What are common behavior changes in someone with Alzheimer's disease?

Troublesome changes in behavior are a common feature of Alzheimer's disease. Examples include being stubborn, resisting care, refusing to give up unsafe activities, pacing or hand-wringing, wandering, using obscene or abusive language, stealing, hiding things, getting lost, engaging in inappropriate sexual behavior, urinating in unsuitable places, wearing too few or too many clothes, eating inappropriate objects, dropping lit cigarettes, and so on. A particular behavior can disappear as a patient's abilities further deteriorate (for example, verbal abuse declines as aphasia progresses), only to be replaced with new problems.

Personality and behavior changes are common over the course of Alzheimer's disease (AD) or dementia. Your loved one may:

  • Get upset, worried and angry more easily
  • Act depressed or not interested in things
  • Hide things or believe other people are hiding things
  • Imagine things that aren't there
  • Pace a lot of the time
  • Exhibit unusual sexual behavior
  • Hit you or other people
  • Misunderstand what he or she sees or hears
  • Stop caring about how he or she looks, stop bathing, and want to wear the same clothes every day

Some of the most difficult aspects of caring for someone with AD or dementia are the changes in behavior or personality. It can be frightening to see your loved one become paranoid or aggressive. Working with your healthcare practitioner to get appropriate medication and assistance in coping with these behaviors is important.

Dr. Eric Pfeiffer
Psychiatrist (Therapist)

When caring for someone diagnosed with Alzheimer's, you need to be a keen observer. Look for what is changed, and then decide if there is something you need to do about it. Not all changes you may see will require a specific response.

Changes are likely to happen in four areas:

  1. Changes in memory: During this phase of the disease you are likely to discover that memory for recent events, recent conversations and updating of events or times, will be the most prominent changes. You may find yourself having to repeat conversations you have had, or you may need to answer the same question more than once. Keeping track of the day of the week and the date, since these require constant updating, may slip fairly easily. You may want to keep the day of the week and the date displayed somewhere prominently in your home to help with orientation. If your loved one does make mistakes, it is important that you respond to them with equanimity, rather than with annoyance.
  2. Changes in communications: You may observe that your loved one will not finish a sentence, or may get stuck on trying to find a word that simply won’t come out. If you understand enough of the sentence, you don’t need to do anything. If you can guess what word your loved one is trying to say, go ahead and supply the word, so that the conversation can continue. For example: if your loved is saying: “We have to go to the ... (can’t come up with the name),” go ahead and say “the Williams’s” so that your loved one can complete the sentence. This will be less frustrating than if you are waiting for the right name to emerge.
  3. Everyday activities: Let us say your spouse starts to mow the lawn or to wash the dishes, but doesn’t finish the job. There is no need to make a big deal out of it. Ask your spouse to please start again on the same or finish the job yourself.
  4. Changes in mood or behavior: if you notice your loved one becoming blue or irritable, try to initiate a new activity with him or her. Suggest something that you know they usually really like to do, like: “let’s go for a walk, it is such a beautiful day today,” or “let’s have a picnic out in the back yard today.” Or offer a compliment that you can sincerely make, such as “you’re wearing such a nice outfit today,” or “I sure appreciate your helping me put away the dishes today.”
The Art of Caregiving in Alzheimer's Disease

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The Art of Caregiving in Alzheimer's Disease

This is an A to Z Guide to the caregiving experience in Alzheimer's disease. It is easy to read, easy to follow. It is authorative, based on thirty years of experieReconce in caring for Alzheimer's...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.