Caregiving tips for common Alzheimer’s behaviors

Right at Home John Headshot (2) (Small)By John Baldwin, FLT News Columnist

Will he wander away again? How aggressive will she be today? One of the most challenging aspects of caring for a loved one with Alzheimer’s is adjusting to the troubling and sometimes abrupt changes in personality and behavior. Brain disease experts concur that these erratic actions are not stubborn defiance, but are actually expressions of the person’s needs muddled by the dementia itself.

It’s important to remember that certain behaviors of people with Alzheimer’s may seem nonsensical to the caregiver, but feel quite real and true to the Alzheimer’s person. Encourage caregivers to assess what happened just before a distressing behavior started. Is hunger, thirst or pain the core problem? How are the family caregiver’s own responses affecting the situation? Pinpoint the emotions behind the Alzheimer’s behavior and then address the loved one’s underlying need rather than the disruptive behavior.

Because those with Alzheimer’s struggle to clearly understand words, they respond more readily to tone of voice, facial expressions and body language. A reassuring touch, a smile and eye contact communicate gentleness and compassion, which help calm the person with Alzheimer’s and ease agitated responses. Although the sudden distress and disorientation can be unsettling, listed are three common Alzheimer’s care situations and steps to help family caregivers calmly accommodate their loved one’s needs.

 

1. Eating and Drinking

As Alzheimer’s progresses, mealtime routines and food selections may need to be adapted to the person’s changing needs. Regularly monitor for weight loss or gain and modify the diet as necessary. One’s appetite may decrease because dementia can limit the sense of smell and taste and the recognition of favorite foods.

  • Continue with the person’s familiar mealtimes and place (e.g., recliner for snacks, family table for meals).
  • Give the person plenty of time to finish the meal. Rushing increases anxiety.
  • Keep an eye on chewing and swallowing and, if necessary, advise when to chew and swallow.
  • Serve small, bite-sized foods that are easy to pick up and chew.
  • Boost fluid intake by offering small cups of water or other liquids throughout the day or foods with high water content, such as soups, fruits and smoothies.
  • Test the temperature of foods and beverages before serving.
  • Limit the distractions of television and even bright, patterned tablecloths, placemats and dishes.
  • Use silverware with large handles. Try bendable straws and lidded cups.

 

2. Bathing and Hygiene

Because hygiene care and bathing are private activities, allowing others to assist with bodily cleaning can feel threatening or repulsive to Alzheimer’s patients. Bathing works best when caregivers help the loved one feel relaxed and in control.

  • Set a routine time for bathing. If the person is used to a morning shower, stick with that time of day.
  • Respect dignity and privacy by using a bath blanket to cover the loved one while he or she undresses or place a towel over the bathing person’s shoulders or lap so he or she feels less exposed.
  • Use an adjustable-height shower chair or tub bench. For added safety, use a hand-held showerhead, nonslip bath mat and grab bars.
  • Select a comfortable water temperature. Check the water throughout the bath time.
  • Be assertive about “it’s bath time,” but never forceful. Resist arguing about the need for personal hygiene.
  • Coach the person with cues on bathing steps: “sit down,” “wash your face,” etc.
  • Sponge baths are a helpful alternative between showers or baths. A full bath or shower two to three times weekly is a healthy guideline for most people.

 

3. Rummaging and Hiding Things

A loved one with Alzheimer’s may rummage through closets, drawers, cabinets, the refrigerator and other storage places and/or squirrel away random objects from food to medications. Often an Alzheimer’s patient is looking for something specific, but cannot communicate that. Trying to understand the cause of the rummaging and hiding behavior helps caregivers tailor an appropriate response.

  • Remove access to harmful items, such as cleaning products, sharp knives, firearms and power tools.
  • Create a specific place – a basket, tote bag or chest of drawers – where the person with Alzheimer’s can freely sort through a set of safe, tactile items including socks, stuffed toys or hats.
  • Keep the person from roaming in unused rooms. This limits the spaces for rummaging and hiding.
  • Ensure mail is safely delivered out of reach of the Alzheimer’s patient,who may toss, lose or hide mail. Consider a post office box or mailbox outside a locked yard gate.
  • Lock up valuable items like jewelry, keys, important papers, checkbooks and charge cards.

 

As a family caregiver, if certain routines are upsetting your Alzheimer’s loved one, give yourself permission to ease your standards a little. And be sure you are getting the in-home care support and respite breaks you need. Flexibility and patience, plus self-care, go a long way in the loving, safe care of those with Alzheimer’s.

The Perrysburg Office of Right at Home is a locally owned and operated franchise office of Right at Home, Inc., serving the communities of Wood, Lucas and parts of Sandusky counties. For more information, contact Right at Home of Perrysburg at http://www.rahnwohio.com, 567-336-6062,or by email at jbaldwin@rahnwohio.com.