Patients
with Alzheimer's disease experience some very difficult mental, emotional and
even physical challenges. Although gradual, the onset of the disease may appear
as memory loss and a decline in certain cognitive abilities. In its early
stages, the symptoms could appear mild. However, over time the disease
progresses and patients may begin suffering more intense and more prolonged
bouts in mood swings.
The reason behind this can be attributed to the feelings of frustration and agitation that patients with Alzheimer's experience as a result of the symptoms they begin to suffer from. For example, a patient trying to remember a simple thing – someone's name, his home address, a task that used to be automatic – can cause him to feel anger and annoyance.
As the disease progresses, so will the incidences and the severity of the symptoms. The result: mood swings.
The reason behind this can be attributed to the feelings of frustration and agitation that patients with Alzheimer's experience as a result of the symptoms they begin to suffer from. For example, a patient trying to remember a simple thing – someone's name, his home address, a task that used to be automatic – can cause him to feel anger and annoyance.
As the disease progresses, so will the incidences and the severity of the symptoms. The result: mood swings.
Causes of
Mood Swings
Determining
the cause of mood swings is а key in
understanding how to handle the situation properly. Unfortunately, it is not
always clear what the cause is; many factors come into consideration. The mood
swings may be a result of medication reactions or it can indicate a urinary
tract infection or a fever. In the early stages the person with AD is usually
able to communicate any physical distress.
In
the early stages of Alzheimer's, the individual may know that something is
wrong, it can lead to feelings of anger, frustration and sometimes depression.
Confusion and memory loss cause the same feelings.
Pay
close attention to what may trigger the onset of mood swings and learn how to
effectively handle the situation. Also, keep in mind the mood swings may be
completely random, going from laughing to crying in seconds and no particular
incident seems to have set this off. All you can do at that time is provide
quiet comfort or try to redirect the patient to an activity.
Occasionally,
as a caregiver, you may feel that the patient’s outbursts are directed to you
personally, and yet it is very important not to take them as personal attacks. Try
to remember that it’s the disease acting out and do your best to change the
situation into something positive. This is important, because feelings, good
and bad, linger much longer in people with dementia and Alzheimer’s. When
cognitively able people experience sadness or grief, strong feelings fade
pretty quickly. However, in people with dementia, these feelings last a lot
longer, often unchanged in intensity. Sadness and anger tend to linger longer
than happy and joyful feelings. With that in mind, you can see the importance
of keeping him in a positive space. When he has one of his outbursts, you can
validate his anxiety with a simple remark: “It sounds like you’re really
upset.” Before he has a chance to pursue his complaints, offer him an
alternative. This could be a bowl of ice cream or a request to help you with
something that he used to do particularly well, which allows you to compliment
him, boosting his ego.
How to Handle Mood Swings
If
a person suffers from Alzheimer's, mood swings are to be expected. Arguing with
someone suffering with Alzheimer's is usually a wasted endeavor; it will only
cause you to become angry and frustrated as well. Instead you are better off
using a calm voice and switch the focus to something else. Offer support when
appropriate; don't point out mistakes or failures. It is best to just say
comforting things, like "I understand it's hard," put the patient's
mind at ease tell her she is safe and you are there to help her if she needs
you. Keep your statements positive and supportive.
Here
are some other approaches your may adopt in your care-giving routine to ease the
potential probability of mood swings in Alzheimer’s patients:
1. Language. Be aware of your own body language - if you are looking upset and stressed, your parent may sense this and feel anxious, too. Try to express positive, supporting attitude whenever you are dealing with Alzheimer’s patient. Try to not rationalize or argue . . . try to accept your parent where they are at with their level of dementia and keep responses simple.
Because someone suffering from Alzheimer's often has a difficult time speaking and understanding what is spoken to them, communicating needs is often a slow process. Speaking slowly and simply, and using physical cues such as pointing or gesturing may help to clarify, conversation, directions, and requests.
2. Scheduling. People with Alzheimer's have to struggle constantly with forgetfulness and the strong emotions that come as a result. Difficult tasks, for example, such as those that involve multiple physical and mental efforts, are frequently the cause of mood swings. Instead of allowing the patient to suffer from frustration and agitation, it would be helpful to schedule these tasks during the time of day when the person is most calm and in a good mood.
