“Behavioral Problems” in Alzheimer’s and Dementia: When to Worry and When to Let Go
Alzheimer’s disease and its related dementias can be unpredictable and perplexing. I often meet families who are desperate to fix a loved one’s “behavior.” I rarely use the phrase “behavior” because it implies that there is wrongdoing on the part of the person living with dementia. All “behavior” has an underlying need or is a form of communication. I encourage families to carefully weigh the value and pick their battles. Often my question to them is “Who is it really bothering?”
Let’s look at a few examples of unconventional conduct from a person living with dementia, and decide which ones we should be worried about finding solutions for.
- He or she is convinced the UPS man is stealing from them.
- He or she thinks their sister is alive, despite her death years ago.
- He or she accuses a relative of stealing money from them.
- He or she has trouble taking a shower because it is loud, cold and they don’t like all the water hitting their body.
Which of these four do we need to find a solution for?
The answer is very personal. There is no sweeping generalization that is right or wrong for everyone. For example, maybe in your house, keeping your loved one living with dementia away from the UPS man isn’t a big deal. Or, maybe it is a big deal: you’ve had a lifelong friendship with your delivery man that is suffering because of the change in perception.
The perception that the sister is alive is very common and not a big deal. Let go of being right and historically accurate. Don’t argue and tell them their spouse is dead, or try to convince them otherwise.
Let’s focus on the good news! Most of these behavioral expressions have pretty easy solutions:
Time it so they are occupied when the UPS man comes.
If your loved one living with dementia is constantly trying to take the car to go visit their deceased sister, you may have a problem. In this case, we need to ensure that the car is not available. We also need to keep them feeling safe and reassured that their sister’s relationship still holds value in their life.
Let them know that, while you don’t think anyone is stealing from them,you will “look into it for them.”
Set the tone of bathing with soothing music; warm up the water and wrap a towel around their shoulders so the water hits the towel first. If showers remain troublesome, switch to a bath.