May 3, 2013

What to Do When Your Love One Behaves Inappropriately in Public?

Sometimes Alzheimer's patients act out in public, or express challenging behaviors. This can lead to embarrassment. What can you do?

By Marie Marley
+Alzheimer's Reading Room 

It isn't unusual for people with Alzheimer's to behave inappropriately in public at times
It isn't unusual for people with Alzheimer's to behave inappropriately in public at times. And often that leads to embarrassment for the caregiver.

For example, the person may become agitated and make scenes in public, causing people to stare. This could include behaviors such as arguing loudly with you or strangers, even about inconsequential matters.

Furthermore, Alzheimer's patients tend to lose their sense of inhibition and may say rude things to people.

Sometimes a person who always demonstrated extreme politeness in public may loudly curse at you or others. In other cases the person may make racist remarks - something they never would have done before.

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I was a caregiver to Ed Theodoru, my Romanian soul mate of 30 years, when he developed dementia. Sometimes I was so embarrassed by what he said and did in pub lic that I actually pretended I wasn't with him.

Ed often made scenes in restaurants. Once he complained very angrily to the waitress that his food was not hot enough and made her take it back to the kitchen. I'm pretty sure my face turned red.

During the same dinner, he commented loudly that a child sitting nearby with his parents was too loud and he wanted to change booths. Needless to say, the parents heard him. I pretended I had not heard him.

Another time he became agitated about having to wait longer than usual in a doctor's waiting room. After a few moments he got up and stomped over to the receptionist and loudly declared he wasn't going to wait much longer. Everyone there stared at him. I wanted to become invisible.

I was Ed's caregiver for the seven years he had Alzheimer's. During that time I developed some approaches to dealing with my embarrassment about his behavior. Here is some advice, based on my experience:
  1. Take the person to places with fewer people around. This could include things like going for a walk in the park rather than attend a crowded art fair. That way if your loved one does make a scene there won't be many people nearby to witness it.
  2. Another approach is to entertain friends at home instead of meeting them at restaurants or movie theaters. Ed tended to behave much better when in his own home. I think going to a restaurant was simply too stimulating and confusing for him.
  3. I once read about a caregiver who passed out little printed cards that read. "My loved one has Alzheimer's - Please excuse her behavior." This is not one of my preferred methods to deal with the problem, however. I feel it would be demeaning to the person with Alzheimer's. Plus, depending on how alert the person is, he or she may realize what you are doing and (rightfully) become angry.
  4. Here are some methods I discovered could sometimes prevent outbursts in the first place.Don't even bring up subjects that might make the person agitated.
    • Don't even bring up subjects that might make the person agitated 
    •  If the person does get upset, distract him or her by rapidly changing the subject 
    • Agree with whatever the person says (unless there's a compelling reason not to) 
    • Do not argue with the person - Do not try to reason with the person
  5. If all else fails you can reduce the frequency with which you take your loved one out in public or, if the behaviors are too extreme, limit excursions to essential trips, such as doctor's appointments.
Finally, try to accept the fact that you can't control your loved one's behavior and it isn't their fault or yours. Realize you love the person despite the behaviors, which are simply a manifestation of the disease.

Come Back Early Today:
A Story of Love, Alzheimer’s and Joy
Marie Marley, PhD, is the award award winning author of, Come Back Early Today: A Story of Love, Alzheimer’s and Joy. You can visit Marie’s website at ComeBackEarlyToday.

A slightly different version of this article was published on the Huffington Post.


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