Dealing With Dad's Difficult Alzheimer’s Behaviors

Amy Goyer describes her Dad's anxiety, anger and other difficult behaviors due to Alzheimer's and provides tips for coping.
Dad was angry when I tried to convince him this wasn't the right way to get into bed.

It’s the moodiness that gets to me. And the irritability and all the yelling. Is this really my sweet, kind father?

Unfortunately, it is. As a recent study found, many who have Alzheimer’s disease will experience depression, anxiety and other behavioral changes long before memory slips or other cognitive deficits occur. This is a topic I know all too well as my dad battles the disease and I see his happy, sweet disposition erode.

In particular, the study found that these changes appeared first as irritability, depression and nighttime behavior changes, followed by anxiety, appetite changes, agitation and apathy.

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Dad experiences all of these and with good reason: He’s confused, insecure, overwhelmed, unsure of what to do, where he is and who we are. He’s desperately trying to control some aspect of his life. Currently, these behaviors are the most heartbreaking and discouraging aspects of caring for him because, above all, I just want him to be happy.

Dad always has been a truly sweet, kind man. Now, though, he yells quite frequently and it’s emotionally draining to feel helpless to alleviate his cognitive and mood discomforts. It has often brought me to tears.

Recently, on the way home from an appointment, Dad became convinced there was something wrong with the car and anxiously yelled at me to stop. So I did, twice, examining the car and reassuring him until we got home and a change of scenery calmed him down.

It’s a delicate dance to care for him and go with the flow of his moods and behaviors. These are some of the other ways I cope:

  • Remain self-aware. Instead of having a knee-jerk emotional reaction to something he’s said or done, I try to be aware of the emotions it has triggered in me. Then I can consciously decide not to take his words or actions personally. Otherwise my emotions can cause me to respond inappropriately.
  • Give affection. A hug, a shoulder rub and an “I love you, Daddy ” often defuses the tension, making him feel more secure and less alone. Often he then apologizes, saying he doesn’t mean to cause problems. I always reassure him that he could never be a problem.
  • Step away. There are times when I’m so tired and I so desperately want him to go to bed or to eat or drink that I start to get too intense myself. If possible, I literally step away. If not, I emotionally take a step back into observer mode.
  • Distract and defuse. Often a simple change of subject — bursting into song, reciting a poem, pointing out his dog or another person — will defuse the behavior and Dad returns to his good-natured self.
  • Apologize. No matter what offense he has imagined, I sincerely say that I’m sorry and I didn’t mean to do it. Even someone with Alzheimer’s can often sniff out an insincere apology, so I keep it truthful at least on some level.
  • Don’t fight the problem. This was one of Dad’s favorite mottos and I’ve taken his advice to heart. A few nights ago, Dad decided to lie sideways on the covers of his bed instead of getting under the blankets to go to sleep. He became quite angry when I suggested there was another way to get into bed and he refused to get up. So I didn’t fight the problem. I stayed calm, allowing him to express his emotions without engaging. After turning up the AC and ceiling fan, I kissed him goodnight and left. Twenty minutes later, he called out, wanting to get into bed and “get warm.”
  • Reach out for support. Sometimes I just need some moral support to keep from slipping into total despair. Texting my sisters or friends or posting on Facebook or other social media garners quick support that helps a lot.
  • Get creative. I try to be conservative with medications for Dad because of the side effects, so I’ve also introduced many alternative or complementary approaches that help manage these behavioral symptoms, including massage, traditional Chinese medicine (acupuncture, herbs, tui na acupressure massage), essential oils (lavender is very calming), music and humor. And sometimes just eating chocolate does the trick!

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Amy Goyer is AARP’s family, caregiving and multi-generational issues expert; she spends most of her time in Phoenix, where she is caring for her dad, who lives with her. She is the author of AARP’s  Juggling Work and Caregiving . Follow Amy on Twitter   @amygoyer  and on   Facebook .

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