Alzheimer’s Disease: How to manage behaviors


By Mary Macary Demakes

In Alzheimer’s disease, cognitive capabilities are gradually lost yet the unaffected areas of the brain can be stimulated. Alzheimer’s can produce negative triggers that stem from physical discomfort, environmental changes and over-stimulation — all which can cause escalating behavioral changes.

A care plan that positively stimulates different areas of the brain can be implemented to care for Alzheimer’s patients. Innovative strategies should be customized to the patient’s personality and particular needs. Habilitation therapy can be incorporated to evoke and maintain positive emotions. The main objective is to optimize treatment of Alzheimer’s for each patient by using innovative methods to address behavioral changes.

The care plan should address the patient’s physical and mental needs in ways that will produce positive emotions. Four areas of concern for patients are clear communication, physical environment, social stimulation and nutrition. Strategies implemented should be monitored to assess the effectiveness of the stimulants.

Clear communication is vital, as Alzheimer’s patients can become easily confused and stressed due to a lack of communication. As the disease progresses, their communication skills diminish. Caregivers can create positive emotions and limit frustration and anxiety by increasing body language and eye contact, speaking slowly and clearly and using gestures.

The physical environment should also be considered. An environment that was once known can become confusing for an Alzheimer’s patient, causing continual stress and frustration. The living environment must be adapted to the patient and any cognitive and physical changes brought on by Alzheimer’s.

To avoid disorientation or injury, safety precautions should be implemented. It is important to color code different areas for specific objects, install locks out of sight to avoid wandering, limit the use of certain appliances by removing them, supervise smoke and alcohol consumption, eliminate extraneous noises, supervise medications and keep walking areas clear.

The addition of light during the late afternoon hours can alleviate behavioral problems. When the environment is changed to compensate for physical decline, challenging behavior is minimized.

Socialization for Alzheimer’s patients is important, as social activities will slow the deterioration process of the disease. Activities must be personalized to the patient’s cognitive level. Every activity should be set up without failure. Positive emotions will be expressed through the patient’s interests and past experiences.

Whole food nutrition is a key element in a care plan for Alzheimer’s patients. A healthy diet will improve his or her overall functioning, both mentally and physically, while strengthening the immune system. Reduced inflammation and a decrease in homocysteine levels reduce the occurrence of infections.

Antioxidants and Vitamin D are essential parts of whole food nutrition. Generally, 15 minutes of daily sunlight on extremities provides enough Vitamin D. If the patient is not able to receive the Vitamin D intake from the sun, a capsule supplement is another option.

Using these innovative strategies diminish problem behaviors as well as improved quality of life and overall health of patients. Positive results seen in patients include healthy weight gain and increased hemoglobin and red blood cell counts. Patients also engaged in more conversation on a daily basis and slept more throughout the night. Improvements in daily functioning include better balance, regular bowel movements and reduced urinary tract infections.

Overall, patients kept at home with a whole food nutritional diet and strategies implemented to avoid negative triggers experience fewer symptoms that lead to challenging behavioral changes.

Mary Macary Demakes is the owner of AAAAA Private Home Care, serving all of Eastern Massachusetts.  She may be reached at 877-774-PHHC, 781-639-8696 or visit