Do Memory Problems Always Mean Alzheimer’s Disease?

(NIA) Many people worry about becoming forgetful. They think forgetfulness is the first sign of Alzheimer’s disease. But not all people with memory problems have Alzheimer’s.

Other causes for memory problems can include aging, medical conditions, emotional problems, mild cognitive impairment, or another type of dementia.

Age-Related Changes in Memory

Forgetfulness can be a normal part of aging. As people get older, changes occur in all parts of the body, including the brain. As a result, some people may notice that it takes longer to learn new things, they don’t remember information as well as they did, or they lose things like their glasses. These usually are signs of mild forgetfulness, not serious memory problems, like Alzheimer’s disease.

Share this infographic and help spread the word about what memory problems are normal and not. 


Mary’s Story

Mary couldn’t find her car keys. She looked on the hook just inside the front door. They weren’t there. She searched in her purse. No luck. Finally, she found them on her desk. Yesterday, she forgot her neighbor’s name. Her memory was playing tricks on her. She was starting to worry about it.

She decided to see her doctor. After a complete check-up, her doctor said that Mary was fine. Her forgetfulness was just a normal part of getting older. The doctor suggested that Mary take a class, play cards with friends, or help out at the local school to sharpen her memory.

Differences Between Normal Aging and Alzheimer’s Disease
Normal Aging Alzheimer’s Disease
Making a bad decision once in a while Making poor judgments and decisions a lot of the time
Missing a monthly payment Problems taking care of monthly bills
Forgetting which day it is and remembering it later Losing track of the date or time of year
Sometimes forgetting which word to use Trouble having a conversation
Losing things from time to time Misplacing things often and being unable to find them


Memory Loss Related to Medical Conditions

Certain medical conditions can cause serious memory problems. These problems should go away once a person gets treatment. Medical conditions that may cause memory problems include:

  • Tumors, blood clots, or infections in the brain
  • Some thyroid, kidney, or liver disorders
  • Chronic alcoholism
  • Head injury, such as a concussion from a fall or accident
  • Medication side effects
  • Not eating enough healthy foods, or too few vitamins and minerals in a person’s body (like vitamin B12)

A doctor should treat serious medical conditions like these as soon as possible.

Learn more about Alzheimer’s disease from MedlinePlus.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About Memory Loss

Alzheimer’s Association
1-800-272-3900 (toll-free, 24/7)
1-866-403-3073 (TTY/toll-free)

Alzheimer’s Foundation of America
1-866-232-8484 (toll-free)

National Institute of Mental Health
1-866-615-6464 (toll-free)
1-866-415-8051 (TTY/toll-free)

Eldercare Locator
1-800-677-1116 (toll-free)


National Institute on Aging


Enhancing Daily Life: Choosing Activities for a Loved One with Alzheimer’s

(Alzheimer’s Association) A person with Alzheimer’s or other dementia doesn’t have to give up the activities that he or she loves. Many activities can be modified to the person’s ability. In addition to enhancing quality of life, activities can reduce behaviors like wandering or agitation.

Choosing Activities

In the early stages of dementia, the person may withdraw from activities he or she previously enjoyed. It is important to help the person remain engaged. Having an open discussion around any concerns and making slight adjustments can make a difference. For example, a large social gathering may be overwhelming, but the person may be able to interact more successfully in smaller groups.

As Alzheimer’s progresses, you may need to make other adjustments to the activity. Use the following tips:

  • Keep the person’s skills and abilities in mind. Stick with activities the person has always enjoyed and adjust, as needed, to match the person’s current abilities. A person with dementia may be able to play simple songs learned on the piano years ago. Bring these types of skills into daily activities.
  • Pay special attention to what the person enjoys. Take note when the person seems happy, anxious, distracted or irritable. Some people enjoy watching sports, while others may be frightened by the pace or noise.
  • Consider if the person begins activities without direction. Does he or she set the table before dinner or sweep the kitchen floor mid-morning? If so, you may wish to plan these activities as part of the daily routine.
  • Be aware of physical problems. Does he or she get tired quickly or have difficulty seeing, hearing or performing simple movements?
  • Focus on enjoyment, not achievement. Find activities that build on remaining skills and talents. A professional artist might become frustrated over the declining quality of work, but an amateur might enjoy a new opportunity for self expression. For activity ideas join ALZConnected, our message boards and online support community. Every day, caregivers like you share new ideas and encourage one another.
  • Encourage involvement in daily life. Activities that help the individual feel like a valued part of the household — like setting the table — can provide a sense of success and accomplishment.
  • Relate activity to work life. A former office worker might enjoy activities that involve organizing, like putting coins in a holder, helping to assemble a mailing or making a to-do list. A former farmer or gardener may take pleasure in working in the yard.
  • Look for favorites. The person who always enjoyed drinking coffee and reading the newspaper may still find these activities enjoyable, even if he or she is not able to completely understand what the newspaper says.
  • Consider time of day. Caregivers may find they have more success with certain activities at specific times of day, such as bathing and dressing in the morning.
  • Adjust activities to disease stages. As the disease progresses, you may want to introduce more repetitive tasks. Be prepared for the person to eventually take a less active role in activities.

