Dear Helpline, My wife was diagnosed with Alzheimer’s disease a few years ago. Over the last 6 months, I’ve noticed she’s been more agitated and aggressive than usual. I can’t seem to get her to settle down as easily as I once had. She is constantly pacing the hallways in our house, resists when preparing for bed, and lashes out verbally. I don’t know what happened! Can you help me? — Robert
Director of Helpline
Alzheimer’s is a progressive disease. Your wife’s diagnosis may have been made when she was in an early stage of the disease. Changes have apparently been gradual, and with you there to help her, life may have continued smoothly.
There are different areas in the brain. For example, there are areas for memory, for speech, for planning, and for physical activities such as sitting and walking.
There are several possible reasons for what you describe as her not being able to “settle down.” As brain cells die, connective paths of thought and memory are broken. Your wife doesn’t know what to expect, where to go, what do. Regular patterns of sleep and waking are affected. When the person with dementia becomes angry, words that we adults have been taught to censor pour out because judgment is impaired.
Have you discussed your wife’s changes in behavior with her doctor? Asking the doctor to assess for pain is a good place to start as pain sometimes causes agitation. If the root is not pain, the doctor may have other suggestions.
Pacing suggests your wife may need something do to. Activities are a great way to provide stimulation and keep a person with dementia busy.
Adult day programs can be a helpful resource for caregivers like yourself. There are two types of adult day programs, social and medical models. Social models provide opportunities for socialization as well as programming specific to people with Alzheimer’s disease.
Medical models provide the same opportunities as social models, but also offer medical services such as occupational or physical therapies, or perhaps they have a doctor on site, or a podiatrist who visits regularly.
If your wife is on Medicaid, many social medical programs now accept Medicaid insurance under contracts with Medicaid managed care programs. To pay out of pocket for medical model programs can be quite expensive. That said, social model programs can be wonderful for people who do not (yet) have more medical needs.
Once you determine where you think your wife might fit in best, I suggest you call the Helpline at 646-744-2900 for a list of adult day programs. Or, if you think a day program is not right for her, you may want to consider home care. A home care worker can help with bathing, feeding, and dressing, preparing lunch, taking your wife for a walk or to the park. You can hire a home care worker for part or all of the day for some or all days of the week.
Routines play a key part for people with dementia. Have a bedtime routine – maybe a warm shower, glass of milk, being read to, or a gentle massage with soothing music before going to bed. You might also think of other routines for mealtime, snack time or getting ready to go outside. This is where you can get creative; try it out and see what works. You know your wife best and know what would work for her.