How to manage difficult behaviors from a family member with Alzheimer’s or dementia

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Some of the greatest challenges of caring for a loved one with Alzheimer’s or dementia are the personality and behavior changes that often occur with these conditions. Here are some strategies to help manage these behaviors when they occur and hopefully before they become escalated.

Behaviors can vary dramatically, with some individuals becoming anxious or aggressive, while others may pace, seek exits, wander, undress, rummage or repeatedly ask questions.

It is important to know that your loved one is not acting this way on purpose. The behaviors are a result of the disease process. These changes in behavior can sometimes lead to frustration and tension, particularly between the person with Alzheimer's and the caregiver. You can best meet these challenges by using creativity, flexibility, patience and compassion. It also helps to not take things personally and try to maintain your sense of humor.

These strategies can help you understand the possible causes for the behavior:

Consult a physician
Sometimes medication side effects, pain and even an untreated infection can cause a sudden change in behavior. That is why it is important to make sure there is not an underlying medical problem that is bringing on your loved one’s behavioral problems. Once the underlying medical problem is addressed, the behaviors may stop or decrease. 

Find the root of the problem
People with dementia use behavior as a way to communicate their needs. Think of behavior as your loved one’s way of saying, “Stop, I need something.”  If you can figure out what they are communicating or what they need, you can often help alleviate the behavior. 

Start by checking that their most basic needs are being met. 

  • Hungry or thirsty
  • Afraid
  • Tired
  • Needing to use the toilet
  • In pain
  • Over-stimulated
  • In unfamiliar surroundings
  • Trying to perform a task that is too complicated

Identifying and solving the root of their problem should help manage the behavior. Going forward here are some additional tips that can help:

  • Pay attention to your body language. Make sure you maintain eye contact, match their motions and emotions, remain calm, and be mindful of your tone of voice, posture, pace and gestures.
  • Live in "their moment." Do not try to re-orientate them to the present time, which can lead to increased agitation.
  • Develop a routine. People with dementia feel safe when they know what to expect next.
  • Involve them in regular daily tasks that are familiar, such as sweeping, dusting, laundry folding, setting the table – this can help give them a sense of purpose and accomplishment.
  • Try to accommodate the behavior, not control it. For example, if they insist on sleeping on the floor, place a mattress on the floor to make them more comfortable.
  • Remember that we can change our behavior.Changing our own behavior will often result in a change in our loved one’s behavior.
  • Keep in mind that the solutions that are effective one day may need to be changed the next day — or may no longer work at all. Again, be creative and flexible.
  • Get support from others.You are not alone. There are many people caring for someone with dementia. Call your local Area Agency on Aging, or the local chapter of the Alzheimer’s Association. They can help you find online or in-person support groups, organizations and services that can help you. 

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