Your Approach

  • Help get the activity started. Most people with dementia still have the energy and desire to do things but may lack the ability to organize, plan, initiate and successfully complete the task.
  • Offer support and supervision. You may need to show the person how to perform the activity and provide simple, easy-to-follow steps.
  • Concentrate on the process, not the result. Does it matter if the towels are folded properly? Not really. What matters is that you were able to spend time together, and that the person feels as if he or she has done something useful.
  • Be flexible. When the person insists that he or she doesn’t want to do something, it may be because he or she can’t do it or fears doing it. Don’t force it. If the person insists on doing it a different way, let it happen, and change it later if necessary.
  • Break activities into simple, easy-to-follow steps. Focus on one task at a time. Too many directions at once can be overwhelming.
  • Assist with difficult parts of the task. If you’re cooking, and the person can’t measure the ingredients, finish the measuring and say, “Would you please stir this for me?”
  • Let the individual know he or she is needed. Ask, “Could you please help me?” Be careful, however, not to place too many demands upon the person.
  • Make the connection. If you ask the person to make a card, he or she may not respond. But, if you say that you’re sending a special get-well card to a friend and invite him or her to join you, the person may enjoy working on this task with you.
  • Don’t criticize or correct the person. If the person enjoys a harmless activity, even if it seems insignificant or meaningless to you, encourage the person to continue.
  • Encourage self expression. Include activities that allow the person a chance for expression. These types of activities could include painting, drawing, music or conversation.
  • Involve the person through conversation. While you’re polishing shoes, washing the car or cooking dinner, talk to the person about what you’re doing. Even if the person cannot respond, he or she is likely to benefit from your communication.
  • Substitute an activity for a behavior. If a person with dementia rubs his or her hand on a table, provide a cloth and encourage the person to wipe the table. Or, if the person is moving his or her feet on the floor, play some music so the person can tap to the beat.
  • Try again later. If something isn’t working, it may just be the wrong time of day or the activity may be too complicated. Try again later, or adapt the activity.

The Alzheimer’s Association Can Help

It helps to know you aren’t alone. Talking to others who are going through the same experiences as caregivers can provide you with ideas, support and resources.


Copyright © 2018  Alzheimer’s Association®. All rights reserved.


Dementia & Driving: Help from the Alzheimer’s Association

(Alzheimer’s Association) Driving demands quick reaction time and fast decision making — because of this, a person with Alzheimer’s will eventually become unable to drive. Dealing with the issue early on can help ease the transition.

Having the Conversation

Losing the independence driving provides can be upsetting. It is important to acknowledge a person’s feelings and preserve his or her independence, while ensuring the person’s safety and the safety of others.

Starting the conversation

  • Initiate a dialogue to express your concerns. Stress the positive and offer alternatives.
  • Address resistance while reaffirming your unconditional love and support.
  • Appeal to the person’s sense of responsibility.
  • Reinforce medical diagnoses and directives. Ask the physician to write a letter stating that the person must not drive. Or ask the physician to write a prescription that says, “No driving.” You can then use the letter or prescription to reinforce the conversation.
  • Consider an evaluation by an objective third party.
  • Understand that this may be the first of many conversations about driving

When the conversation does not go well

Some people give up driving easily, but for others this transition can be very difficult. Be prepared for the person to become angry with you, due to the memory and insight issues that are part of Alzheimer’s.

  • Be patient and firm. Demonstrate understanding and empathy.
  • Acknowledge the pain of this change and appeal to the person’s desire to act responsibly.
  • Ask a respected family authority figure or your attorney to reinforce the message about not driving.
  • If the conversation does not go well, do not blame yourself. The disease can impair insight and judgment, making it difficult for people to understand that their driving is no longer safe. Also the disease can cause mood and personality changes that make reactions more pronounced.
  • As a last resort, take away the car keys, disable the car or remove the car completely. When you do any of these things, be sure to provide safe, reliable alternative transportation.

Planning Ahead

For people in the early stages of Alzheimer’s, it is never too soon to plan ahead for how you will get around when you can no longer drive. Putting a plan in place can be an empowering way to make your voice heard.

Tips for planning ahead

  • Remember that each situation is unique. What works for one person may be different from what works for another. You can get the information and support you need from the Alzheimer’s Association at 800.272.3900.
  • Involve family and close friends in the plan.
  • Confront resistance. Empathize with those who are uncomfortable having the conversation and stress the importance of preparing for the future.
  • Develop an agreement for all to share that includes practical safety steps, such as a periodic driving assessment, a GPS monitoring system for the car, and alternate transportation options.

Transportation Options

Driving is not the only transportation option available. There are many options people can explore that will allow them to continue to travel independently and remain in control of their mobility.

  • Transition driving responsibilities to others. Arrange for family members and friends to provide transportation.
  • Arrange a taxi service.
  • Use special transportation services for older adults. Access local resources using the Eldercare Locator at or use our Community Resource Finder to search for transportation services.
  • Reduce the need to drive by having prescription medicines, groceries or meals delivered.

Signs of Unsafe Driving

Determining when someone can no longer safely drive requires careful observation by family and caregivers. The following list provides warning signs that it’s time to stop driving:

  • Forgetting how to locate familiar places
  • Failing to observe traffic signs
  • Making slow or poor decisions in traffic
  • Driving at an inappropriate speed
  • Becoming angry or confused while driving
  • Hitting curbs
  • Using poor lane control
  • Making errors at intersections
  • Confusing the brake and gas pedals
  • Returning from a routine drive later than usual
  • Forgetting the destination you are driving to during the trip

Driving Evaluation

At the earliest stages, a person with Alzheimer’s disease may begin to have difficulty with complex tasks such as driving. Although family and caregivers can watch for signs of unsafe driving, a proactive strategy would be to get a comprehensive driving evaluation by an occupational therapy driving rehabilitation specialist. The evaluation provides a more objective understanding of the current impact of the disease on driving capacity and results in a plan of options. The goal is always to retain the highest level of independence and mobility in the community. Initial recommendations may include strategies to reduce driving risk during the early part of the disease. The occupational therapist can offer strategies specific to the individual’s goals and needs. The American Occupational Therapy Association website includes a national database of driving specialists as well as a wealth of resources for both persons with Alzheimer’s disease and their families.

We Can Help

Each situation is unique. What works for one person may be different from what works for another. You can get the information and support you need from the Alzheimer’s Association.

More Resources


Copyright © 2018  Alzheimer’s Association®. All rights reserved.


