One of the most distressing and difficult behaviors that can manifest itself in Alzheimer's disease is screaming and other very loud, repetitive vocalizations. Sometimes people can scream or shout words that have no precise meaning for very long periods of time. It can make your role as caregiver very hard indeed and may lead to admission into a care facility if you cannot stop this behavior.
Diagnosing the Causes of Screaming
The first thing a caregiver needs to do is to get an accurate diagnosis. At worst the problem may relate a symptom of a life threatening illness. Some illnesses or diseases can be successfully treated or further damage prevented. Screaming can also be a sign of brain infections such as meningitis, concussion and other traumatic head injuries. Screaming also occurs with dementia's such as Alzheimer's, but also in some types of multiple sclerosis, the result of poisons that cause brain damage, or irritability resulting from toxicity (e.g. urea, in kidney and liver disease). Screaming can also be a symptom of some mental illnesses.
Once a doctor has confirmed that your relative/client's screaming is a result of the brain damage caused by Alzheimer's there are two big things you need to know:
- First - his/her screaming is not malicious or intentional. It is not being done to make you crazy, although it may feel like it at times.
- Secondly -this behavior will stop. It may take a bit of time, but it will stop as their Alzheimer's progresses, or you find a cause for the screaming that can be treated. Tranquillizing medications may be used if other treatments fail.
Therapeutic Activities and Treatments to Manage Symptoms
Screaming and other loud or abusive vocalizations may be caused by not being able to communicate things such as discomfort, hunger, fear, having little or no contact with others, from pain. Screaming can certainly be seen as an expression of an unmet need or needs so a trial-and-error nursing approach to assess what the cause might be is required.
Recording possible causes, and the various approaches that seem to have a positive effect, will help others looking after them. It may also be helpful for doctors trying to find effective treatments should the behavior continue for a long period of time. Use an ABC approach (antecedents, behaviour, consequences) described in this sharepost.
Assessing pain in middle and late stage Alzheimer's is very important. Time and again studies show that pain and medications are underused in people with dementia's such as Alzheimer's who are shouting, screaming and vocalizing in an apparently inappropriate way.
This sharepost on problem behaviors in mid-late stage Alzheimer's may also give you some ideas on how to help your loved one.
Your doctor needs to be involved to assess progress and suggest new approaches. This may involve using medications for short periods of time.