Inappropriate Public Behavior

October 19, 2010

Of all the difficulties faced by dementia caregivers, inappropriate public behavior is often the most embarrassing and isolating.  Public toileting, sexual behavior, anger management issues (covered separately), “hitting” on members of the opposite sex, saying inappropriate things — the list goes on and on.  The potential for embarrassment keeps the caregiver from going out socially and keeps friends and family from issuing invitations to the caregiver, who can’t leave his loved one with dementia by herself.    Where does this leave the caregiver?  Isolated.

This stage of the disease may last several months or several years, or your loved one may never exhibit these problems.  If he does, there are things you can do to cope.

First of all, stay calm.  Getting mad, blaming the patient, yelling, or similar reactions will only make things worse.  Your mood influences that of your loved one.  Reacting rashly will confuse the patient, making it more difficult to stop the behavior.

Try to distract the patient from the behavior.  It may take several tries.  Try to find a “hot button” issue that usually distracts the patient.  For my father-in-law, the issue was his hair.  I could distract him from doing anything if I would say, “Papa!  Your hair is messed up!  You need to go to the restroom and comb it!”  For Coach Frank Broyles’ wife, the issue was milkshakes.  If Mrs. Broyles was agitated, a family member would say, “Let’s go get a milkshake!” and everything improved immediately.  Find your loved one’s “hot button” issue and use it liberally.

For those who try to undress in public or exhibit public sexual behavior, consider a “busy apron” which has buttons, zippers, snaps, etc. all over the front, but is just about impossible for them to remove.  It covers their real clothing, keeping them from removing it.    Several companies offer these over the internet.

One woman had business cards printed that said, “My husband has Alzheimer’s disease.  Please excuse his behavior.”  Most people, when they know why the person is acting strangely, will be quite understanding.

Consider dementia daycare.  My father-in-law went to a wonderful dementia daycare center called Caring Days.  There, he became a watercolor artist, having never painted prior to his diagnosis.  When exposed to art therapy, music therapy, and an mentally stimulating activities, my father-in-law’s behavior improved.  Also, remember that dementia caregiving is a marathon, not a sprint.  If you don’t take care of yourself, and get RESPITE for yourself, you won’t make it to the finish.

If these strategies don’t work or are insufficient, talk to your loved one’s physician who may decide medication(s) is necessary.

Finally, most people don’t notice things as much as you think.  As a dementia caregiver, you have to make allowances for the fact that your loved one will behave inappropriately at times.  Even if it’s something as minor as speaking kindly to a stranger as if she is a friend, it will be uncomfortable for the caregiver.  To avoid isolation, you must let a lot of this roll off your back.  Most people don’t care about the behavior of others near as much as we believe they do.  Try not to let this bother you.

Do you have ideas about preventing inappropriate behavior?  Please share!

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