Clinging

The person with Alzheimer's disease may become extra dependent on you and follow you everywhere. This can be frustrating, difficult to handle, and rob you of your privacy. The person may act this way as a result of feeling insecure and fear that when you leave, you will not return.

Suggestions:

• Provide something to occupy his/her attention while you step away
• You may want to call on a sitter to give yourself some privacy

Losing things and accusations of theft

The person with Alzheimer's disease may often forget where objects were placed. In some cases they will accuse you and others of taking missing objects. These behaviours are caused by insecurity combined with a sense of loss of control and of memory.

Suggestions:

• Discover if the person has a favourite hiding place
• Keep replacements of important items, eg, keys
• Check waste baskets before emptying them
• Respond to the person’s accusations gently – not defensively
• Agree with the person that the item is lost and help find it

Delusions and haIIucinations

It is not uncommon for the person with Alzheimer's disease to experience delusions and hallucinations. A delusion is a false belief. For example, the person may hold the false belief of being under threat of harm from the caregiver. To the person with AD the delusion is very real and causes fear, and may result in distressing self-protective behaviours.

If the person is experiencing an hallucination, he/she might see or hear things that are not there; for instance, figures at the foot of the bed, or people talking in the room.

Suggestions:

• Do not argue with the person about the validity of what was seen or heard
• When the person is frightened try to give comfort. Your calm voice and gently holding a hand can be comforting
• Distract the person by drawing attention to something real in the room
• Check with your doctor about medications that are being used, these may contribute to the problem

Sexual relationships

Alzheimer’s disease does not usually affect sexual relationships, but the person’s attitude may alter. Gentle cuddling and holding may be mutually satisfying, and will let you know if the person is able or inclined to engage in further intimacy. It is wise to be patient.

The person may not respond in the same way as before, or may seem to lose interest. For some couples, sexual intimacy continues to be a satisfying part of their relationship.

The opposite may occur, too. The person may make excessive demands for sex, or behave in a manner that makes you feel uncomfortable. You may feel guilty about needing or wanting to sleep separately.

Suggestions:

• Seek help from other caregivers or professionals you trust
• In some countries there are people with special skills in this area, such as psychologists, social workers or counsellors who can provide advice and guidance
• Don’t be afraid to discuss these and related issues with a professional who is trained to understand and help you manage them

Inappropriate sexual behaviour

The person with Alzheimer's disease may display inappropriate sexual behaviour, but it is rare. Behaviour may include undressing in public, fondling the genitals, or touching someone in an inappropriate way.

Suggestions:

• Try not to over-react to the behaviour - remember it is the disease taking effect
• Try to distract the person to another activity
• If the person removes clothing, gently discourage the behaviour, and try to distract the person

Wandering

This can be a worrying problem which you may need to manage. The person with AD may wander around the home or leave the house and wander around the neighbourhood. They may get lost. Safety is a primary concern when the person with AD is out in public alone.

Suggestions:

• Make sure the person carries some form of identification
• Make sure your home is secure and that the person is safe in your home and cannot leave without your knowing
• When the person is found, avoid showing anger – speak calmly, with acceptance and love
• It is helpful to keep an up-to-date photograph in case the person gets lost and you must ask for help from others

Violence and aggression

From time to time, the person may become angry, aggressive or violent.

This can happen for a variety of reasons such as sense of loss of social control and judgment, loss of the ability to express negative feelings safely, and loss of the ability to understand the actions and abilities of others. This is one of the most difficult things to cope with for a caregiver.

Suggestions:

• Keep calm, try not to show fear or alarm
• Try to draw the person’s attention to a calming activity
• Give the person more space
• Find out what caused the reaction – and try to avoid it in the future
• If violence occurs often, you will need to seek help. Talk to someone for support, and speak with your doctor about help in managing the person