Alzheimer Disease: Tips for Caregivers

caregiver stress image Millions of Americans have Alzheimer disease. There are also millions of unpaid caregivers for people with Alzheimer or other forms of dementia. Caregiving is stressful. It helps to know what to expect and what to do.

What Caregivers Can Expect as the Disease Gets Worse

Over time, here are changes you can expect in a person with Alzheimer:

  • Problems with thinking, such as:
    • Poor judgement
    • Not making sense
    • Seeing things that are not there
    • Sensing a threat—when there is none
    • Confusion and not knowing where they are
  • Inappropriate social behaviors
  • Wandering
  • Looking for things and hiding objects
  • Aggressiveness, anger, and frustration
  • Being awake at night
  • Refusal to eat

What Caregivers Can Do to Lower Stress

Patient Who Tends to Wander

  • Be alert for restlessness or the person not knowing where they are. This often happens before wandering.
  • Reassure the person. Tell them where they are.
  • Lower noise levels and confusion.
  • Involve the person in busy activities and exercise.
  • Have a written plan for yourself—if the person wanders.
  • Keep a recent photo of the person to give to police—if the person wanders.
  • Tell the police and your neighbors that the person wanders.
  • Have the person wear bright clothing.

Patient Who Looks For and Hides Things

  • Hide dangerous or toxic products from the person.
  • Lock cabinets and certain rooms.
  • Put valuable things where the person cannot reach them
  • Learn where the person tends to hide objects.

Divert the person's attention. 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—a chest of drawers, a box, or chest.

Patient Who Becomes Angry or Aggressive

  • Look for the immediate cause, if possible.
  • Do not take the person’s anger personally.
  • Reassure the person.
  • Do not confront the person—they may not be able to control their behavior.
  • Do not restrain the person. This may increase anger.
  • 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 anger triggers.

Patient Who Sees, Hears, or Fears Things That are Not Real

  • Do not argue with the person about what is real or not.
  • Increase lighting so there are less shadows.
  • Remove or cover mirrors.
  • Stay calm. If safe to do so, reassure them and give 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. Use things that calm, such as a warm bath.
  • Keep a nightlight on.

Patient Who Refuses to Eat

  • Offer more small meals throughout the day rather than a few large meals.
  • Make the person’s favorite food.
  • Provide finger food.
  • Provide soft foods that do not need much chewing.
  • Remove distractions during mealtimes.
  • Have a different caregiver help the person with eating.

If the behaviors do not get better, talk to the doctor. Medicines can be adjusted or changed.

What Can Be Done to Reduce Caregiver Stress

Caregivers are under a lot of stress. Here are some tips that can help:

  • Look for help. Try adult day care, in-home assistance, visiting nurses, and Meals-on-Wheels.
  • Ask family and friends for help. Consider joining support groups or an online community.
  • Take care of yourself. Be mindful of what you eat. Get plenty of exercise and rest.
  • Take time for yourself. Stroll around the mall. Have lunch with friends or take a nice walk.
  • Do not be hard on yourself or the situation. Sometimes more help is needed. This includes an in-home caregiver and residential care.
  • Talk with a lawyer about legal, financial, and care issues.

Caregiving is a huge responsibility. But your health is important too. Be sure to take care of yourself as you care for others.

RESOURCES:

Alzheimer’s Association
http://www.alz.org

Help Guide
http://www.helpguide.org

CANADIAN RESOURCES:

Alzheimer Society
http://www.alzheimer.ca

Health Canada
https://www.canada.ca

REFERENCES:

Alzheimer dementia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/alzheimer-dementia. Accessed October 14, 2021

Alzheimer's caregiving. National Institute on Aging website. Available at: https://www.nia.nih.gov/health/alzheimers/caregiving. Accessed October 14, 2021.

Caregiving. Alzheimer’s Association website. Available at: https://www.alz.org/help-support/caregiving. Accessed October 14, 2021.

Last reviewed October 2021 by EBSCO Medical Review Board   Last Updated: 10/14/2021