Advice and Strategies for Dealing with Specific Behaviors

PACING:
Walk with them.
Hold their hand.
Tell them they are safe and loved.
Keep the walkway clear so they are safe from falling.
Try and distract them from pacing by looking at a magazine or doing a puzzle with you.

LATE AFTERNOON BEHAVIORS (SUNDOWNING)
Give them a hug.
Tell them where they are.
Tell them they are safe.
Tell them that you are not leaving.
Change the topic.
Turn on more lights.
Close the blinds or curtains.
Ask them if they are hungry or to help you in the kitchen.
Begin an easy activity like sorting silverware or wiping off a table.

REFUSING CARE
Keep a daily routine.
Don’t ask if you “want to” bathe, brush your teeth or get dressed. Tell them it’s time for a care activity.
Have all the supplies ready before the activity.
Explain in simple terms what you’ll be doing.
Make sure that if they say NO that it isn’t because they don’t understand.
If they begin to fight you, step away and try again later.

USING THE BATHROOM
Mark the bathroom clearly.
Use a sign with the word Bathroom in it.
Put a picture of the toilet on the door.
Watch for cues like fidgeting and pacing.
Write down the day when toilet accidents occur to help predict their schedule.
Walk with them to the bathroom every two to three hours and don’t make a big deal out of it. Don’t wait for them to ask.
Carry extra toileting supplies with you when you are away from home (including clothes).

HOME SAFETY
Try to make their world simple.
Use plain colored placemats, tablecloths, towels and sheets.
Block off stairs so they can’t fall up or down them.
Have all of your house locks set to one key.
Place safety latches up high or down low on outside doors.
If they wander have them wear an ID bracelet and sign up for the Alzheimer’s Safe Return Program.
Lock all cabinets that contain soaps, cleaners, poisons and medicine.
Insure they don’t have access to the stove.

DRESSING
Allow twice the amount of time you think it will take to get dressed.
Don’t act rushed or in a hurry.
Limit their choices to two outfits and let them choose.
Lay their clothes out in the order in which they get dressed.
Talk them through getting dressed.
Use short, simple, one–step commands.
If they like one outfit and refuses to wear anything else, buy several outfits that look just like it.
Use pants with elastic waists and pullover tops.

WANDERING
Make sure they wear a Medical ID bracelet.
Keep a recent photograph to help the police if they get lost.
Keep all of your doors locked.
Consider a keyed deadbolt.
Place safety latches up high and down low on doors.
Enroll them in the Alzheimer’s Association Safe Return Program.
Make sure they get enough exercise and sleep.
Let them do chores like folding laundry and setting the table.
Place a cloth over the doorknobs or paint the doorknobs and the doors the same color as the walls.

COMMUNICATION
Pay attention to what they are trying to tell you.
Keep what you are telling them short and simple but not child-like.
Use one-step commands when telling them what to do.
Don’t tell them more than they need to know at one time.
Be patient. Give them lots of time to answer your questions.
If they lose the thought ask the question again.
Give them lots of time to finish what they are saying.
Don’t argue with them. Agree and do it your way.
Don’t try to reason with some that has lost the ability to reason.
Don’t correct them if the did something wrong.
Never say, “I just told you that”, just repeat the answer.
Don’t ask her to remember what happened in the past.
Never say, “you can’t.” Say, “Do as much as you can and I’ll help you.”
Don’t demand things from them. Show them what you want them to do.

IN THE CAR
Keep the car keys out of sight.
Tell them where you’re going as you leave the house.
If they ask, tell them the Dr. or insurance company said they couldn’t drive anymore.
Open the car door for them.
Help them put on their seatbelt.
Use the Child safety door locks.
Make trips to places they like to go.
In the later stages, put them in the back seat where they’ll feel safer.
If they refuse to get out of the car don’t argue. Drive around the block and try again.
If they refuse to get out at a location where they’re expecting you have someone meet you to welcome them and invite them in.

EATING
Serve meals at the same time every day.
Serve foods with different colors and textures.
Make the table a calm place to eat.
Use plain colored dishes to set off the color of the food on the plate.
Use a shallow bowl with a lip if they push food off their plate.
Put only the utensils they need next to the plate.
If they refuse to eat there could be too many choices on the plate so try one item at a time. You may have to help them get started. Show them how.

SURVIVAL TIPS
Put staying healthy on top of YOUR list.
Have a back-up plan if something happens to you.
Take one day at a time.
Keep your sense of humor.
Pat yourself on the back for the good job you’re doing.
Get enough sleep and eat right.
Make time for the things you like to do.
Talk about how you feel with others (support group).
Join their Journey. They will never join yours.

Source: The Alzheimer’s Association ( HYPERLINK “http://www.alz.org” www.alz.org) and The Barbara Broyles Legacy.
Additional information provided by Robert E.P. Elmer III, Master Trainer of Alzheimer’s Care and Carolyn Collin, R.N., Master Trainer of Alzheimer’s Care and Nurse Manager of two dedicated communities for those with Alzheimer’s and other memory disorders.