BEHAVIOURAL AND PSYCHOLOGICAL PROBLEMS IN THE CASE OF ALZHEIMER’S DISEASE: RESTLESSNESS AND AGITATION

Thursday, April 2, 2009 4:17
Posted in category General Health

Many people with dementia, especially Alzheimer’s disease, become restless, anxious, and agitated. They may pace nervously up and down, talk incessantly, or fidget. This can be very wearing to carers. Sometimes it is a side-effect of medicines, but not very often. The medicines most commonly responsible are sedatives that belong to the group known as phenothiazines. The doctor who prescribes them should be aware of this side-effect and warn you to be on the look-out for it.

Often the restlessness and agitation is a response to an inappropriate belief. An elderly patient of mine thought she was living in her boarding-school and couldn’t understand why her mother hadn’t come to fetch her to take her home for the summer holiday. She was under the impression that she was alone in the school, having been there for several days after all her friends and the teachers had left. She was understandably very upset and very agitated. This happened frequently, usually at about eleven o’clock in the morning.

If a situation like this arises, try to be reassuring. You may have to enter into the spirit of the misbelief and, for instance, take some of the responsibility away from the mind of the sufferer by saying that you will look after whatever it is that is causing the concern.

When the distressing behaviour occurs at a regular time, it may be possible to break the cycle, for instance by making sure that the sufferer is otherwise engaged in a favourite activity at the appropriate time. If this doesn’t work, try a walk or a drive together or a visit to a neighbour. After attempting this diversional therapy for a few days or sometimes a little longer, you may find that the problem doesn’t recur. If it does, try to establish a different routine that regularly diverts attention away from other matters to something specific at this particular time.

If fidgeting is a problem – the constant rearrangement of decorations on the mantelpiece and so on – provide something else to fidget with. Worry beads, a few coins, or a piece of string are amongst the things that some relatives have successfully managed to substitute for a more generalized fidgety behaviour. If absolutely essential, drugs can again be tried as a last resort.

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