If you have a loved one with Alzheimer’s disease, it may seem that just about anything can set them off. You want to be patient but you find yourself getting frustrated and pulled into arguments. How can you keep these arguments at bay or diffuse them if they start?
People with Alzheimer’s need to have positive relationships and environments, with routines that improve their mood, reduce their stress and make them feel connected and secure. But as the disease gets worse, their behavior and communication can change. That can lead to misunderstandings, frustration and conflicts.
How Alzheimer’s can change someone’s behavior
Alzheimer’s disease doesn’t just affect memory and thinking. It can cause behavior changes, too. Your loved one with Alzheimer’s may become agitated, anxious or easily irritated and negative. In rare cases, they could even become aggressive.
They may hallucinate or have delusions, seeing things that aren’t there or believing things to be true that aren’t. They might not sleep well, and they may wander through or rummage in the house. They may try to find their way home since they don’t recognize the house as their home. They may try to find their way to a parent they believe is looking for them and become upset when you try and convince them otherwise.
Alzheimer’s can also make it hard for them to communicate. Your loved one may struggle to find words, follow conversations or understand instructions. They may repeat themselves.
“They may not remember conversations, events or things they just saw or did,” said Helle Brand, a physician’s assistant with Banner Alzheimer’s Institute. “Their thinking can be distorted.” So, for example, they may become angry that you didn’t tell them they had an appointment, even though you talked about it recently.
What you can do to keep arguments from starting
You want to try your best to support your loved one with Alzheimer’s disease while respecting their dignity. Try to remember that the disease is changing their brain.
The most important thing you can do is to be patient and empathetic. When you are patient, it gives your loved one time to respond without feeling rushed and getting frustrated. And when you’re empathetic, your compassion and understanding will come through in your communication.
Try to prevent situations that can trigger frustration, such as:
- Changes in routine
- Unfamiliar environments
- Overstimulation
- Fatigue
- Pain
- Hunger
- Thirst
“Look frustration and irritability in the eye as a marker for something difficult or challenging for the person,” Brand said. “It’s a sign that you need to step up supervision, guidance or assistance.” They show you that you need to change or modify how you talk to or interact with your loved one.
Here are some strategies that can help reduce the frustration that can lead to arguments:
Accept them where they are
People with Alzheimer’s will have changes in their abilities. “Don’t try to hold them at a higher level of functioning or reasoning than they’re capable of,” Brand said. For example, if your loved one struggles to tie their shoes, you might want to push them to try so they keep using their brain. But you may need to accept that their brain is losing the ability to function the way it did.
Use simple language and short sentences
Break your information down into small chunks that are easier to understand. Speak clearly, make eye contact and use a calm voice. Gestures and visual cues can also help.
Be sure your language is inclusive
“A person with Alzheimer’s may not understand their disease, but they know there’s a problem,” Brand said. Avoid demeaning phrases like, “You need to…,” “Why didn’t you…,” “You have to…” or “I just told you…”. Instead, use collaborative language like, “Let’s get showered” or “It’s time for us to get ready for our appointment.”
Listen actively
Try not to interrupt them or finish their sentences. That way, they have time to express themselves.
Validate their emotions
For example, you can say, “I understand you’re feeling frustrated.”
Use non-verbal cues
Make eye contact, smile and gently hold their hand or rub their back. Non-verbal cues can keep the communication warm, open and reassuring and can help the other person feel calmer and less frustrated.
Create a peaceful environment
Noise and clutter may make your loved one feel confused or overwhelmed. When you’re trying to communicate, turn off the TV or radio and close doors and windows to block outside noise. Clear out the clutter so the living space is calm and organized.
Set routines
Regular times for meals, personal care, medication and sleep can help your loved one feel more secure and confident. Communicate the schedule, with reminders as needed. “Constancy reduces anxiety,” Brand said.
Focus on the present
Your loved one may not remember much about the past or understand the future. So keep your conversation and activities centered around the present.
Respect their perceptions and beliefs
Try not to contradict them. Instead, support and reassure them. “If you try to correct or challenge what someone is saying, it immediately starts escalating,” Brand said. It boils down to trying to reason with someone who cannot follow reasoning or logic anymore.
So if they don’t remember something you told them, accept that as their truth. “You can apologize and say, ‘I’m sorry, I thought we had talked about this,’” Brand said. “It’s hard for them to stay angry or upset if you’re sincerely apologetic.” Even if they are having a delusion, it’s not going to change. It’s real to them. Try to agree with them and move on.
Encourage decision-making and independence
You can empower your loved one by offering simple choices. It’s a good idea to limit the options to two or three things instead of asking open-ended questions. For example, they could choose between two outfits they want to wear that day.
Work with the health care providers who are managing their care
Your loved one may be dealing with anxiety or depression. They may have separation anxiety because they have trouble orienting their day and tracking time, and depend on you, the caregiver, to make sense of the day for them. They may have anticipatory anxiety because they know something important is coming up, but they can’t remember it so they repeat their questions.
What you can do if emotions are escalating
You want to pay close attention to your loved one in case they are getting agitated, restless or aggressive.
- Try your best to stay calm: Staying calm during an argument or outburst can be tough, but it can diffuse tension and help your loved one feel safe. Take a deep breath, count to ten or just step away.
- Redirect to another activity: Guide your loved one in taking a walk, listening to music, working on a craft project, doing a puzzle or having a snack. “You could say something like, ‘I can see that this is really bothering you. I always feel better when I have a cup of tea. Why don’t we try that?’” Brand said.
- Use humor as a distraction: Share a funny story — maybe even something from their past that they might remember.
- If you need to, remove yourself from the scene: “Short-term memory being what it is, it can be a whole new scenario in just a few minutes,” Brand said. “You can say, ‘I really want to talk about this, but I have to go to the bathroom.’ Come back fresh, with a snack or something pleasant. You might have a whole different situation.”
- Get help from support groups or professionals: You can learn insights and strategies from other people who are dealing with the same issues and from health care providers who specialize in caring for people with dementia.
Make time to care for yourself
Caregiving can be demanding on your body and your mind. But it’s important to care for yourself and manage your stress. Otherwise, you may end up burned out, exhausted and overwhelmed.
Ask family members and friends for help with caregiving and support. Make time for activities that recharge you, such as exercise, hobbies, meditation or spending time outdoors. Taking care of yourself puts you in a better position to be patient and compassionate with your loved one.
Ask your loved one’s health care providers about respite (short-term caregiving relief) care options in your community. Respite care gives you a break from the stress of caregiving so you can take care of your own needs and have some time for self-care. You may be able to work with a professional caregiver, an adult daycare program or a residential care facility.
The bottom line
When you’re caring for a loved one with Alzheimer’s disease, it’s easy for frustrations to come up that can quickly turn into arguments. Remember that their disease is causing changes in their brain that affect their understanding and behavior. Do your best to be patient and empathetic.
If you need help caring for your loved one or finding solutions to day-to-day problems, reach out to an expert at Banner Health for support.
