Alzheimer’s Dementia is a debilitating disease. It begins with simple forgetfulness, slight mental confusion, and difficulty concentrating; as the disease progresses so do the severity of the symptoms. In the later states of Alzheimer’s Dementia, patients struggle to perform simple tasks and to recognize common things. More distressing to patients and their families are the behavioral changes such as sadness, depression, loneliness, all of which often lead to severe mood swings and anger. No one yet fully understands why anger sets in with Alzheimer’s patients in the later stages, but Alzheimer’s aggression is a reality of the progression of the disease. Some doctors believe Alzheimer’s aggression to be a symptom of the disease itself, while others see it as a result of a patient’s frustration with their own cognitive decline. Whatever the cause, it is a phenomena that can be extremely distressing to the families of patients and their caregivers.
The 3 Triggers of Alzheimer’s Aggression
Alzheimer’s aggression may occur with no triggers and no warnings, and so it is difficult to predict when a patient may exhibit this kind of behavior. However, caregivers of Alzheimer’s patients have dealt with the progression of the disease for long enough to understand that there are three major triggers to Alzheimer’s aggression that, when avoided, greatly reduce the likelihood of a patient lashing out.
Alzheimer’s patients struggle with the basic cognitive tasks that healthy people take for granted. This can lead to situations where a patient and their family run into issues. While family members may mean well by asking questions and attempting to carry on a conversation, too much cognitive stimulus may lead to confusion on the part of the patient. Bringing too many people into the room with the patient can also lead to stress, and the combination of these factors can quickly trigger aggressive behavior. Another thing that can cause confusion is any kind of complex instructions, which in the case of Alzheimer’s patients (in the later stages) can be as simple as discussing their bed time ritual.
Alzheimer’s patients experience a great deal of discomfort in relation to their symptoms. One of the most common symptoms of the disease is lack of sleep from insomnia, which can actually worsen other symptoms and cause a patient a great deal of discomfort. To make matters worse, patients whose cognitive decline is more advanced generally lose the ability to describe their discomfort to caregivers, and this in turn can lead to aggression. Additional causes of discomfort involve side effects from medications, and pain that the patient may not be able to describe or fully understand.
The most common cause of Alzheimer’s Aggression is environment. Environment includes everything from how cluttered the patient’s personal space is to how many people are present around the patient or coming in and out of their space. Rapid changes in environment, such as loud noises, a sudden cessation of ambient sound, the sudden arrival of several family members, among other things, can all trigger a spike in a patient’s aggression.
Measures to Help Prevent Alzheimer’s Aggression
Once aggression or agitation sets in, medication is often the first remedy caregivers utilize. However, the use of anti-psychotic medications is controversial and comes with some nasty side effects. Therefore, a new trend of preventative measures, as well as some non drug-related measures to treat aggression, has taken root in treatment facilities to help prevent and treat aggression at its root cause. It is important with these measures to identify the root cause of the aggression, and to treat it accordingly.
It is important to understand that new or unfamiliar situations will invariably make an Alzheimer’s patient uncomfortable. With this in mind, it is important to plan ahead when it comes to a loved one with the disease. Will there be too many people? Will there be too much noise? Is there a risk for sudden burst of sound? Will there just be too much going on? Asking questions like these will help to make a plan so that the environment and activity can be suited to the patient’s preferences.
Keep it simple
We often take for granted our ability to prioritize and filter information, even when we receive too much. For Alzheimer’s patients, this task is not so easy. Even a few questions in succession, if asked too quickly, can lead to confusion and frustration, and that’s when Alzheimer’s Aggression can set in. When caring for someone with the disease, it is important to keep things simple and to the point. But, it is also important not to belittle the patient, as this will most certainly anger them. Keep it simple while remaining respectful.
Do not criticize
Family and friends of those affected by Alzheimer’s Dementia often have difficulty coping with their loved one’s mental state. They may grow frustrated with the memory loss, declining abilities, and personality changes. Through this frustration, some may even lash out and criticize their loved ones. But criticism only adds fuel to the fire when it comes to Alzheimer’s aggression, and must be avoided at all costs.
Do not argue
For people with Alzheimer’s Dementia, the very nature of reality is altered. They begin to see the world in a different way, and this new view may not make sense to those around them. The temptation to try and argue or reason through these changes is futile, and will only lend to the aggression that we seek to avoid. Therefore, it is best to listen respectfully and resist the temptation to try to correct an Alzheimer’s patient.
Focus on long term memory
Alzheimer’s Dementia most severely affects short term memory and working memory. For most of the disease’s progression, long term memory seems to remain intact. Therefore, focusing on the past and recalling past times together can be therapeutic and beneficial to a patient’s overall wellbeing. Allowing a patient to tell their story is a great way to help them relax, and it is a fantastic opportunity for patients and their caregivers to connect on a deeper level.
Alzheimer’s Dementia specifically affects short term and working memory, making daily tasks increasingly difficult as the disease progresses. One method to help avoid frustration during these tasks is to use memory cues to help the tasks along. Putting sticky notes in key places with helpful messages can be a huge relief for patients who need only read what is written to be reminded of what they are supposed to be doing. It is helpful if this process begins early in the disease’s progression to help develop consistency in the practice. With a little help from these notes, Alzheimer’s patients will feel less frustrated, and this may help alleviate the tendency for Alzheimer’s Aggression.