3. Routine. Alzheimer's mood swings can be reduced by keeping routines, the person with AD will feel more safe and secure. Usually the person in the early stages finds his own routine and derives comfort by keeping that routine. Let him keep as much control as possible, arguing or trying to "rearrange" the schedule causes unneeded stress and confrontations. As the disease progresses, a caregiver will generally dictate schedule or routine. For now, relax your standards about what you feel he should be doing. Establishing routines will help eliminate confusion and predictability, two factors that often lead to mood swings. The more familiar the tasks are to the person, the easier they will be to perform.
4. Flexibility. The most basic functions in a person with Alzheimer's can decline steadily over time. Abilities can even change on a daily basis. Caregivers should allow flexibility into the routine and adapt new or other tasks and activities if necessary.
In order to avoid battles, it is important for a caregiver to remember to focus on the person, and not on the specific request or task on hand. For example, if getting a parent to bathe is your goal, and you see that they are not in the mood and are going to refuse, it is best not to waste your time arguing, but to wait for another point in time to suggest that bath. As long as the person is not in any danger, make it a point to avoid arguments whenever possible.
1. Language. Be aware of your own body language - if you are looking upset and stressed, your parent may sense this and feel anxious, too. Try to express positive, supporting attitude whenever you are dealing with Alzheimer’s patient. Try to not rationalize or argue . . . try to accept your parent where they are at with their level of dementia and keep responses simple.
Because someone suffering from Alzheimer's often has a difficult time speaking and understanding what is spoken to them, communicating needs is often a slow process. Speaking slowly and simply, and using physical cues such as pointing or gesturing may help to clarify, conversation, directions, and requests.
2. Scheduling. People with Alzheimer's have to struggle constantly with forgetfulness and the strong emotions that come as a result. Difficult tasks, for example, such as those that involve multiple physical and mental efforts, are frequently the cause of mood swings. Instead of allowing the patient to suffer from frustration and agitation, it would be helpful to schedule these tasks during the time of day when the person is most calm and in a good mood.
3. Routine. Alzheimer's mood swings can be reduced by keeping routines, the person with AD will feel more safe and secure. Usually the person in the early stages finds his own routine and derives comfort by keeping that routine. Let him keep as much control as possible, arguing or trying to "rearrange" the schedule causes unneeded stress and confrontations. As the disease progresses, a caregiver will generally dictate schedule or routine. For now, relax your standards about what you feel he should be doing. Establishing routines will help eliminate confusion and predictability, two factors that often lead to mood swings. The more familiar the tasks are to the person, the easier they will be to perform.
4. Flexibility. The most basic functions in a person with Alzheimer's can decline steadily over time. Abilities can even change on a daily basis. Caregivers should allow flexibility into the routine and adapt new or other tasks and activities if necessary.
In order to avoid battles, it is important for a caregiver to remember to focus on the person, and not on the specific request or task on hand. For example, if getting a parent to bathe is your goal, and you see that they are not in the mood and are going to refuse, it is best not to waste your time arguing, but to wait for another point in time to suggest that bath. As long as the person is not in any danger, make it a point to avoid arguments whenever possible.
5. Simplicity. One of
the causes of mood swings among those who have Alzheimer's is their struggle
with the complexity of tasks or activities. It would help if tasks are
simplified and choices are limited. Having too many choices can make it
difficult for an Alzheimer's sufferer to decide. By reducing the number of
things or actions a person has to choose from or perform, a patient wouldn't have to think too hard or too long, which helps prevent feelings of agitation. Limit
choices and keep tasks simple. Do everything one step at a time.
Instructions need to be broken down into manageable steps.
Saying, "Why don't you get dressed?" to someone with Alzheimer's can
lead to frustration, belligerence, and downright refusal to do so. Placing one
item at a time within reach of a loved one will help to alleviate the pressure
of such a complicated process and relieve the stress of making such
decisions.
6. Medications. Medications
should be considered as a last resort to deal with Alzheimer's mood swings,
according to The Alzheimer's Association. Putting more drugs in the system
should only be considered with severe symptoms are present or when physical
harm to themselves or others is indicated. Only then should anti-depressants,
tranquilizers or anti-psychotic drugs be carefully considered. No drugs are
approved by the U.S. Food and Drug Administration (FDA) to treat behavioral
symptoms with Alzheimer's.
Sources and Additional Information:
