II. BEHAVIORAL PROBLEMS: IDENTIFYING PRECIPITATING CONDITIONS

There is a great deal of variability in behavioral problems exhibited by people suffering from Alzheimer's Disease. For example, some people wander and get lost; others do not. Some may wander during the early part of the illness, while others do not start wandering until later in the progression of the disease.

Behaviors that are associated with Alzheimer's Disease can include short-term memory loss, language difficulty, wandering, agitation, disorientation, incontinence, hiding and misplacing things, angry outbursts and trouble with learning new things. In the later stages of the disease individuals often lose the ability to walk, talk, feed, dress, bathe and otherwise care for themselves.

Many behaviors that are difficult for the caregiver may change week to week. Therefore, it can be helpful for the caregiver to understand the source or precipitant to the behavior as well as the setting in which it occurred in order to more effectively handle or modify it. Being flexible and creative in efforts to safeguard the person as well as support his/her deteriorating ability to carry out daily activities may be important factors in adapting the home environment.

Catastrophic reactions in the person with brain disease can occur very rapidly and result in behaviors that are disturbing to the caregiver (e.g., extreme agitation, abusive behavior, hiding or losing things, wandering). The following are a few of the possible precipitants the caregiver may want to be aware of:

  • Change in environment (unfamiliar place or event).
  • Change in medication.
  • Different caregiver.
  • Change in routine.
  • Change in lighting conditions (e.g., glare, shadows, poor lighting).
  • Overly noisy environment or strange sudden noises.
  • Too much stimulation (e.g., too many people or confusion).
  • Overly demanding tasks.
  • Attitude of caregiver (e.g., impadence, anger).

  • Charting behaviors when they occur and focusing on circumstances both before and after the behavior problem occurred, may help the caregiver understand how behavior and symptoms develop and how they may be connected with the environment. For example, was there a change in environment, medication or routine? Were there strange or unfamiliar sounds or shadows in the room? Is the person having difficulty with vision or hearing problems that might be complicating his/her behavior? Is the activity too complex or confusing? See Appendix III on "How To Chart Behaviors."

    As long as the caregiver can remember what worked one day may no longer be effective the next day, then the unpredictability of the situation may be better tolerated. The person's behavior is symptomatic of his/her illness and is not being done intentionally.

 

 
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