There are millions of Americans who have Alzheimer disease. And with this, there are the millions who are unpaid caregivers for a person with Alzheimer or other forms of dementia. The health and emotional stability of people who care for Alzheimer patients directly affects the patients themselves, and thus should be an important part of the patients’ care plans.
What Caregivers Can Expect as the Disease Progresses
- A decline in logical thinking and judgment
- Inappropriate social behaviors
- Confusion and disorientation
- Rummaging and hiding objects
- Aggressiveness, anger, and frustration
- Night wakefulness
- Refusal to eat
What Caregivers Can Do to Decrease Stress
Patient Who Tends to Wander
- Recognize common precursors to wandering, such as restlessness and disorientation.
- Reassure and reorient the person.
- Reduce noise levels and confusion.
- Involve the person in productive daily activities and exercise.
- Have a written plan for yourself if the person does wander.
- Keep a recent photograph of the person to give to police if the person does wander.
- Inform the police and your neighbors of the person’s tendency to wander.
- Have the person wear bright, distinctive clothing.
Patient Who Rummages and Hides Things
Protect your valuables, and hide dangerous or toxic products from the person. Take some time to:
- Lock cabinets and specific rooms.
- Store valuables and unsafe substances out of reach of the person.
- Learn where the person tends to hide objects.
You can also create diversions. Try these tips:
- Use a basket of towels or laundry. They may repeat folding the items in the basket for a period of time.
- Give them a box of mixed objects to sort out, such as screws, bolts, or beads.
- Create a special place, such as a chest of drawers, a box, or chest.
Patient Who Becomes Angry or Aggressive
- Identify the immediate cause, if possible.
- Do not take the person’s belligerence personally.
- Reassure the person.
- Do not confront the person about their behavior, it may be beyond their control.
- Avoid using restraint. This may further frustrate the person.
- If needed, step back and stand away from the person. Give the person a safe space to let their anger play out.
- Try a relaxing activity, such as having the person listen to soothing music.
- Look for patterns in potential anger triggers.
Patient Who Hallucinates or Is Paranoid
- Don’t argue with the person about whether or not what they are talking about is real.
- Increase lighting so there are less shadows.
- Remove or cover mirrors.
- Stay calm. If safe to do so, provide reassuring words and a comforting touch.
Patient Who Cannot Sleep at Night
- Limit intake of caffeine.
- Increase physical activity during the day.
- Limit naps.
- Establish a nighttime routine, including calming elements, such as a bath and a warm drink, such as milk.
- Keep a nightlight on.
Patient Who Refuses to Eat
- Provide the person with a number of small meals throughout the day rather than a few large meals.
- Make the person’s favorite food.
- Provide finger food.
- Provide soft foods that don’t require chewing.
- Remove distractions during mealtimes.
- Have a different caregiver help the person with eating.
If the behaviors do not improve, talk to the doctor. Medications can be adjusted or changed.
What Can Be Done to Reduce Caregiver Burden
The daily routine of caring for a chronically ill person can put tremendous physical and emotional strain on caregivers, particularly for families who have assumed care responsibilities more recently. Here are some tips on coping with the stress that may come with caring for someone with Alzheimer:
- Know that there is help available. You are not alone. Adult day care, in-home assistance, visiting nurses, and Meals-on-Wheels are some services that may be helpful.
- It is okay to ask for help from family and friends. Also consider joining support groups or an online community.
- Take care of yourself. Be mindful of what you eat, get plenty of exercise, and get enough rest.
- Squeeze in some personal time. Stroll around the mall, have lunch with friends, or just take a nice walk.
- Manage your stress level.
- Do not be hard on yourself or the situation. Accept changes that may come with meeting the needs of someone with Alzheimer. Sometimes care beyond what you can provide is needed. This includes in-home caregiver services and residential care.
- Get your legal and financial planning in order. Talk with an attorney about legal, financial, and care issues.
The importance of easing the mental and physical burdens of those who care for Alzheimer patients cannot be underestimated, as the health of Alzheimer’s patients is closely related to the health of their caregivers. But your health is important too. So be sure to take care of yourself as you care for others.
Mental Health America
2014 Alzheimer’s disease facts and figures. Alzheimer’s Association website. Available at: http://www.alz.org/downloads/Facts_Figures_2014.pdf. Published 2014. Accessed March 22, 2017.
Alzheimer dementia. EBSCO DynaMed Plus website. Available at:https://www.dynamed.com/topics/dmp~AN~T114193/Alzheimer-dementia. Updated February 10, 2017. Accessed March 22, 2017.
Alzheimer's caregiving tips: Rummaging and hiding things. National Institute on Aging website. Available at: http://www.nia.nih.gov/sites/default/files/Alzheimers_Caregiving_Tips_Rummaging_and_Hiding_Things.pdf. Published July 2012. Accessed March 22, 2017.
Caregiver center. Alzheimer’s Association website. Available at: http://www.alz.org/care/overview.asp. Accessed March 22, 2017.
Eating. Alzheimer's Association website. Available at: http://www.alz.org/Resources/FactSheets/FSEating.pdf. Published 2006. Accessed March 22, 2017.
Gaugler JE, Kane RL, et al. The effects of duration of caregiving on institutionalization. Gerontologist. 2005;45(1):78-89.
Gonyea JG, O'Connor MK, et al. Project CARE: A randomized controlled trial of a behavioral intervention group for Alzheimer's disease caregivers. Gerontologist. 2006;46(6):827-832.
Last reviewed March 2017 by Michael Woods, MD, FAAP Last Updated: 3/12/2015