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DISCLAIMER ...
There is no hard and fast answer to addressing a problem behaviour.
The following information is provided as a tool to help the Caregiver find the solution that works for situation they are faced with.

Problem Behaviours - Introduction

Between 80% – 90%  of those with Alzheimer’s will develop some behavioral symptoms.

Alzheimer’s disease causes brain cells to die, so the brain works less well over time. This changes how a person acts. There are a number of recognised behaviour problems associated with Alzheimer's disease. These problems can interfere with normal daily activity and sleep and may increase the risk of harm to the person with Alzheimer's and their caregiver.

This section is provided as a resource to Caregiver's looking for possible causes and coping strategies to help deal with the day-to-day struggle. Each of the behaviour pages is divided into three specific areas. It is hoped that caregivers may find some help in dealing with their own situation:

  • Possible Causes - Physiological or Medical, (Internal or External)
  • Coping strategies - that may assist in finding a solution that suits the situation each individual caregiver may face.and list
  • Possible Additional Research and Reference material

Anger
Hallucinations / Paranoia
Incontinence
Bathing
Dressing
Eating
Sleeping
Repetitive Actions
Verbal / Screaming
Wandering
Wanting to 'Go Home'

 

 

General Overview

As a caregiver for a loved one with dementia, it can be extremely worrying and upsetting to experience the behavior problems associated with mid-stage Alzheimer’s disease. Patients may exhibit a wide variety of behavioral problems that can threaten their own or other people’s safety, including wandering, aggressiveness, hallucinations, or sleeping and eating problems.

While it’s not always easy to understand unexpected outbursts or erratic and aggressive actions, many behavior problems are made worse by a poor environment and an inability to deal with stress. By learning how to make changes in the home environment and caring atmosphere, you can help to reduce stress, improve problem behavior, and increase the quality of life for both the patient and yourself.

Awareness and management of difficult behaviors by the Caregiver becomes an important means of dealing with stress and easing tension between the care receiver and the caregiver. For the sufferer these behaviors are an effort to communicate that something is wrong, not an effort to be difficult. Dementia is a progressive, increasingly debilitating illness. Therefore, the treatment must adjust to the individual, rather than be seen as a concrete set of rules that will remain unchanged over time.

Each individual is impacted differently, with the loss of function in no straight line. In other words, any attempt to devise one program of standardized care for Dementia would be the same as deciding that everyone diagnosed with cancer should have exactly the same treatment.

Problem behavior is often a way the Alzheimer’s patient tries to communicate with you. The progression of the disease means that they may no longer be able to communicate verbally, but they are still emotionally conscious and will remain so, often until the very end of life.

In many cases the patient’s behavior is a reaction to an uncomfortable or stressful environment. If you can establish why the patient is stressed or what is triggering their discomfort, you should be able to resolve the problem behavior with greater ease. Remember that the person with dementia is not being deliberately difficult. Their sense of reality may be different to yours, but it’s still very real to them.

Some ways to help identify the causes of problem behavior:

  • Try to put yourself in the person's situation. Look at their body language and imagine how they might be feeling and what they might be trying to express.
  • Ask yourself what happened just before the problem behavior started? Did something trigger the behavior?
  • Are the patient’s needs being met?
  • Does changing the environment or the atmosphere help to comfort the person?
  • How did you react to the problem behavior? Did your reaction help to soothe the patient or did it make the behavior worse?

Problem behaviors have as their basis two sets of factors:

Internal factors:

External factors:

Such as

  • a sense of feeling threatened,
  • loss of control,
  • loss of previous structure,
  • frustration with tasks that exceed ability,
  • misinterpretation of the behavior of others,
  • fatigue,
  • impaired perceptions,
  • pain,
  • the effects of medication. 

Including:

  • the physical environment,
  • the approach of the caregiver,
  • environmental stimulation.