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Recognizing and Dealing With Alzheimer’s Personality Changes

Medically Reviewed by Carol DerSarkissian, MD on August 07, 2022

Alzheimer’s sometimes brings on personality changes that can make your loved one hard to recognize. The once-friendly person may now be wary of others. They may reject what they used to enjoy or blurt out random, impolite comments. And personality changes brought on by Alzheimer’s-related dementia may worsen over time as brain cells continue to die.

Common Personality Changes

Alzheimer's usually first strikes the part of your brain that controls your memory. Damage to the cerebral cortex, which affects your social behavior, communication, and language – the essence of your personality – comes later. Changes you might notice include:

  • Loss of interest in things they used to enjoy
  • Acting suspicious, confused, or anxious
  • Getting aggressive, hitting, or angering more easily
  • Being rude or insensitive
  • Seeming distant, distracted, or passive
  • Seeing or believing things that aren’t there (hallucinations, delusions)
  • Unusual sexual behaviors, such as becoming clingy or falling in love with someone else

Certain stressful situations, such as changes in schedules or a move to a new place, may heighten confusion and fear for someone with Alzheimer’s.

If you can identify a trigger in advance, you can plan for how you’ll handle or head off the reaction. Stay on the alert for these situations, big or small. Examples of triggering situations include:

  • A move to a new place or to a nursing home
  • A hospital stay
  • Caregiver turnover or new schedules
  • Requests to bathe or change clothes. Bathing can be a major stumbling block because they might resist help with an intimate act, fear water, get cold, or feel embarrassed.

When the cause isn’t clear-cut, make notes of what happened. Log certain words, requests, or stimuli that set off behavior problems. You’ll have it handy next time.

How to Deal With Personality Changes

It can be hard to accept the loss of your loved one’s “old self.” It may help to remind yourself that the personality changes stem from a brain disease and are not deliberate. Here are some ways that you can respond:

Apathy and lack of drive. These are common symptoms of dementia. Don’t try to reason with them or push them to do something. Instead, try to find ways to engage them as they are now. Simple activities such as listening to music, sorting or stacking objects, or going for a walk or a car ride are good options. Inattention or distraction. Find a quiet time and place to talk. Sit or stand where you’re at eye level with them. Remind them of your name and relationship to jog their memory if need be.

Confusion. Patience is key when someone with Alzheimer’s is anxious or overwhelmed by sounds, lights, or other stimuli. Speak in short, simple sentences. Use soothing voices and gentle humor.

Physical aggressiveness. Lashing out or anger may be your loved one’s way of telling you that they’re scared, confused, or in pain. Some ways to calm and comfort them include:

  • Try to find out if they need something but can’t tell you. They may need to use the bathroom or are tired, hungry, or thirsty.
  • Walk together.
  • Look through old pictures. Long-term memories are often slower to fade than short-term memories.
  • Talk about the past, such as family and good times.
  • Listen to music.
  • Read aloud from an engaging book or magazine.

Impulsivity. Your loved one might say or act in random or inappropriate ways, especially if their Alzheimer’s is severe. They might ask people personal questions, divulge private infomation about themselves, or make sexually suggestive comments. They might expose or touch themselves in public. Stay calm and try not to show your frustration. Count to 10 or step away for a moment if it’s safe. You also can:

  • Alert family and friends that they might witness impulsive behaviors.
  • Stay away from places that might trigger inappropriate behaviors, such as crowded or hectic places.
  • Distract them with a snack, a photo on your phone, or something interesting to hold.
  • Consider ordering cards that explain that your loved one has Alzheimer’s. It can be a quick and discreet way to ask for patience.

Emotional distress. Be calm and reassuring. Acknowledge their feelings, by saying, “You seem upset.” To soothe them, you can:

  • Quiet any noise and dim the lights.
  • Offer a favorite treat, like ice cream.
  • Hold their hand or hug them if that helps.

If you can’t figure out the cause of the distress, call for support or contact your doctor. The Alzheimer’s Association has a 24/7 helpline for free advice (800-272-3900).

Delusions or paranoia. Alzheimer’s can make people see, hear, or believe things that aren’t real or true. Talk to them in a soft, soothing voice, even if they don’t seem to hear you. Ask your doctor if hallucinations and other problems may be related to medications or other illnesses. Try not to argue with or blame your loved one. Use gentle touch and let them know that they are safe.

Take Care of Yourself, Too

Grief over your loved one’s Alzheimer’s is natural. Reach out to friends, counselors, or support groups to help you process your feelings. Keeping a journal of your thoughts can help. Also try to:

  • Make time for your own interests and friends.
  • Tend to your own medical needs and health.
  • Take breaks.
  • Exercise and eat healthy meals.

Show Sources

SOURCES:

University of California San Francisco, Weill Institute for Neurosciences Memory and Aging Center: “Behavior and Personality Changes.”

National Institute on Aging: “What Happens to the Brain in Alzheimer's Disease?” “Alzheimer's Caregiving: Caring for Yourself,” “Managing Personality and Behavior Changes in Alzheimer's.”

Cleveland Clinic: “Cerebral Cortex,” “Alzheimer's Disease: Caring for Loved Ones with Unpredictable Behavior.”

Alzheimer's Association: “Treatments for Behavior,” “Bathing,” “Staying Safe: Steps to Take for a Person Living With Dementia,” “2022 Alzheimer’s Disease Facts and Figures.”

Mayo Clinic: “Alzheimer’s Disease.”

Scientific Reports: “Relationship between elevated impulsivity and cognitive declines in elderly community-dwelling individuals.”

Alzheimer Society of Canada: “Managing Ambiguous Loss and Grief.”

University of California, San Francisco Weill Institute for Neurosciences: “Behavior & Personality Changes.”

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