Managing challenging behaviours

Neurocognitive disorders can cause challenging behaviours. These apparent changes in personality are a major source of distress for the person with the disease and for caregivers, family members and health care providers. Simple strategies can help to prevent or control certain behaviours.  Here are some ways to better manage the challenging behaviours of a person with Alzheimer’s disease.

Generally speaking, it is important to find out what triggered the behaviour.

Wandering

If your loved one walks away from home unattended, he or she may get lost or become injured. Try to:

• Find out why he or she left the house
• Provide reassurance and distract him or her with another activity
• Make locks on the outside doors less accessible
• Plan regular walks and exercise
• Place reminders (coat, keys, hat, etc.) out of sight
• Inform neighbours
• Register the personn with a geolocation service (bracelet or other system)

Restlessness and agitation

• Identify the trigger
• Distract the person with a meaningful activity
• Calm the person down with music or touch
• Let the person walk in a safe place—after all, pacing is a form of exercise
• Look for a pattern and arrange to be with the person when there is a risk of restlessness or agitation
• Reduce sources of anxiety, such as changes in the daily routine

Repeated actions

If your loved one keeps repeating the same words or actions over and over:

• Ask if he or she is worried about anything
• If the behaviour isn’t bothering anyone, do nothing
• Distract your loved one with a simple activity (e.g., folding laundry, peeling vegetables)
• Don’t take accusations personally
• Try to change the subject
• Stay calm

Suspicion

People with this disease sometimes feel others are trying to hurt them or steal their possessions. If this is the case for your loved one:

• Provide comfort
• Don’t try to argue or reason with him or her
• Don’t take accusations personally
• Distract the person with another activity

Sexual behaviour

If your loved one removes his or her clothes or makes physical and verbal advances towards others:

• Don’t judge or scold
• Remain calm and show your affection
• Determine the person’s actual need: perhaps he or she needs to use the washroom, is lonely or bored, or is feeling too hot or cold?
• Distract the person with another activity
• Provide privacy

Aggression

If your loved one has a physical or emotional outburst (e.g., shouting or hitting):

• Be calm and reassuring
• Determine the cause to prevent the situation from recurring
• Give your loved one space to cool down
• Distract him or her
• Avoid physical contact: this could intensify the physical violence
• If your safety is threatened, leave

If the behaviours are extreme or are compromising you or your loved one’s safety, you may need to use medication to control them. Don’t hesitate to talk to your doctor about it or contact your CLSC. 

For more information, call Caregiver Support Helpline at 1 855 852-7784. Our professional counselors are on hand to listen, provide information and direct you to resources and services in your area.