Joy in Caregiving: Have Fun with Your Loved One

(AARP) As caregivers we are so focused on health care, safety, finances and logistics that we can easily lose sight of quality of life — both for those we care for and for ourselves. Experiencing joy while caregiving isn’t always easy, but I believe it’s more than just a nice thing to do: It’s a crucial survival skill. Every moment of joy fills our tanks a bit so we can keep going. And a little bit of fun can go a long way to relieve stress, motivate, activate and connect — as well as relieve boredom.

I’ve learned to prioritize both noticing the inherent joys throughout the day as well as proactively creating joyful moments. Here are some ideas for infusing joy into your loved one’s life, as well as your own.

Music. When I ask caregivers how they create joy and fun, music is the most common response. Play your loved one’s favorite genre of music — from 1940s swing to gospel to rock. Listen on the radio or television (watching Lawrence Welk reruns is my dad’s favorite thing to do), or set up a playlist on an MP3 player. You can use Pandora, iHeartRadio, Amazon Prime music and Sirius XM to play songs that bring peace, ease pain, energize, distract from anxiety, induce memories (such as military or patriotic music) or trigger a spontaneous sing-along.

Adventures. I approach every outing as an adventure — whether it’s to a medical appointment, shopping, dinner, a movie, a ball game or just a car ride to get out of the house. Outings are more difficult for my dad these days (he’s 93 and has Alzheimer’s disease), but we still go out for drive-through coffee and lemonade on good days. Plan ahead for the best places for parking, and recruit someone else to drive or come along to lend a helping hand and make it more fun.

Food. The taste and scent of good food as well as the act of making it can stir happy memories for all of us. Try making your loved ones’ favorite meal (or ask them to do so). Stop for a cup of coffee or tea. Bake together or watch cooking shows on television, and talk about the food you’d like to have. Savor every bite.

Physical activity. Get moving, and make it fun. I made the effort to keep Dad swimming as long as he could, and that helped me stay fit, too. What else? There’s dancing — even chair dancing (move those arms!) — or you can try tossing a ball back and forth, marching, and yoga breathing and poses. Even a short walk to the mailbox can change a mood.

Games. Think about games your loved ones can play, like familiar card games, board games or word games (my parents always had fun with Mad Libs). Charades can be doable even for those with communication disorders. Work on crossword puzzles and jigsaw puzzles together, or even play “I spy….” Games can help pass time in a waiting room and distract from boredom or pain.

Celebrations and holidays. Make any excuse for a party. Celebrate all anniversaries and birthdays. Every holiday, whether it’s Valentine’s Day, St. Patrick’s Day or the first day of spring, offers the opportunity to decorate their home or room (my family has headgear and jewelry for all holidays — just for fun). Also celebrate accomplishments from small things like a successful shower or fastening their own buttons to large things like getting out of the hospital. Celebrations can be marked by a “Congratulations!” sign, a full-blown party or a big hug and a happy dance.

Humor. Just be silly. Laugh at yourself, tell jokes, retell old family stories, watch funny movies or videos on YouTube, read funny stories. Have a wheelchair race or put your glasses on upside down. Laugh about the everyday mistakes and foibles we all experience (like when I forgot to give Dad his false teeth and didn’t realize it until we were out at a ball game. He just smiled, made a funny face and laughed it off).

Nature. For many people, simple nature brings the most joy. Bring fresh flowers, or visit a garden or nursery. You can also plant flowers, walk outside, build a snowman, cuddle up with a pet, watch an animal play or go for a car ride to see the spring blooms, the snow or the fall leaves.

Home videos and scrapbooks. Put the old home movies on DVD or digitize them, and watch them together. If your loved ones don’t have scrapbooks, make some together — just sorting through old photos can be fun. Use your camera phone, too — take snapshots and selfies and share them, or look at family and friends’ photos on social media sites.

Intergenerational exchanges. Bring children and elders together for a visit. Holding or even just seeing a baby can bring great joy. Ask a grandchild to read a book aloud or recite a poem he or she memorized. Grandkids can also teach elders how to use a computer or smartphone. Ask a grandparent to share a hobby or teach the younger generation how to bake a pie, clean properly or build something.

Massage and other bodywork. A simple hand, foot or neck massage brings joy. Try it with scented lotion, such as lavender to soothe, or lemon or grapefruit to energize. A masseuse comes to our house once a week for Dad, and that massage is the happiest time for him.

Notice the inherent joy in every day. Make an effort to be mindful of the joy that you might be missing when your mind is racing and your tension rages. The memory of Mom’s smile as I tucked her in bed every night will forever bring me joy. The small victories like Dad brushing his teeth by himself. The “Thank you, sweets” from Dad when I adjust his pillow. Dad tapping his toes under the blanket as he listens to music. Don’t miss a precious subtle moment.

Being creative and open to the humorous, joyful moments will help you face the tougher aspects of caregiving. You might consider keeping a “joy journal” and noting the joyful moments. They will bring you comfort in the future.


Amy Goyer is AARP’s family and caregiving expert and author of AARP’s Juggling Life, Work and Caregiving.

She spends most of her time in Phoenix, where she is caring for her 93-year-old dad, Robert, who has advanced Alzheimer’s disease. Follow her blog and videos and connect with Amy on TwitterFacebook and LinkedIn.

Copyright 2018 AARP


Advance Care Planning: Getting Your Affairs in Order

(National Institute on Aging)

Ben’s Story

Ben has been married for 47 years. He always managed the family’s money. But since his stroke, Ben is not able to walk or talk. His wife, Shirley, feels overwhelmed. Of course, she’s worried about Ben’s health. But, on top of that, she has no idea what bills should be paid or when they are due.

Louise’s Story

Across town, 80-year-old Louise lives alone. One night, she fell in the kitchen and broke her hip. She spent a week in the hospital and 2 months in a rehabilitation nursing home. Even though her son lives across the country, he was able to pay her bills and handle her Medicare questions right away. That’s because, several years ago, Louise and her son made a plan about what he should do in case Louise had a medical emergency.

