If you remember nothing else remember this: all behaviors are expressions of need. Research has shown that an Alzheimer’s affected loved one can still experience emotion and a sense of self even in the more advanced stages. The inability to effectively communicate her or his emotions or thoughts results in difficult, disruptive, or inappropriate behaviors. The truth is, the behaviors are inappropriate to you, but not to your loved one. She/he sees the world through her/his mind’s eye. Frustration, anger, emotional or physical pain and thoughts are being communicated on your loved one’s level. It’s up to you to listen, observe, and try to understand and address those needs.

The first thing you should consider when your loved one has a sudden change in behavior is a medical cause, and urinary tract infection (UTI) is usually the culprit. Just the normal changes with aging put all of us at greater risk for UTI’s.

Behaviors can be triggered by uncomfortable or frightening environmental stimuli like shadows, sounds, and hot or cold temperatures. Your loved one can also mimic your attitude, behavior, and body language so it’s best to maintain a calm demeanor.

There are several things you can do to minimize behaviors. Comforting daily routines that are structured and predictable work best. Avoid boredom and over-stimulation. Create a “go to” place for comfort like a quite room for those times your loved one becomes overwhelmed with activities around her/him. Reminiscing is also beneficial. It allows your loved one to retreat to a more pleasant time and communication may be easier.

Three alternative strategies that can be useful are gentle massage, music, and rocking. Gently massaging your loved ones shoulders, neck, and upper back for five to eight minutes is relaxing and stress reducing. It works best when done before the behavior takes place. If you know your loved one tends to be more difficult at a certain time of the day, try gentle massage shortly before that time. Music is also calming and stress reducing. Play music your loved one enjoys, preferably something soothing, when she/he becomes agitated. Again, if you know there is a certain time of the day that is more difficult, start the music in advance. Music can also be used to energize and exercise. Dancing or just moving to the music is uplifting and imparts physical benefits too. Physical activity has been shown to have a positive effect on reducing agitation. For those of you with loved ones who pace or wander, a rocking chair may be the answer. Wanderers have a need for movement and rocking can satisfy that need. It doesn’t hurt to try.

Behaviors can be anticipated, managed, and prevented if you know the cause, effect, and normal progression of the disease. With knowledge and the right tools you will be empowered to cope with any situation. Of course the cardinal rule is never argue; you will lose!

Mary C. Fridley