Avoid agitation Archives - Alzheimers Support

Avoid Agitation and Aggression

The person with Alzheimer’s often appears to be stubborn, obstinate, argumentative, aggressive and downright mean at times.

I say “appears to be,” because in reality they are none of those things. Someone who has dementia is someone with a brain injury and damage to the brain prevents him from reacting in a normal way. Instead of doing as you might suggest, he may lose his temper— whether it’s time to eat, or shower, get dressed, or go to bed. The person with Alzheimer’s dementia can become disagreeable.

What we often forget, is this—the person with Alzheimer’s has a brain altering disease. He can not control his emotions or reactions to them.

Healthy people can overreact, too, especially when bombarded with more things than they can handle at one time. For the healthy person, dealing with daily issues, means repeating steps that we do every day till they become second nature; brushing our teeth, combing our hair, adjusting the water temperature for a shower, dressing and undressing. We’ve done it everyday for years, and do it now without giving it a second thought.

The person with Alzheimer’s wakes up to a brand new world–every day. He doesn’t remember what he did or learned last month, or last week, or yesterday, or this morning, or an hour ago. So when you ask him to take a shower he is bombarded with more things than he can handle at one time; where is the bathroom, how does he set the water, where are the towels, where are his clothes, when he slips into a shirt–how does he fasten buttons or tie a shoe or who will be waiting in the other room when he finally does get dressed? Most important of all, they are thinking —Where am I anyway?

You need only to simplify things for them. Slow things down, slow the pace to a level that your loved one can handle. By simplifying his/her life, making their life less stressful and erratic and contentious, there will be fewer flare ups of aggressive behavior. Speak slowly, and don’t ask him/her to do more than they can handle.

When my mom needed a shower; I set the water to running, adjusted the temperature, folded her clothes neatly on a stool in the bathroom (pull-over shirts and pull-up pants are easiest for them to dress themselves), laid out a towel, wash rag, hand soap and shampoo (in plain sight), her toothbrush (labeled) and toothpaste were on the sink. Her hairbrush (labeled) and comb were on the vanity. Before I learned my lesson and found a way to be agreeable and help my mother, she would bring all the tooth brushes to me every single morning to ask which one was hers. Remove that stress from their lives, label their items with name tags so they don’t have to ask.

Here are a few other things that will create a more stress-free environment for you and the person with Alzheimer’s–

Simplify their chores; select what they will wear, choose what they will eat, but allow them the dignity of choice if they make a request–they aren’t children
Don’t ask them to do things they can no longer manage, don’t insist that they remember or should remember–Accept that THEY DON’T REMEMBER
Don’t rush them but allow a slower pace for daily chores and general living
Don’t crowd them with lots of people (visitors), loud noises, family feuding, etc.; the more activity around them–the more stress they feel
Don’t treat them like children, giving orders all the time–instead give choices
Leave things in familiar places, keep routines constant and familiar
Simplify instructions; give them less to think about and remember, one-step instructions
Don’t allow them to become overly tired, or rushed
Don’t make them feel inadequate, or stupid, or foolish; if he can’t tie his shoes, buy slip-on shoes
Minimize the number of things they need to remember; lay out their clothes every morning, prepare their shower; when serving meals provide appropriate utensils, fork, spoon

I found that keeping a journal helped me to stay calm in those early days of learning about Alzheimer’s when my own mom was aggressive and angry most of the time. Often, after Mom and I had an angry argument, I could skim back over my own words in my journal and find a solution I hadn’t thought of earlier. A journal is a good way to let off steam too. I could be totally upset and angry, but after putting pen to paper for a half hour, it didn’t seem quite so bad after all.

The book “The 36 Hour Day,” written particularly with the caregiver in mind, suggests that if you find that the patient’s Catastrophic reactions are occurring more frequently and you are reacting with anger and frustration–this may be a warning that you are over-tired.

Don’t forget to take care of yourself, too. It is essential that you have time away from all the duties of caregiving; make the effort to get some time off for yourself on a regular basis.
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