Plan for the Future

No one ever plans to be sick or disabled. Yet, it’s this kind of planning that can make all the difference in an emergency.

Long before she fell, Louise put all her important papers in one place and told her son where to find them. She gave him the name of her lawyer, as well as a list of people he could contact at her bank, doctor’s office, insurance company, and investment firm. She made sure he had copies of her Medicare and other health insurance cards. She added her son’s name to her checking account and safe deposit box at the bank. Louise made sure Medicare and her doctor had written permission to talk with her son about her health and insurance claims.

On the other hand, Ben always took care of family money matters, and he never talked about the details with Shirley. No one but Ben knew that his life insurance policy was in a box in the closet or that the car title and deed to the house were filed in his desk drawer. Ben never expected that his wife would have to take over. His lack of planning has made a tough job even tougher for Shirley.

What Exactly Is an “Important Paper”?

The answer to this question may be different for every family. Remember, this is a starting place. You may have other information to add. For example, if you have a pet, you will want to include the name and address of your veterinarian. Include complete information about:

Personal Records

  • Full legal name
  • Social Security number
  • Legal residence
  • Date and place of birth
  • Names and addresses of spouse and children
  • Location of birth and death certificates and certificates of marriage, divorce, citizenship, and adoption
  • Employers and dates of employment
  • Education and military records
  • Names and phone numbers of religious contacts
  • Memberships in groups and awards received
  • Names and phone numbers of close friends, relatives, doctors, lawyers, and financial advisors
  • Medications taken regularly (be sure to update this regularly)
  • Location of living will and other legal documents

Financial Records

  • Sources of income and assets (pension from your employer, IRAs, 401(k)s, interest, etc.)
  • Social Security and Medicare/Medicaid information
  • Insurance information (life, health, long-term care, home, car) with policy numbers and agents’ names and phone numbers
  • Names of your banks and account numbers (checking, savings, credit union)
  • Investment income (stocks, bonds, property) and stockbrokers’ names and phone numbers
  • Copy of most recent income tax return
  • Location of most up-to-date will with an original signature
  • Liabilities, including property tax—what is owed, to whom, and when payments are due
  • Mortgages and debts—how and when they are paid
  • Location of original deed of trust for home
  • Car title and registration
  • Credit and debit card names and numbers
  • Location of safe deposit box and key

Legal Documents

There are many different types of legal documents that can help you plan how your affairs will be handled in the future. Many of these documents have names that sound alike, so make sure you are getting the documents you want. Also, State laws vary, so find out about the rules, requirements, and forms used in your State.

Wills and trusts let you name the person you want your money and property to go to after you die.

Advance directives let you make arrangements for your care if you become sick. There are two ways to do this:

  • A living will gives you a say in your health care if you become too sick to make your wishes known. In a living will, you can state what kind of care you do or don’t want. This can make it easier for family members to make tough healthcare decisions for you.
  • A durable power of attorney for health care lets you name the person you want to make medical decisions for you if you can’t make them yourself. Make sure the person you name is willing to make those decisions for you.

For legal matters, there are two ways to give someone you trust the power to act in your place:

  • A general power of attorney lets you give someone else the authority to act on your behalf, but this power will end if you are unable to make your own decisions.
  • A durable power of attorney allows you to name someone to act on your behalf for any legal task, but it stays in place if you become unable to make your own decisions.

Who Can Help Me Put My Legal and Financial Affairs in Order?

You may want to talk with a lawyer about setting up a general power of attorney, durable power of attorney, joint account, trust, or advance directive. Be sure to ask about the lawyer’s fees before you make an appointment.

You should be able to find a directory of local lawyers at your library, or you can contact your local bar association for lawyers in your area. Your local bar association can also help you find what free legal aid options your State has to offer. An informed family member may be able to help you manage some of these issues.

Read about this topic in Spanish. Lea sobre este tema en español.

For More Information About Getting Your Affairs in Order

1-888-687-2277 (toll-free)
1-877-434-7598 (TTY/toll-free)
1-877-342-2277 (español/línea gratis)
1-866-238-9488 (TTY/línea gratis)

National Hospice and Palliative Care Organization
1-800-658-8898 (toll-free)

Centers for Medicare & Medicaid Services
1-800-633-4227 (toll-free)
1-877-486-2048 (TTY/toll-free)

Eldercare Locator
1-800-677-1116 (toll-free)



Stress Busters from the American Heart Association

(American Heart Association) We all have stress — at work, at home, and on the road. Sometimes we can feel especially stressed because of a bad interaction with someone, too much work, or everyday hassles like getting stuck in traffic.

Negative stress can keep you from feeling and performing your best — mentally, physically and emotionally. But no one’s life is completely stress-free. It’s important to know how to manage the stress in your life. Try these three simple techniques for dealing with it.

Positive Self-Talk

Let’s be honest, we all talk to ourselves! Sometimes we talk out loud but usually we do it in our heads. Self-talk can be positive (“I can do this” or “everything will be OK”) or negative (“I’ll never get better” or “I’m so stupid”). Negative self-talk increases stress. Positive self-talk can help you calm down and control stress. With practice, you can learn to shift negative thoughts to positive ones. For example:

Negative to Positive

  • “I can’t do this.” > “I’ll do the best I can. I’ve got this.”
  • “Everything is going wrong.” “I can handle this if I take one step at a time.”
  • “I hate it when this happens.” “I know how to deal with this; I’ve done it before.”
  • “I feel helpless and alone.” > “I can reach out and get help if I need it.”
  • “I can’t believe I screwed up.” “I’m human, and we all make mistakes. I can fix it.”

To really make it work, practice positive self-talk every day — in the car, at your desk, before you go to bed or whenever you notice negative thoughts. It’s a great practice to teach kids, too!

