2. Skipping Medications or Taking Extra Doses

Short-term memory loss can have real consequences when it comes to taking medications. The person with Alzheimer’s may insist that they’ve taken their medication when they haven’t, or they may insist that they need to take their pills when they’ve already been given the appropriate dose for the day.

“I strongly recommend a pillbox — for everyone, but especially for people with dementia, because we all can get distracted during the day. A small thing like a phone call that comes in at the time you usually take your medicine can lead to uncertainty: Did I take my pill or didn’t I?” says Yang.

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And the pillbox can also allow other people to double-check whether someone has taken their medicines, she says. “If the pills for Monday are still there, and today’s Monday, then your loved one has not taken their medicine, and you can show them the pillbox to demonstrate,” says Yang.

A “smart” pill dispenser like Hero can also help manage complex pill regimens and relieve some of the burden on the caregiver.

3. Losing Personal Items

When a person has Alzheimer’s or another form of dementia, it’s expected that things will get misplaced or lost, says Yang. “You might have to hold on to the things that are very important, like passports or IDs. When possible, you might want to have a few copies of things like keys,” she says.

If your loved one with dementia likes the independence of having a wallet or handbag, just make sure that they don’t contain large sums of money or normal credit cards, she says. “Instead, they could carry a little bit of cash and cards that won’t be of major importance if they are lost,” says Yang.

Prepaid debit cards (with a small spending limit), or special cards for people with dementia, such as Sibstar, offered in the United Kingdom by Mastercard, are good alternatives to traditional credit cards.

For items that seem to “walk away” frequently, Bluetooth trackers might be a good investment. They can help you hunt down lost keys, wallets, and remote control devices.

Another pro tip: Keep duplicates of favorite items, such as pens and hairbrushes, to stop anxiety from escalating and preserve everyone’s mental health.

4. Paranoia and Suspicion of Other People

“Paranoia is similar to delusion, which is a false belief, and this is very common in people with Alzheimer’s disease, even when they just have mild memory changes,” says Yang.

“For example, say they accidentally misplace something. They may externalize the blame to someone else and say, ‘Someone else must have come in and stole my wallet,’ rather than, ‘I forgot where I put my wallet,’” says Dr. Yang.

Because these thoughts or beliefs often persist even when the person is shown evidence to the contrary, it’s best not to argue with them, says Yang.

“Generally, it’s better to acknowledge what has actually occurred — in this case, they can’t find their wallet. Try to redirect the discussion by suggesting that you try to find the wallet together,” she says.

There is often an underlying fear fueling the paranoia; if you can address that and reassure the person, that can help too, adds Yang.

5. Agitation

Many times, Alzheimer’s caregivers are faced with bouts of inexplicable, intractable agitation by their loved one, a common Alzheimer’s symptom.

“Agitation can mean a number of different things, and so I like to get the caregiver to describe what’s going on with their loved one. Also, a person with Alzheimer’s could exhibit signs of agitation for several different reasons,” says Yang.

For example, a person who has been sitting or lying down in the same position for a long time could be uncomfortable or even in pain, she says. “And that pain could be causing the agitation,” she points out.

Boredom, or an inability to communicate one’s thoughts, could also be an underlying reason for frustration or agitation, says Yang.

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Yang suggests using a systematic approach to help assess and understand behavior changes related to dementia when you’re not quite sure what’s causing them.

“This method is called the DICE approach, which stands for describe, investigate, create, and evaluate. For a particular behavior, you describe what’s happening, and then investigate the circumstances — for example where or when it happens and other details. Then you create a plan: For example, if after steps one and two, you think the agitation might be related to pain, your plan may be to give them Tylenol to see if that seems to help,” says Yang.

Then the final step is to evaluate: Did the plan you created improve the situation? If not, you may have to begin the process again, or talk with your provider, she says.

If you’re interested in learning more about the DICE approach, the organization offers a subscription and how-to videos.

The Alzheimer’s Association also offers tips for dealing with agitation and other behaviors in an online and downloadable brochure.

6. Sundowning: Agitation in the Evening

Increasing agitation as twilight approaches, called sundowning, is one of the classic Alzheimer’s symptoms. “It’s almost like the ‘witching hours,’ where the sun goes down and the person with dementia starts to be really restless,” Yang says. “This relates to the disruption of the sleep-wake cycle: It’s very common for people with dementia to be awake at night and then sleep during the day.”

Yang offers a few suggestions on how to improve this. “[Expose your loved one to] natural light early in the day — even taking them outside, if possible. If you can find safe ways to keep that person more stimulated during the day, that may help as well,” she says.

Avoiding caffeine later in the day and limiting naps (if possible) may help as well, according to the National Institute on Aging.

7. Aggression

Aggression is also very common and could be caused by many different things, says Yang. “In some cases, especially if the person is particularly angry or frustrated, it’s best to leave that person alone and approach them later,” she says.

Oftentimes, people with Alzheimer’s get aggressive when you’re trying to help them with something related to personal care, such as getting dressed or ready to go to bed, says Yang.

“It may be helpful to have a plan, either in written or picture form, of what the routine will be, and then try to keep the regular routine that you’ve created, so your loved one understands what’s happening. But some days, that might not make a difference, and the person might still get aggressive,” she says.

In those cases, ask yourself if whatever you’re trying to do is something that really needs to happen in that moment, says Yang. “If it’s for their safety, you may have to find a way, but if it’s just because it’s the plan or it’s convenient to do it at that time, it could be a good idea to leave it and try again later,” she suggests.

She also recommends approaching the person with Alzheimer’s gently, being at their eye level, and asking permission to touch them (if touching is required).

But still, even the best and most intentional efforts may fail to keep aggression at bay.

“Dementia or Alzheimer’s doesn’t mean that it’s okay for them to hurt family members or caregivers. If that happens, or it seems like a possibility, talk with your medical team about potential medications to help calm them down or help sedate them,” she says.

8. Engaging in Sexually Inappropriate Behavior

“This is a form of disinhibition. With dementia, it’s very common for people to lack some of the social filters that we all have developed as we grow into adulthood. Some of that filter has been removed because of the disease,” Yang says.

If the inappropriate behavior is verbal, Yang suggests firmly saying that the comment was not appropriate, and then redirecting the conversation.

Activities like dressing, bathing, changing diapers, or bending over someone may trigger sexually inappropriate behaviors, according to UCLA Health.

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“If it’s touching or physically inappropriate behavior, you might have to get another person to be with you to do any sort of personal care type of things,” says Yang.

As a last resort, there are medications that can help lower someone’s libido, but they can carry a lot of unwanted side effects, she says.

If the person with Alzheimer’s makes inappropriate comments to strangers when you are out in public, you may want to carry printed cards that explain that this is an Alzheimer’s symptom and offer an apology for the behavior, says Yang.

9. Wandering Outdoors

It’s not unusual for people with dementia to wander or become lost outside. An estimated 6 in 10 people with dementia will wander at least once, and many do so repeatedly, according to the Alzheimer’s Association.

“I think this happens when people may be disoriented as to where they are. For example, they might be at home, and they’re not recognizing that this is their home,” says Yang.

Yang suggests trying little fixes to see if they help. “For example, put away the person’s purse or shoes or things that kind of signal ‘this is time to leave.’”

Hanging something like a mirror on the door can signal that this isn’t a door that you need to open or walk through. “These are things you can potentially remove when you need to use the door,” she says.

Door alarms and security cameras can also alert you if your loved one wanders outside, and the Alzheimer’s Association offers a MedicAlert membership plan with Wandering Support that may be a good investment for some people, says Yang.

10. Refusing to Bathe

Refusal to bathe is common, usually a little bit later, in the moderate stage of Alzheimer’s disease.

“There can be a few factors at work. For one, it’s very common for people with dementia or Alzheimer’s to have a fear of water on their face, and so I recommend separating the washing of the hair from the washing of the body,” says Yang.

Taking your loved one to a beauty salon regularly (once or twice a week) or washing their hair in a sink (provided they can sit or recline safely without getting water in their face) could be a good solution, she says.

If you’re holding on to a hard-and-fast rule about how frequently your loved one needs to bathe, you may need to let go of that, says Yang. “Maybe you move from daily to twice a week, depending on the season and whatnot,” she suggests.

UCLA offers a series of videos for people caring for someone with dementia, including one on refusal to bathe, that Yang recommends.

11. Smearing Feces

“When people are having difficulty with the steps involved in personal toileting, it’s typically in the later and more severe stage of the disease,” says Yang.

When the steps involved in using the bathroom and cleaning oneself become challenging — meaning the cognitive ability required isn’t there anymore — that potentially means the person needs either a higher level of care in a facility, or they need more assistance at home, she says.

“Depending on the person and the relationship to the caregiver, you may want to go to the bathroom with your loved one with dementia, particularly if they are having a bowel movement, or keep an eye on how long they’ve been in the bathroom and check in if they’ve been in there for what seems like an unreasonably long amount of time,” she says.

If your loved one with Alzheimer’s has an incident where they are smearing feces on the walls or other places, it’s definitely a sign that they need help with toileting, says Yang.

12. Shredding Toilet Paper or Using Too Much

Yang has had patients who clog the toilet with too much toilet paper, or who take rolls of toilet paper and tear off individual pieces and rip them into tiny, hard-to-clean-up little pieces.

“If this is an issue, I suggest people give their loved one the appropriate amount of toilet paper needed and maybe store extra rolls somewhere besides the bathroom,” says Yang.

Source: https://t-tees.com
Category: WHY