Confusion is a common behavior starting in Stage 1 of Alzheimer's Disease. The person may call you by a different name, forget their address, a phone number or forget what their toothbrush is for. It's easy to get frustrated with this behavior, especially if it happens day after day.
- Stay calm and remember that it's part of the disease. Some days may be better than others.
- Give a brief explanation but don't overwhelm with a lot of information. Keep it simple.
- Try to jog their memory with pictures of important places and relationships.
Sundowning is late-day confusion caused by a number of factors: mental and physical exhaustion; disturbed internal body clock; reduced lighting and increased shadows; less need for sleep.
- Keep the person busy throughout the day with both mental and physical activities.
- Limit caffeine and sweets and only serve them in the morning.
- Serve dinner early
- Keep their bedroom partially lit to lessen confusion by the dark surroundings.
Aggression—in addition to the effects by the disease—can be caused by several other factors: poor communication, physical discomfort and their environment.
- Being tired because of poor sleep
- Side effects from medication
- Being in pain and unable to let you know
- Feeling overstimulated or overwhelmed by an environment because of loud noises, clutter, or lighting (glare, too dark/too light, flashing lights of TV)
- Feeling lost
- The caregiver's poor communication such as hard to follow instructions, asking too many questions, being negative and/or critical.
Agitation often occurs when the person is in an unpleasant environment, a new environment and their frustration trying to remember things.
- Be aware of the same reasons above that can prompt aggression.
- Modify the environment; get to a known comfortable environment like their bedroom.
- Ask them what's causing the agitation.
- Go for walk to take their mind off the agitation
- Don't become agitated yourself; they'll recognize this.
Suspicion is caused by the brain perceiving things in new, sometimes unusual ways, leading them to make accusations of friends, spouses and caregivers.
- Listen and find out what's bothering them.
- Don't argue
- Offer a simple explanation
- Engage them in an activity to change their focus..
Hallucinations can be terrifying for the individual or they can simply be non-threatening images from their past. Causes of hallucinations in addition to Alzheimer's include: schizophrenia, dehydration, intense pain, alcohol/drug abuse, medications and eyesight/hearing problems.
- Be supportive and respond in a calm manner.
- Ask them to take a walk into another room, preferably one that is better lit.
- Re-focus their attention with their favorite activity.
- Make sure the environment doesn't have distracting lights, shadows or noises that can be misinterpreted.