having Alzheimer’s disease and includes contact phone numbers and address.
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Pocket cards can serve a similar purpose, but are more likely to be lost.
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If the patient is only alone during the daytime hours, a day program might solve the problem.
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For those living with family or caregivers, competing activities and exercise can help keep wandering to a minimum.
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Any planned move to a different address should involve consideration of the potential for wandering, as this is often when the problem begins or worsens.
Disruptive vocalizations
In moderate to severe disease stages, disruptive vocalizations may begin. These involve repetitive calling of a name, pleas for help, or “nonsense” syllables. A sundowning pattern, with vocalizations starting up in the evening hours, is common. These vocalizations, like those of a crying baby, can be extremely distressing to those within hearing. If the patient is in a care facility, other patients may retaliate by striking the patient or shunning and isolating the patient.
It may be useful to think of these vocalizations as a message. The patient might be needing attention or stimulation, be uncomfortable (e.g., in pain, hungry, thirsty, wet), or be anxious or afraid (if delusional or hallucinating).
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Suggestions for dealing with disruptive vocalizations include the following:
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Frequent toileting, on a schedule.
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Ensuring that the patient has glasses and hearing aids in place.
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Snacks left out for the patient to eat between meals.
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Afternoon naps.
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Scheduled activities for distraction during busy times, such as change of shift in the care facility.
Medications that can be useful to reduce disruptive vocalizations include SSRI antidepressants, trazodone, and beta blockers. Atypical antipsychotics could be used, but are associated with increased mortality in this population.
Agitation and sundowning
Agitation is overactivity with no obvious purpose, often involving pacing, fidgeting, or vocalizing. Agitation can occur in the evening in a sundowning pattern, be provoked, or occur at random times.
When agitation occurs, it is well worth your time to pause and observe:
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What are the specific agitated behaviors?
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What happened just before they started?
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What made them better?
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What made them worse?
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Are there patterns? (e.g., mealtime, change of shift)
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Once you’ve made your observations, you may find that you have an obvious target for intervention. Maybe the patient should be in her room during change of shift. Or maybe you see that she becomes agitated when she is rushed during personal care. All triggers should be eliminated as far as possible. Depression, delusions, hallucinations, and pain should be treated.
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Medications can be helpful for agitation, with the understanding that some drugs will do little more than sedate the patient so that the problem is not so obvious. Medications used for agitation include SSRI antidepressants, trazodone, and beta blockers. Brexpiprazole, an atypical antipsychotic, was approved by the FDA in 2023 for this indication.
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Agitation occurring in a sundowning pattern is a special case because it happens at a predictable time. Morning exercise and light exposure can help in reducing this pattern of agitation for some patients. For others, medications can be used 1-2 hours before the time of usual disturbance. In addition to the drugs noted above, melatonin can be used for this indication.
Aggression
Aggressive behavior is like agitated behavior, except that it is more dangerous because it is directed towards other people or objects. The potential for injury or damage should not be underestimated. This is a later-stage behavior, and when it first manifests, it is important that the immediate situation be managed safely.
Recommendations include the following:
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The caregiver should back off.
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All other people and objects in the vicinity should be removed.
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The most trusted person present should speak to the patient in a calm, clear voice.
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The patient should be given a “time out.”
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A visit to the ER may be indicated.
Once the situation has calmed down, it may be possible to debrief.
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Exactly what did the patient do?
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What came just before it happened?
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What made it better?
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What made it worse?
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Is there a message?
Although this might enable you to avoid the occurrence of aggression in the future, it is nonetheless important that you see the patient’s primary care clinician to discuss the incident. Medication may be needed, and for this purpose, the same drugs used for agitation are employed: SSRI antidepressants, trazodone, beta blockers, and brexpiprazole. A safety plan should be formulated, and consideration should be given to placement in a care facility.
Key points
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When the brain doesn’t work, no amount of argument or scolding is going to make it work!
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It falls to family and caregivers to provide a safe, welcoming, and interesting environment for the person affected by Alzheimer’s disease. When emerging problems are handled appropriately, the quality of life for the patient and everyone else involved is greatly enhanced.
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What this section tried to convey to you is that you can do this! Armed with information and tips detailed here, you can master the problems and issues that arise, and even become an expert yourself in behavioral management.
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The initial table of contents -- what this section covers -- shows the road map of issues included here. Other resources can be found on the home page of this website.