Top 10 Emergency Stress-Stoppers

Emergency stress stoppers are actions to help you defuse stress in the moment. You may need different stress stoppers for different situations, and sometimes it helps to combine them. Here are some ideas:

  1. Count to 10 before you speak or react.
  2. Take a few slow, deep breaths until you feel your body un-clench a bit.
  3. Go for a walk, even if it’s just to the restroom and back. It can help break the tension and give you a chance to think things through.
  4. Try a quick meditation or prayer to get some perspective.
  5. If it’s not urgent, sleep on it and respond tomorrow. This works especially well for stressful emails and social media trolls.
  6. Walk away from the situation for a while, and handle it later once things have calmed down.
  7. Break down big problems into smaller parts. Take one step at a time, instead of trying to tackle everything at once.
  8. Turn on some chill music or an inspirational podcast to help you deal with road rage.
  9. Take a break to pet the dog, hug a loved one or do something to help someone else.
  10. Work out or do something active. Exercise is a great antidote for stress.

Stress-Busting Activities

Doing things you enjoy is a natural way to relieve stress and find your happy place. Even when you’re down, you may find pleasure in simple things like going for a walk, catching up with a friend, or reading a good book.

When stress makes you feel bad, do something that makes you feel good, even if only for 10 or 15 minutes. Some of these activities may work for you:

  • Make art — draw, color, paint, or play a musical instrument.
  • Work on a scrapbook or photo album to focus on good memories.
  • Read a book, short story or magazine.
  • Meet a friend for coffee or a meal.
  • Play a favorite sport like golf, tennis, or basketball.
  • Do a hobby like sewing, knitting, or making jewelry.
  • Play with your kids or pets – outdoors if possible.
  • Listen to music or watch an inspiring performance.
  • Take a walk in nature.
  • Take a relaxing bath and feel the stress wash away.
  • Meditate or practice yoga.
  • Work in the garden or do a home improvement project.
  • Go for a run or bike ride to clear your head.

The key is to find your groove and make it a practice. You’ll be amazed at how quickly you may start to feel better once you disrupt the cycle of stress.


Copyright © 2018 American Heart Association, Healthy For GoodTM,


Tips for Managing Common Symptoms and Problems in Dementia Patients

(HelpGuide) As a caregiver for a loved one with Alzheimer’s or dementia, it can be extremely worrying to experience behavior problems such as wandering, aggressiveness, hallucinations, or sleeping and eating difficulties. Many behavior problems are made worse by a poor environment and an inability to deal with stress. By learning how to make changes in the caring atmosphere, you can increase the quality of life for both the patient and yourself.

Identify the Causes of Alzheimer’s or Dementia Behavior Problems

One of the major challenges of caring for a loved one with Alzheimer’s or dementia can be coping with the troubling behavior and personality changes that often occur. It’s important to remember that the person with dementia is not being deliberately difficult. Your loved one’s sense of reality may be different to yours, but it’s still very real to him or her. As a caregiver, you can’t change the person with dementia, but you can employ strategies to modify or better accommodate any problem behaviors. Both the environment you create at home and the way you communicate with your loved one can make a huge difference.

The patient’s behavior can often be a reaction to stress or a frustrated attempt to communicate. If you can establish why the patient is stressed or what is triggering any discomfort, you should be able to resolve the problem behavior with greater ease. Remember, the patient responds to your facial expression, tone of voice, and body language far more than the words you choose. Use eye contact, a smile, or reassuring touch to help convey your message and show your compassion. Try not to take problem behaviors personally and do your best to maintain your sense of humor.

While these caregiver tips are directed at those caring for Alzheimer’s patients, the same behavior problems are also common in other types of dementia.

Some ways to help identify the causes of problem behavior:

  • Try to put yourself in the person’s situation. Look at your loved one’s body language and imagine what he or she might be feeling and what they might be feeling or trying to express.
  • Ask yourself what happened just before the problem behavior started? Did something trigger the behavior? Try a different approach to see if that changes the reaction.
  • Are the patient’s needs being met? Is the patient hungry, thirsty, or in pain?
  • Does changing the environment or the atmosphere help to comfort the person?
  • How did you react to the problem behavior? Did your reaction help to soothe the patient or did it make the behavior worse?

Create a Calm and Soothing Environment

The environment and atmosphere you create while caregiving can play a large part in helping an Alzheimer’s patient feel calm and safe.

  • Modify the environment to reduce potential stressors that can create agitation and disorientation in the Alzheimer’s patient. These include loud or unidentifiable noises, shadowy lighting, mirrors or other reflecting surfaces, garish or highly contrasting colors, and patterned wallpaper.
  • Maintain calm within yourself. Getting anxious or upset in response to problem behavior can increase the patient’s stress or agitation. Respond to the emotion being communicated by the behavior, not the behavior itself. Try to remain flexible, patient, and relaxed. If you find yourself becoming anxious or losing control, take a time out to cool down.

Manage stress in an Alzheimer’s patient

Different stress-reducing techniques work better for some Alzheimer’s patients than others, so you may need to experiment to find the ones that best help your loved one.

  • Exercise is one of the best stress-relievers for both the Alzheimer’s patient and you, the caregiver. Consult with your loved one’s physician to make sure it’s safe to participate in light exercise. Regular walking, movement, or seated exercises can have a positive effect on many problem behaviors, such as aggression, wandering, and difficulty sleeping. Indoor shopping malls are vast walking opportunities protected from the weather. Or you may even consider singing and dancing.
  • Simple activities can be a way for the patient to reconnect with their earlier life. Someone who used to enjoy cooking, for example, may still gain pleasure from the simple chore of washing vegetables for dinner. Try to involve the person in as many productive daily activities as possible. Folding laundry, watering plants, or going for a drive in the country can all help to manage stress.
  • Remembering the past may also help soothe the Alzheimer’s patient. Even if your loved one can’t remember what happened a few minutes ago, he or she may still clearly recall things from decades ago. Try asking general questions about the person’s distant past.
  • Use calming music or play the person’s favorite type of music as a way to relax them when agitated. Music therapy can also help soothe the person during mealtimes and bath times, making the processes easier for both of you.
  • Interacting with other people is still important. While large groups of strangers may only increase stress levels for an Alzheimer’s patient, spending time with different people in one-on-one situations can help to increase physical and social activity.
  • Pets can provide a source of positive, nonverbal communication. The playful interaction and gentle touch from a well-trained, docile animal can help soothe an Alzheimer’s patient and decrease aggressive behavior. If you don’t have a pet of your own, see Resources section below for organizations that offer pet visits.

