ALZHEIMER – CORONAVIRUS. HOW TO DEAL WITH BEHAVIORAL AND EMOTIONAL PROBLEMS?

Family members, caregivers consult me, what to do? to control disturbing behaviors, emotional changes, of people with Alzheimer’s or another dementia. They ask for prescriptions to reassure them … but, the truth is, not everything are pills!!

COVID has revealed: the vulnerability of older adults living with non-communicable diseases such as dementia; ageism expressed in different ways in social and institutional structures; and in this case the lack of knowledge about the disease.

We know that dementia as such does not cause COVID-19, however, inappropriate behaviors by these people can increase the risk of infection. For example, they may forget to wash their hands; ‘Escape’ and go out without protection; open the door without considering the risks of the visitor; get irritated, cry and demand to go out … and well, “I already explained the risks, but he still wants to go out.”

WHAT TO DO? GUIDELINES.

• If, from one moment to another, the person carrying the disease becomes confused, agitated, yells, insults, ignores, becomes disoriented, wants to undress, that is, “he is worse than before” and this happens abruptly, the first thing is to rule out that have an underlying medical condition, call it pneumonia, urinary tract infection, dehydration, decompensated diabetes, etc. Remember that they can no longer express themselves clearly, they cannot find words to say what they feel, want, think. These abrupt manifestations indicate the urgency of taking the person to the Emergency of a health center.

• Know, understand, accept, that the person with Alzheimer’s forgets what is recent, although he still remembers the past well. They do not remember what they have just heard, said, read, but they sing a song of their time very well, and that can confuse us. ‘I told him not to open the door, to call me, even if he is a relative and whoosh! open the door… whose responsibility, is it? Can I get your attention? We are the ones who have to anticipate and strengthen that door so that it cannot be opened conventionally or opted for another strategy. Do not confront or mistreat them with ‘but if I told you’, ‘how, don’t you remember?’ ‘How many times do I have to repeat things to you …!’

• They don’t understand well or they just don’t understand anymore. So, I shouldn’t expect you, for example, to understand the importance of consistent and well-done hand washing. Depending on the stage of the disease we will have to be vigilant and supervise or we will invite them to wash or wash their hands. It is forbidden to insult, question … “How dirty … how is it possible …”. Help with warning signs inside the home, how to wash hands, and arrange the necessary.

• Changing routines upsets them. They can no longer go out to the park, to exercise. That generates anxiety, sadness and even aggressiveness. They will not understand the reason for the limitation … Knowing well their personality, tastes and preferences will help us to prepare activities to carry out, multiple and varied considering that their attention is quickly exhausted.

• Pressure, yelling, threats, bad attitudes, changes in the environment, routine, caregivers, decompose them and can lead them to have aggressive behaviors or become sad and cry. It may also be that they cry or become sad, a product of the illness itself. They ask to go “to their house” (they do not know the current one) or to “visit their mother.” They cannot be confronted. You have to change the focus of attention to something else that interests them. We can also say that we will go out later.

• Drugs to control behaviors can be used if environmental factors, underlying diseases have been corrected; These must be prescribed by the specialist doctor.