After years, or even a lifetime, of respecting your loved one as an equal or an elder, it’s natural to feel uncomfortable at the thought of “managing” their behavior. But while the person you’re caring for is (of course) still an adult, it’s important to recognize that Alzheimer’s will reduce their ability to regulate their emotions and actions — which means you may need to take a new approach to interacting with them.
Alzheimer’s often makes daily life confusing, frustrating and even frightening for people who suffer from it. Although your loved one’s aggression and suspicion may seem to come out of nowhere, they usually arise from traceable causes. By identifying the reason for a behavior, empathizing with your loved one’s feelings, and redirecting their focus to a more enjoyable activity, you’ll help them feel calmer and safer in your care.
Here are seven practical tips for managing common behaviors associated with Alzheimer’s, in ways that will minimize stress — both for you and the person you’re caring for.
1. Identify the behavior’s immediate trigger
2. Take some deep breaths before you respond
3. Move the conversation to a distraction-free location
4. Tune into non-verbal communicative cues
5. Let your loved one vent their frustration
6. Empathize without trying to argue
7. Redirect your loved one’s attention
Tip #1: Identify the behavior’s immediate trigger
While problematic behaviors can arise for a variety of reasons, outbursts of aggression are typically triggered by a specific event. For example, many people with Alzheimer’s experience delusions that friends and family members are conspiring against them — and those suspicions can erupt into a storm of verbal abuse when you deny your loved one’s accusation of theft or fraud (baseless though it may be). Many problem behaviors originate in physical discomfort, which your loved one may struggle to communicate verbally. Confusion, criticism, and invasion of personal space can also set off aggressive reactions. Pinpoint the trigger, and you may be able to prevent a repeat performance.
Tip #2: Take some deep breaths before you respond
Your loved one may not be able to control their anger — but you can control yours, if you choose to. While it may be tempting to snap back and defend yourself, that’ll only feed more stress and anger into the interaction, which will make the tension even harder to defuse. Instead, step back and take a few deep breaths. Remember that your loved one wants to behave rationally, but has a disease that prevents them from seeing the situation clearly. By setting a calm emotional tone right from the start, you’ll make the interaction much easier for you and your loved one.
Tip #3: Move the conversation to a distraction-free location
Alzheimer’s can make it hard to stay focused under the best of circumstances — and your loved one’s attention will be especially prone to wander in stressful situations. To make sure the conversation goes as smoothly as possible, turn off distractions like TVs and radios; or move to a quieter room. Positioning yourself at their eye level will make it easier to maintain eye contact, which will help you keep your loved one’s full attention. If they appear confused, it may also be helpful to remind them of the topic of conversation.
Tip #4: Tune into non-verbal communicative cues
As Alzheimer’s attacks the brain’s language centers, verbal communication becomes much more difficult — especially under stressful circumstances. But while your loved one may struggle to express their emotions, and to understand what you’re trying to explain, they’ll likely remain very responsive to non-verbal communication even in the disease’s later stages. Calming gestures, kind facial expressions, and a relaxed posture can all help put your loved one at ease. Watch for non-verbal cues on their end, too. They may be doing their best to tell you what’s wrong, even if they can’t put it into words.
Tip #5: Let your loved one vent their frustrations
Even if your loved one has difficulty communicating what they’re feeling, they may find it very therapeutic to give vent to their emotions while you sit and listen. In a peaceful location, give them space to talk through (and/or act out) their anger, frustration, confusion and hurt. It doesn’t matter how accurate their conclusions are, or how excessive their reaction may appear. The most important thing is simply to show them you’re here for them.
Tip #6: Empathize without trying to argue
Though your loved one’s behavior may be based on a paranoid suspicion, they firmly believe in the reality of their conclusions. No amount of logical debate or contradictory evidence is going to change their mind; in fact, the most likely outcome is that they’ll lash out even more angrily in self-defense. But while your loved one’s beliefs may be delusional, remember that their emotions are every bit as real as yours. Just listening patiently to their side of the story, and expressing sincere empathy for what they’re feeling, can often work wonders.
Tip #7: Redirect your loved one’s attention
If you can’t convince your loved one to change their beliefs or behavior, what can you do? The most effective technique is to gently guide their attention away from the event or idea that’s causing them stress, and direct it toward something more positive and reassuring. For example, it’s often less stressful for a person with Alzheimer’s to talk about familiar people and places from the past, rather than trying to remember recent events. Playing some nostalgic music, or putting on a favorite movie or TV show, can bring back that smile you love to see.
Most crucially of all, remember not to take your loved one’s aggressive outbursts personally — even when the full force of their anger is directed squarely at you. They’re doing the best they can to assemble a clear picture of the world in the midst of wildly fluctuating emotions, unreliable memories, and an ever-diminishing sense of independence; and as the disease progresses, it’s harder for them to remember how deeply you love and care for them.
Still, you can help prevent — or at least reduce the intensity of — many aggressive behaviors by creating a low-stress environment with plenty of peace, quiet, reassurance, and familiar mementos of the past. Keep an eye out for potential triggers, and do your best to keep your cool. That’s sometimes all it takes to help your loved one keep theirs.