Take time to connect with the Alzheimer’s patient

Taking the time to really connect with the person you’re caring for can release hormones that boost the patient’s mood and reduce stress. And it can have the same effect on you, too.

Even if the person you’re caring for can no longer communicate verbally, it’s important to take a short time when you’re at your calmest to focus fully on him or her. Avoid all distractions—such as the TV, cell phone, and computer—make eye contact (if that’s possible), hold the person’s hand or stroke his or her cheek, and talk in a calm, reassuring tone of voice. When you connect in this way, you’ll both experience a process that lowers stress and supports well-being.

Managing Alzheimer’s Symptoms: Wandering

While wandering around the house may be irritating to you as the caregiver, it’s not necessarily unsafe for the patient. However, some wandering can be dangerous: going into areas of the house such as stairwells, decks, hot tubs, or swimming pools; leaving the house alone via a window or door; or leaving your yard or property.

Two characteristic precursors to wandering are restlessness and disorientation. An Alzheimer’s patient may exhibit signs of restlessness when hungry, thirsty, constipated, or in pain. They may also become disoriented, pace, or wander when bored, anxious or stressed due to an uncomfortable environment or lack of exercise. To address this you can:

  • Make time for regular physical exercise to reduce restlessness
  • Immediately redirect pacing or restless behavior into productive activity or exercise
  • Reassure the person if they appear disoriented
  • If wandering tends to occur at a particular time of day, distract the person at that time with another activity
  • Reduce noise levels and confusion. These can disorient the person. Turn off the TV or radio, close the curtains, or move the person to quieter surroundings.
  • Acclimate ahead of time if you move the patient to a new environment by making several visits
  • Consult the doctor if disorientation is becoming a problem. Disorientation can be a result of medication side effects, drug interactions, or over-medicating.

Practical ways to prevent wandering

You may be able to prevent wandering by:

  • Installing child-safety devices in your home to keep doors and windows secured
  • Hiding items like purses, shoes, or glasses that the person would always take with them if they left the house
  • Acquiring comfortable chairs that restrict movement, making it difficult for the patient to stand up without assistance

Planning for when the Alzheimer’s patient does wander

In case an Alzheimer’s patient in your care does wander, it’s a good idea to have a plan in place.

  • Notify neighbors and local police about the Alzheimer’s patient’s tendency to wander, and make sure they have your phone number.
  • Have your loved one wear an ID bracelet or ID labels in clothing. New digital devices using GPS or cellular technology can track the patient’s location if he or she wanders off.
  • If a police search becomes necessary, you’ll need a recent photo of the person’s face. Also keep on hand some unwashed clothing to help search-and-rescue dogs. (To do this properly, place the clothing in a plastic bag with plastic-gloved hands, and replace the clothing monthly.)
  • In the U.S., sign up for the Alzheimer’s Association’s Safe Return Program, an identification system to help rescue lost Alzheimer’s patients who have wandered away (see Resources section below).

How to find a missing Alzheimer’s patient

A person with dementia may not call out for help or answer your calls, and often won’t leave many physical cues. He or she may get trapped somewhere, leaving them at risk for dehydration and hypothermia.

  • Check dangerous areas near the home, such as bodies of water, dense foliage, tunnels, bus stops, high balconies, and heavily traveled roads.
  • Look within a one-mile radius of where the patient was before wandering.
  • Look within one hundred feet of a road, as most wanderers start out on roads and remain close by. Especially look carefully into bushes and ditches, as the person may have fallen or become trapped.
  • Search in the direction of the wanderer’s dominant hand. People usually travel first in their dominant direction.
  • Investigate familiar places, such as former residences or favorite spots. Often, wandering has a particular destination.
  • If you suspect that the person used a car or public transportation, you’ll need to consider likely places that are farther afield.

Managing Alzheimer’s Symptoms: Rummaging and Hiding Things

Caring for a patient who rummages around or hides things in the home is a challenge, but not an insurmountable one.

Protecting your property

  • Lock certain rooms or cabinets to protect their contents, and lock up all valuables.
  • Have mail delivered out of reach of the Alzheimer’s patient—perhaps to a post office box.
  • If items do disappear, learn the person’s preferred hiding places.
  • Restrict access to wastebaskets and trashcans, and check all wastebaskets before disposing of their contents in case objects have been hidden there.

Protecting Alzheimer’s patients from harming themselves

  • Remove or prevent access to unsafe substances, such as cleaning products, alcohol, firearms, power tools, sharp knives, and medications.
  • Prevent electrical accidents by blocking unused electrical outlets with childproofing devices. Hide stove knobs so the person can’t turn on the burners.
  • Lower the temperature on water heaters.
  • Designate a special drawer of items that the person can safely “play” with when keen to rummage.

Managing Alzheimer’s symptoms: Belligerence, Anger, or Aggressive Behavior

While creating a calm environment can have a large impact on managing the stress that often results in aggressive behavior, there are also some things you can do during an angry outburst.

  • Don’t confront the person or try to discuss the angry behavior. The person with dementia cannot reflect on unacceptable behavior and cannot learn to control it.
  • Do not initiate physical contact during the angry outburst. Often, physical contact triggers physical violence.
  • Let the person play out the aggression. Give him or her space to be angry alone. Just be sure that both you and the patient are safe.
  • Distract the person to a more pleasurable topic or activity.
  • Look for patterns in the aggression. Consider factors such as privacy, independence, boredom, pain, or fatigue. Avoid activities or topics that anger the person. To help find any patterns, you might keep a log of when the aggressive episodes occur. If the person gets angry when tasks are too difficult, break down tasks into smaller pieces.
  • Get help from others during the activities that anger the patient.
  • Don’t take the aggressiveness personally. It, too, is just part of the dementia.

