Five Causes of Difficult-to-Manage Behavior in People with Alzheimer's

Christine Kennard Health Pro
  • I've always found that if caregivers understood some of the reasons for difficult and challenging behaviour it helps them to deal with it better. There may be just one cause for such changes, or a number of unrelated causes that you need to think about to help resolve their more destructive aspects. In this SharePost I have put together some of the relevant information, with links to more that I hope will help.


    It is worth remembering that, as I have pointed out before, it is often unhelpful for caregivers to decide the exact level of intent in someone's behaviour. Whether an incident of aggression, an inappropriate sexual advance, or a refusal to cooperate with a care procedure is intentional or not it causes a lot of caregiver stresses. Apportioning blame when someone has brain damage can hinder rather than help you. 

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    1. Health Influences Behavior in People with Alzheimer's.

    There are physical reasons why people act in the way they do. Brain damage that occurs in Alzheimer's disease is significant and progressive. As brain cells and their connections are destroyed cognitive changes occur. Confusion makes previous activities difficult and later impossible.


    Illnesses, such as infection of the urinary tract and respiratory tract, an upset stomach, constipation, incontinence, and very commonly discomfort and pain, can all cause behaviour changes.


    Remembering the basics, good nutrition, adequate fluids, appropriate clothing and warmth and comfort is fundamental to good health.


    Here is a video clip so you can see the changes and mapping of the brain in Alzheimer's. Information on brain shrinkage in old age and Alzheimer's is also a major diagnostic feature of the disease.


    2. Psychological Needs Influence Behavior in Alzheimer's.

    There have been many changes in emphasis in the last 25 years and there is now more emphasis on how behavior can best be managed and, wherever possible, normalized. We spend more time trying to understand the person as an individual rather than just a disease process. Memory, language, perception about how our brains interpret messages from our senses and motivation all contribute to our knowledge and understanding of people with Alzheimer's.  Here are two links on how psychological needs influence behavior.

    Behavior as an expression of unmet need in Alzheimer's

    The impact of Alzheimer's on roles and relationships


    3. People's Pasts influence Behavior in Alzheimer's.

    People with Alzheimer's, as with all of us, take a personal journey through life. Overlapping and intertwining psychological influence are those life experiences. Memories of long ago are often more easily retrieved than the more recent experiences. These memories may be painful, sad and traumatic and can be acted out in inappropriate ways. This link-Dementia and Post Traumatic Stress Disorder in Veterans and Victims of War is just one example of how important knowing a person's life history may be to help treat people with Alzheimer's


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    4. Social Background, Culture & Ethnic Background Influences Behavior in Alzheimer's.

    Just as the risk of Alzheimer's can be increased, say in Hispanics, it is also true that social background, our cultural and ethnic backgrounds will affect our reaction to the disease and the treatment we receive. Ethnicity will change our experience of Alzheimer's disease.


    5. Environment Influences Behavior in Alzheimer's.

    Environment can play a huge part in how we behave, especially when people are no longer able to express themselves clearly. Caregivers have to look after and predict how someone's surroundings may make them uncomfortable and unhappy. This can include the layout of their rooms, heating, light levels, mobility issues, ability to get fresh air, go on an outing, have contact with people inside their home and outside. There is more information on Problem Behaviors in Mid to Late Stage Alzheimer's


    I hope this SharePost has given you some ideas on what you can look for and try to change. Making slow changes so you can identify causation of behavior problems to help you isolate problems. Of course life is not a static experience and something that worked once may not at another time. Don't put off getting medical help if you believe a health issue is causing a problem. Physicians can sometimes offer you help, advice and offer a referral to more specialized services too.


Published On: December 13, 2011