Alzheimer’s disease and other forms of dementia can diminish memory, reasoning and other skills. But there’s more to dementia than memory loss. “Behavioral changes are very common and affect upwards of 95% of people with dementia,” said Ganesh Gopalakrishna, MD, a geriatric psychiatrist at Banner Alzheimer’s Institute in Phoenix, AZ. We spoke with Dr. Gopalakrishna regarding what sorts of changes to behavior and personality should be expected following (and even before) a dementia diagnosis.
Common changes to personality and behavior
Knowing what to expect is extremely valuable in helping your loved one to adjust. It’s also important for caretakers and loved ones to know what common personality and behavioral changes can affect people diagnosed with Alzheimer’s and other forms of dementia. Having this information ahead of time will help explain the reasons for some of the difficulties and conflicts that may arise. Those with dementia often experience one or more of the following:
- General apathy, even for activities once found pleasurable
- Anxiety for simple acts throughout the day
- A quickness to anger and worry
- Hiding things or believing that others are hiding things
- Imagining things that aren’t there
- Ambiguous loss and grief
- A tendency to wander from home
- Decline in personal hygiene
- New or unusual sexual behavior
- Hitting you or others
- Misunderstanding what they see or hear
Dr. Gopalakrishna explained that depression and anxiety are very common in patients and can even begin to present 10-15 years before cognitive symptoms like memory loss will appear. The combined effects of behavioral and cognitive changes compound to create a very stressful situation. Learning to cope with the symptoms, one-by-one, as they appear, will make finding peace easier when various symptoms are present at the same time – for everyone.
Adjusting as the caretaker
It is common to feel overwhelmed with the behavioral symptoms related to dementia. Witnessing these changes in your loved one can feel isolating and unnerving. Remember that you aren’t alone. Lean on the support of your health care provider and inform them as personality changes appear and develop. Together, you’ll be more equipped to confront these changes with patience and optimism.
Dr. Gopalakrishna explained that behavioral interventions, such as cognitive stimulation, physical activity and music therapy, are possible and can be very effective. As symptoms develop or when other interventions aren’t feasible, medications can also be very effective in alleviating symptoms. In every case, a strong partnership with your loved one’s health care provider will make life gentler for everyone.
Easing the burden of a changing personality
“Behavioral symptoms can be very unsettling for patients with dementia,” commented Dr. Gopalakrishna. For your loved ones, these new emotional changes feel like the world is changing around them. Helping them to cope with their evolving emotions in a peaceful way is an important role for caretakers. In these moments, caretakers can rely on various tactics to help bring calm and understanding.
A reliable routine eases the mind
Changing plans and new faces can be very overwhelming and can flip the switch from peace to panic. Keep a written, consistent calendar as often as possible and remind your loved one often when new things are upcoming.
If feasible, creating a routine that includes regular breathing exercises, meditation or prayer will give you and your loved one a familiar toolbox to pull from when feeling agitated.
Create a safe environment
Safety is the most important thing for caretakers and their loved ones. As new behavioral and personality changes develop, it can be overwhelming and scary. “Many patients are burdened with depression, paranoia, or hallucinations,” said Dr. Gopalakrishna. “This can be enough to make one feel unsafe even in their own home. The first step in these situations is to provide a safe environment, limiting the chances of any accidental or intentional harm to self or others.” Caretakers should also consider locking up firearms if their loved ones are showing signs of aggression or despair. It’s important to eliminate as many opportunities for danger as possible before they happen.
Behavioral swings can happen in an instant. In those moments, having a solution on hand will help to avoid escalation. Take a look at these Care T.I.P.S. (Try Including Practical Strategies) provided by the Banner Alzheimer’s Institute. You’ll find helpful flashcards with solutions for many scenarios including avoiding arguments, apathy and nutrition.
From the outside
Alzheimer’s and other forms of dementia affect the lives of more than just those diagnosed with the disease. As a caretaker, friend or family member, witnessing the changes in your loved one can be heartbreaking. You may feel all alone in your struggle to connect and care for them. Remember that you may also need support in these times. Seek counseling and professional care as needed to ease your loved one’s burdens and your own.
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