DIMENSIONS Autumn 2001

QUESTIONS AND ANSWERS

Q. I am caring for my aunt who has Alzheimer's disease. Sometimes she yells and screams, and I cannot figure out why she is doing this, or how to get her to stop. Is there anything I can do to prevent this behavior, or to stop it when it does occur?

A. People who are robbed by dementia of their ability to communicate may express themselves through yelling, repetition of words or sounds, or unintelligible speech. It can take patient detective work and creativity to alleviate their distress.

• Look for clues: Does it occur at particular times, places, or with certain individuals? Do the words suggest a cause or need? Is it spontaneous or in response to something?
• Deal with physical problems such as constipation, arthritis, infections, and discomfort from immobility. Ask questions that can be answered by yes or no.
• Treat psychiatric symptoms. Spontaneous cries of "they're going to kill me" may point to psychotic perceptions; "help!" or "oh, my god!" usually indicate anxiety
• Reduce over-stimulation. Cries of "leave me alone!" are reactions. Back off from what you are doing with the patient, simplify the environment. Limit activities or visits.
• Stimulate the senses. Someone experiencing sensory deprivation from vision or hearing loss may self-stimulate by repeating sounds such as "na-na-na-na.' Try music, giving access to a pet, sitting him or her near the kitchen or by the front window.
• Compensate for immobility: Take him or her outdoors, avoid physical restraints and excessive bed rest, and support large muscle movement, as in dance [or through walking].
• Consult available professionals: a physician for medical causes, a psychiatrist for symptoms of anxiety or depression or clinical psychologist for analysis of behaviors.
• Take care of yourself. Cries of distress pierce the heart. Remember that it is not intentionally aimed at you; it is caused by brain damage.

This article is reprinted with permission from the Alzheimer's Association, Northern California chapter. For more information about AD contact the Alzheimer's Association national chapter at 1-(800)-272-3900.