Dealing with Alzheimer’s can be a heart-breaking experience. I’ve seen many families struggle with it. They all do so in different ways—but no matter what, it’s never easy. One thing I see families struggle with over and over are the emotional outbursts and odd bits of behavior that come later in the course of the disease.
Sometimes people with Alzheimer’s are prone to emotional outbursts—even if that person was a relatively stable and calm individual before. Anger, fear, and sadness might suddenly hit with little warning. For example, the loved one might get incredibly upset simply because their favorite TV isn’t on, or their eggs are overdone.
At the same time, they might sometimes do things that we wouldn’t dream of doing…and be oblivious to how inappropriate their actions are. For example, they might wander out of the bathroom without getting fully redressed. Or they forget to shower and change. Or they might just make inappropriate comments.
When people are emotional, or not aware of what’s appropriate, we tend to think of them like—well, like children. We understand why young children are emotional and often act inappropriately. They are still learning society’s rules, and still learning how to control their emotions and act appropriately. And so many families figure that the person with Alzheimer’s is having a similar problem. So what do they do? They try to re-teach the person control. They try to re-teach them society’s rules.
But this rarely works. A child doesn’t know how to control their own behavior—but they can learn. And so we teach them. With time, they become accustomed to what behaviors are expected of them and behave as they are supposed to (more or less). In other words, we seek to correct.
When dealing with Alzheimer’s, correcting won’t work. The problem is not that the person doesn’t know the rules, or that they have forgotten how to act. The problem is that the disease is attacking the parts of the brain responsible for control. So a person with Alzheimer’s has trouble controlling how they act. They have trouble controlling strong emotions and impulsive behavior. And they might even feel embarrassed about this after the fact.
So, instead of correcting, we need to redirect. The idea is simply: instead of trying to “retrain” the person with Alzheimer’s we instead retrain ourselves to manage situations. The goal is to avoid or minimize the disruptive behavior. For example:
Keep it simple. Follow simple, habitual routines when possible. Avoid presenting your loved one with complicated decisions or multiple options.
Keep tabs. You can’t always depend on your loved one remembering every step, even for something as simple as getting dressed. Be sure to check and make sure things have been done correctly.
Keep things consistent. Minimize changes in the surroundings and in your loved one’s daily routine.
Keep calm. If your loved one becomes agitated or aggressive, try to stay calm. Use a gentle tone of voice. Try to engage them, get them to talk. You can talk about what is upsetting them or, if this is too much, just talk about something pleasant they remember.
Step away, if you need. Sometimes, you might just need to take yourself and your loved one out of a situation. Just be sure that you do this is a loving way.