Managing Difficult Behaviors
Many family caregivers report that some of their greatest challenges come from the mood, personality, and behavior changes that can occur as Alzheimer’s disease impacts the brain.
Our recommendation for handling these situations is to first bring a clear understanding of two crucial principles: First, this behavior is happening because of the impact of the disease. Second, this behavior is not meant as a deliberate, personal attack on you.
This article explores other key understandings and strategies that will help you face the changes you may see if your loved one displays difficult behaviors. .
It’s important to remember that while Alzheimer’s disease is changing your loved one’s mind, YOU cannot change your loved one. Because of the disease, your loved one’s brain is now damaged in certain key areas controlling mood, personality, judgement, and behavior. It is not something that you can control or change.
Rather than working to control your loved one’s behavior, consider this:
Behavior usually has a purpose. If a loved one with Alzheimer’s disease cannot tell us what they want or need, they might do something, such as wearing multiple shirts, instead of a jacket, because they are cold. Thus while the behavior may seem unusual, it is very likely that the person is trying to fulfill a legitimate need. Always consider what needs your loved one might be trying to meet with their behavior—and, when possible, try to accommodate them.
Behavior is usually triggered. It is important to understand that your loved one’s behavior is usually triggered—there is some factor in their life that leads to a behavior in response. It doesn’t occur out of the blue. It might be something a person did or said that triggered a behavior, or it could be a change in the physical environment. There may be times when behaviors appear to come out of the blue, but typically that is only because we don’t know what the trigger might have been. The key to coping with difficult behavior is disrupting the patterns that are created in your loved one’s day to day life that might trigger these behaviors. You might try a different approach to a daily pattern such as how they get dressed, for example.
Your loved one cannot be changed, but YOU can change how you approach the situation! Remember, in many respects YOU can control the environment around your loved one. Unfortunately, this adds increased pressure to your already deepening burden, but the fact is, changes in your loved one’s behavior, if they are to occur, are up to YOU to help bring about.
Try to adjust to the behavior, not control the behavior. For example, if your loved one wants the same sandwich for lunch and dinner, that can be acceptable, medically speaking. So go ahead and serve the preferred sandwich repeatedly at lunch and dinner. The result is likely to be no more occasions of your loved one being upset or refusing to eat. In this case, YOU changed your behavior and accepted the meal choice, which led to an optimal result. Changing our own behavior will often result in a change in our loved one’s behavior in a positive way.
Consider a medical checkup. In some cases, the appearance of unusual or difficult behaviors may have an underlying medical reason. It could be the person is in pain or experiencing an adverse side effect from medications such as urinary or bowel incontinence or hallucinations. There may be an adjustment to the care plan to assist in managing the problem.
Keep in mind this is a progressive illness and what works today, may not tomorrow. The natural progression of the disease process means that solutions that are effective today may need to be modified tomorrow or may no longer work at all. The key to managing difficult behaviors is being creative and flexible in your strategies to address a given issue.
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