Identifying Behavioral Triggers In Patients With Alzheimer’s And Dementia


Alzheimer’s and dementia patients suffer from a debilitating condition that robs them of their intellectual capacity as well as the ability to accomplish everyday tasks.  Imagine the frustration these patients must feel and then assume that their caregivers must feel the same amount of frustration, if not more.  Not only must they deal with the mental decline of the their patients, but also the behavioral problems that come with the disease.

It is important to remember, however, that some behavioral problems in patients are manageable without having to seek medication or institutionalization.  This can be done by identifying behavioral triggers in patients with Alzheimer’s disease or dementia and then resolving problems through words and actions.

In some cases, identifying the source of irritation can be easy.  Patients are sensitive to environmental changes, whether strong physical changes or even subtle ones.  For example, a new primary caregiver or unfamiliar visitors stopping by would be large physical changes to the environment.  Subtle changes might be erratic scheduling or even distracting patterns on plates and tablecloths.  After identifying this specific trigger, a way to deal with the problem would be to eliminate loud distractions and maintain daily routines as much as possible.  Maybe cutting down on the number of unfamiliar visitors, or providing more rest periods in between heavy activities would help reduce the stress.

Use conflict resolution when the patient is agitated or aggressive.  Instead of battling the patient, let them know you are on their side.  Statements of understanding and reassurance when delivered calmly can help settle the conflict.  If a caregiver matches the temperament of the angry patient the situation will probably escalate.  A patient with severe dementia or Alzheimer’s disease likely cannot reflect on his aggressive behavior and so is not able to control himself.  Thus, chastising the patient for bad behavior will not help the situation.  Be careful not to initiate physical contact during conflicts.  This is known to be a negative behavioral trigger.  Touching should be associated with relaxing or enjoyable activities only.

Some other behavioral triggers stem from such factors as privacy, independence, boredom, fatigue, confusion or pain.  Learn to identify these triggers and have a plan of action.

If you notice a patient becoming agitated because of privacy or independence issues, such as bathing or dressing, try and let the patient do a little more on his own.  The patient may feel embarrassed at times during baths and may want parts of his or her body covered up.  Oblige the patient and allow them to feel comfortable.

If boredom or fatigue triggers negative behavior then allow the patient’s aggression to play out.  As long as you are both safe, there is nothing wrong with the patient expressing a little bit of anger.  If you feel yourself becoming frustrated from the conflict then take a time out.  As a caregiver, dealing with stress calmly and patiently is very important.  Don’t take a patient’s aggressiveness personally.

Some behavioral triggers might also be related to certain activities or topics of conversation.  Keeping a log of such aggressive episodes is helpful in discovering patterns and pinpointing reasons why the patient became agitated.  That way, these topics and activities can be identified and removed from the daily routine.  For example, violent television shows have been known to be behavioral triggers in some patients.

Confusion can also be a behavioral trigger.  If a patient gets angry when tasks seem too difficult, break them town into smaller pieces.  Simplify statements if a patient is having problems concentrating on your words.

Some patients will be unable to distinguish fantasy from reality.  If a patient wants to discuss something he imagined, or confuses the past with the present, do not argue with him.  Arguing what is real or imagined could be a behavioral trigger that leads to aggressive behavior.  Rather, continue to be sympathetic when they speak and respond to the emotional content of what they are saying.

Pain and anxiety are also behavioral triggers so do not underestimate the importance of a patient’s health and relaxation.  Regular physical examinations should be scheduled to make sure the patient is not in pain.  Music and aromatherapy are helpful treatments in reducing stress.  Whereas some patients would enjoy a concentrated massage, others would just like a simple hug so as not to feel lonely.

It takes patience and an attention to detail for a caregiver to effectively deal with aggressive behavior.  But many caregivers are willing to invest that time and effort if extra medication can be avoided.  Identifying behavioral triggers in Alzheimer’s and dementia patients, and then taking steps to prevent such negative behavior, is a form of treatment all its own.