Understanding and Dealing with Behavior and Personality Changes in Alzheimer’s Patients

In Alzheimer’s disease, the brain cells start to die. Since the cells do not replenish, the brain begins to shrink. These changes mean that all brain functions are affected, including how patients think, recall information, and solve everyday problems.

The patients also show behavior and personality changes that other people do not readily recognize as symptoms of the disease. Some of these changes appear earlier than the other symptoms. This is the usual reason why families seek medical attention.

Alzheimer’s disease is a good topic of discussion for you and other caregivers because of several interesting factors.

One is the fact that at this time, the US has 6.2 million people aged 65 and older who have Alzheimer's dementia. This number is expected to increase in the coming years as the entire baby boomer population reaches retirement age. There is a huge chance that you will have to care for affected patients frequently.

Another factor is the very challenging nature of dealing with personality changes in these patients. To families, their loved one is now a different person. To their caregivers, on the other hand, patients are just being extra difficult.

What are some common behavior and personality changes in Alzheimer’s disease?

1. Threatening and violent behaviors.

Patients have difficulty communicating and expressing themselves. As a result, they get angry and upset more easily. Alzheimer patients become aggressive out of frustration or boredom, too. They can snap and yell for the slightest of problems. It may be unsettling for you to find them pacing at times. Patients with Alzheimer’s also get violent and hit others.

2. Fear and anxiety.

Patients worry about many things, especially in the early course of the disease, when they realize that they are less unable to function as usual. Their anxiety worsens some of their symptoms, and the cycle repeats itself.

3. Apathy and indifference.

Because of the brain changes in Alzheimer’s disease, patients show a lack of interest, enthusiasm, or concern for others and for things happening around them. These can be a sign of depression, too, which is common among Alzheimer’s patients.

4. Hallucination and paranoia.

Patients sometimes report that they see, hear or feel something that is not there. This experience is called hallucination. They also become paranoid or suspicious of others. Oftentimes, patients hide things or believe that others are hiding things from them.

5. Unusual sexual behavior.

Alzheimer’s patients become impulsive and uninhibited. Family members feel embarrassed when they see their previously respectable parent or grandparent exposing themselves or are overly interested in sex.

6. Compulsion.

Patients sometimes have a strong urge to do something repeatedly even if the action puts them in harm’s way.

What to do when patients show changes in behavior and personality.

1. Be more understanding.

Now that you know that the brain changes in Alzheimer's disease are to blame for the patient's 'new' personality, be more considerate. They may be rude and aggressive, kick or bite you, but these actions are part of the symptoms of the disease. They have difficulty controlling these behaviors. A little understanding goes a long way in caregiving.

2. Don't take it personally.

Patients with Alzheimer's disease might hurl hurtful words at you. You will be judged and criticized in the most humiliating way. You may hear them curse and swear, too.

Under normal circumstances, you’ll probably be triggered and angered by the 'abusive' treatment. But the scenario is different for these patients. It is best to not take what they say to heart and just let the behavior pass.

3. Anticipate and meet their needs.

The changes in behavior and personality are often the result of unmet needs. As a caregiver, be more sensitive to their preferences. Know their usual routines and their personal favorites, from food to TV shows. See to their comfort, too. Anticipate their needs to reduce their stress. Ask yourself if the patient is hungry or thirsty or if they have to use the toilet.

4. Calm the patient.

When the patient becomes stressed, they act out and possibly become combative. Firstly, you have to be calm yourself. Try to focus on their feelings rather than reasoning with them and then meet their needs.

5. Ensure that they are taking their medications.

Caregivers cannot administer medications, but they can remind patients to take their meds on time. Medications help control the symptoms and therefore also help manage behavior and personality changes.

Caring for patients with Alzheimer’s disease is very challenging, especially if they show unpleasant demeanors. Understanding that these changes are symptoms, too, will go a long way to help these patients have a quality life.