Managing Alzheimer’s Symptoms: Hallucinations and Suspicion

Hallucinations can be the result of failing senses. Maintaining consistency and calmness in the environment can help reduce hallucinations. Also, violent movies or television can contribute to paranoia, so avoid letting the patient watch disturbing programs.

When hallucinations or illusions do occur:

  • Don’t argue about what is real and what is fantasy.
  • Respond to the emotional content of what the person is saying, rather than to the factual/fictional content.
  • Seek professional advice if you are concerned about this problem. Medications can sometimes help to reduce hallucinations.

Alzheimer’s and suspicion

Confusion and the loss of memory can also cause Alzheimer’s patients to become suspicious of those around them, sometimes accusing their caretakers of theft, betrayal, or some other improper behavior.

  • Offer a simple answer to any accusations, but don’t argue or try to convince them their suspicions are unfounded.
  • Distract the patient with another activity, such as going for a walk, or by changing the subject.
  • If suspicions of theft are focused on a particular object that is frequently mislaid, such as a wallet for example, try keeping a duplicate item on hand to quickly allay the patient’s fears.

Managing Alzheimer’s Symptoms: Sleep Problems

Brain disease often disrupts the sleep-wake cycle. Alzheimer’s patients may have wakefulness, disorientation, and confusion beginning at dusk and continuing throughout the night. This is called “sundowning.”

There are two aspects to sundowning. First, confusion, over-stimulation, and fatigue during the day may result in increased confusion, restlessness, and insecurity at night. And second, some Alzheimer’s patients have fear of the dark, perhaps because of the lack of familiar daytime noises and activity. The patient may seek out security and protection at night to alleviate this discomfort.

Ways to reduce nighttime restlessness

  • Improve sleep hygiene. Provide a comfortable bed, reduce noise and light, and play soothing music to help them get to sleep. If the person prefers to sleep in a chair or on the couch, make sure they can’t fall out while sleeping.
  • Keep a regular sleep schedule. Be consistent with the time for sleeping and keep the nighttime routine the same. For example, give the person a bath and some warm milk before bed.
  • Keep a night light on. Some people with dementia imagine things in the dark and become upset. Stuffed animals or a pet may also help soothe the patient and allow them to sleep.
  • Place a commode next to the bed for nighttime urination. Walking to the bathroom in the middle of the night may wake the person up too much, and then they can’t get back to sleep.
  • Increase physical activity during the day to help the person feel more tired at bedtime.
  • Monitor napping. If the person seems very fatigued during the day, a short rest in the afternoon can lead to a better night’s sleep. But keep naps short—too much daytime sleep can increase nighttime wakefulness.
  • Limit the patient’s caffeine, sugar, and junk food intake during the day.

Dealing with nighttime wakefulness and pacing

If the patient paces during the night, make sure that the primary daytime caregiver can sleep. This requires either a very safe room for the patient to pace in, or else another caregiver who takes over at night. You need your rest, too. Do not restrain the patient in bed, but consider a hospital bed with guardrails in the later stages of Alzheimer’s. If night wakefulness has gotten too hard for you to manage, consult with a doctor if you wish to try administering sleeping pills.

Bright Lights, Better Sleep?

Often, people who have dementia find it harder to respond to day and night transitions, which can make it difficult to get to sleep or stay asleep. A recent study found that adding daytime bright light exposure to the use of melatonin supplements improved sleeping patterns in dementia patients. They enjoyed longer uninterrupted sleep, fewer episodes of getting out of bed at night, and less agitated behavior.

Adapted with permission from A Guide to Alzheimer’s Disease, a special health report published by Harvard Health Publications.

Managing Alzheimer’s Symptoms: Eating Problems

Ensuring someone with Alzheimer’s eats and drinks enough can be a challenge for any caregiver. These tips may help:

  • Encourage exercise – Exercise can make a person feel hungrier: The hungrier the person feels, the more likely he or she is to eat.
  • Monitor medications – Some medications interfere with appetite. Others may cause dry mouth, so make sure that the patient gets enough liquids with food. Discuss eating problems with your loved one’s doctor to see if medication needs to change.
  • Make mealtimes pleasing to the patient – Add flowers to the table or play soothing music. Make the patient’s favorite food and serve it on dishes that contrast highly with food colors. Reduce distractions in the eating area. Also, avoid foods that are too hot or too cold, as these may be unpleasant to the patient.
  • Feed the patient like a baby – Try giving the patient little spoonfuls, and sing short, funny rhymes to get him or her to eat. Get the person to smile so that the mouth opens, and then slip a little food in. Provide finger foods and children’s sipper cups, as the person may have trouble using utensils and normal cups.
  • Monitor chewing and swallowing – Chewing and swallowing difficulties can develop as Alzheimer’s progresses. If necessary, give instructions on when to chew and when to swallow. Keep the person upright for 30 minutes after eating to avoid choking.
  • Transition into providing only puréed or soft foods – In the later stages of Alzheimer’s, the person can no longer swallow food and may choke on food. Swallowing problems can lead to pneumonia because the patient may inhale food or liquid into the lungs. Begin a liquids-only diet when the time is right.

Don’t Forget to Take Care of Yourself

Caregiving for a loved one with dementia can be extremely demanding and stressful. Each day can bring more challenges and higher levels of anxiety, often without any signs of appreciation from the person you’re taking care of. Unfortunately, when you’re stressed and fatigued, you lose the ability to remain calm and soothing, and the patient will inevitably pick up on those negative feelings. This in turn can add to the patient’s own levels of stress and increase their problem behavior.

