Alzheimer's Caregivers: Patience, Sympathy Are Key
Also, antidepressants, anti-anxiety and antipsychotic medications are used to ease some of the behavioral symptoms that can be a part of Alzheimer's disease, including agitation and anxiety. None of these medications have been specifically approved to treat Alzheimer's, however, so the Alzheimer's Association recommends discussing the risks and the benefits of any medication with a doctor.
Despite the limitations of existing medications, problem behaviors can sometimes be overcome with the right type of stimulation and care.
"We need to see ourselves as a therapeutic agent," said Mintzer. "Patients have needs. When social stimulation is diminished, patients tend to get agitated." He noted that sundowning -- increased confusion and agitation that some people with Alzheimer's experience later in the day -- "may occur because the amount of care goes down in the evening, whether at home or in a nursing home."
"Sit down and talk with them for five minutes every hour," Mintzer suggested. "Talk with them in a non-threatening manner. Share a meal, or even sit down and split a cookie. It may not meet your needs for a social interaction, but that's not the purpose of it."
Using a calm voice is always important, and it's often easier to redirect attention than to try to get your friend or loved one to change a behavior. It's important to acknowledge any questions or requests, even though it may be the fifth time in 10 minutes that you've been asked what the time is. Each request is new to them.
Dinau said that she tries to keep routines as normal as possible. Instead of letting someone have dinner in bed, she guides them to the table to eat and then has a conversation with them during dinner. "A little activity here and there really helps," she said.
Mintzer also said it's important to have routine structure. Things can change within a day, but try to keep activities similar. For example, if Tuesday is the day you go out to lunch together, make a doctor's appointment for Tuesday. Then, while you're on your way to lunch, you can say something like, "Do you mind if we stop at the doctor on our way?" That way, he said, you're not changing the routine but just adding an element to it.
An array of devices also exist now that can help make a home safer for someone with Alzheimer's. He said these range from the very simple drawer and cabinet locks used to keep young children away from dangerous items to more high-tech safety devices like motion sensors for the stove and tracking devices that can be worn by people with Alzheimer's in case they wander.
But there does come a time when the disease ravages the brain so significantly that someone with Alzheimer's can't consistently control their behavior, Mintzer said. "When they get this impaired, they lack the ability to understand reality and suffer from delusions," he said, adding that medications that treat symptoms can be helpful at this point.