Taking care of yourself and getting help and support is essential for both your well-being and your loved one’s quality of life. Respite care can provide a break to help you relieve stress and restore energy. Make use of any services available to you and don’t be afraid of asking for help from other family members. It can make all the difference to your success as a caregiver.

More Help for Alzheimer’s Behavior Management

Alzheimer’s Disease and Dementia Help Center: Educate yourself about Alzheimer’s disease and dementia and make important decisions early to help you feel more in control.

Memory loss

Caregiving support

Resources and References

Managing Alzheimer’s behavior problems

Dealing with Behavior Problems – Links to detailed materials on agitation/anxiety, aggressiveness/combativeness, delusions/paranoia, apathy/depression, screaming/vocalization, sexual behavior problems and sleep disorders. (Alzheimer’s Association)

Managing Agitation Behavior in Alzheimer’s Patients – Demented patients show a variety of different behavioral problems, including anger, agitation, depression, suspiciousness, paranoia, wandering, sexual inappropriateness, hallucinations, and delusions. (

The “Challenging Behaviors” Index – An A-Z directory of how to care for and respond to the difficult behaviors of a person with Alzheimer’s Disease or other dementia. (Alzheimer’s Outreach)

Caring for Someone with Dementia: Unusual Behaviour – Provides tips for dealing with unusual behaviors such as repetitive questions, phrases, or motions; following; calling out; lack of inhibition; laughing or crying uncontrollably; pacing; fidgeting; and suspiciousness. Links to articles on more common behaviors like wandering and aggressiveness. (Alzheimer’s Society of the UK)

Hands-On Skills for Caregivers – Gives practical, insightful tips for how to physically approach a difficult patient; how to talk to them respectfully; and how to get them to co-operate with you, both physically and mentally. (Family Caregiver Alliance/National Center on Caregiving)

The Dartmouth Memory Handbook – Digital copy of the 4th Edition edited by Robert B. Santulli, M.D, associate professor of psychiatry at the Geisel School of Medicine at Dartmouth. Includes chapters on dealing with behavior problems. (Caldwell Law)

Pet therapy for managing Alzheimer’s behavior problems

Animal Therapy Group Listing – Offers an international directory of organizations that offer assisted animal therapy. (Land of Pure Gold Foundation)

Management of home safety; safe return program

Home Safety Behavior-By-Behavior – Ways to make your home safe for the Alzheimer’s patient who wanders, who rummages or hides things, who hallucinates; tips for social occasions at home and for adjusting the home environment to compensate for failing senses. (ADEAR: Alzheimer’s Disease Education & Referral Center)

Safe Return Program – A nationwide U.S. program where you enroll the patient for help with wandering: includes identification products, a network of local chapters, a 24-hour emergency crisis line, and a photo database. (Alzheimer’s Association)


Authors: Melinda Smith M.A., Doug Russell, L.C.S.W., and Monika White, Ph.D.



Alzheimer’s Quick Tips: Making Mealtimes Easier

(Mayo Clinic) Alzheimer’s disease and eating challenges often go hand in hand. As Alzheimer’s progresses, poor nutrition can aggravate confusion and lead to physical weakness, as well as increase the risk of infection and other health concerns.

If you’re caring for a loved one who has Alzheimer’s, understand what causes eating problems and how you can encourage good nutrition.

Consider Underlying Conditions

If your loved one is having trouble eating, check for underlying problems, such as:

  • Oral problems. Make sure dentures fit properly and are being used. Check for mouth sores or other oral or dental issues.
  • Medication effects. Many medications decrease appetite, including some drugs used to treat Alzheimer’s. If you think medications are contributing to eating problems, ask your loved one’s doctor about substitutions.
  • Chronic conditions. Diabetes, heart disease, digestive problems and depression can dampen interest in eating. Constipation can have the same effect. Treating these or other underlying conditions might improve your loved one’s appetite.  Also, consider talking to your loved one’s doctor about removing dietary restrictions.

Acknowledge Declining Skills and Senses

In the early stages of Alzheimer’s, your loved one might forget to eat or lose the skills needed to prepare proper meals. Call to remind him or her to eat or help with food preparation. If you make meals in advance, be sure to review how to unwrap and reheat them. You might also consider using a meal delivery service.

In addition, your loved one’s sense of smell and taste might begin to diminish, which can affect interest in eating.

As Alzheimer’s progresses, your loved one might forget table manners and eat from others’ plates or out of serving bowls. Changes in the brain might cause him or her to lose impulse control and judgment and, in turn, eat anything in sight — including nonfood items. During the later stages of the disease, difficulty swallowing is common.

Expect Agitation and Distraction

Agitation and other signs and symptoms of Alzheimer’s can make it difficult to sit still long enough to eat a meal. Distractions at mealtime might make this even worse. To reduce distractions, turn off the TV, radio and telephone ringer. Put your cellphone on vibrate. You might also clear the table of any unnecessary items.

If your loved one needs to pace, try cutting a sandwich into quarters and giving him or her a section while he or she walks.

Discourage your loved one from drinking alcoholic beverages. Although alcohol might stimulate the appetite, it can lead to confusion and agitation as well as contribute to falls.

Get Visual

Use white dishes to help your loved one distinguish the food from the plate. Similarly, use placemats of a contrasting color to help distinguish the plate from the table. Stick with solid colors, though. Patterned plates, bowls and linens might be confusing.

Try Large-handled Utensils

To prevent slipping, apply suction cups to the bottom of plates or use placemats that have traction on both sides. You could also make placemats from a roll of the rubbery mesh typically used to line shelves. Sometimes bowls are easier to use than plates.

Likewise, spoons might be easier to handle than forks. The larger the spoon’s handle, the better. Try bendable straws or lidded cups for liquids.

Offer Foods One at a Time

If your loved one is overwhelmed by an entire plate of food, place one type of food at a time on the plate. You could also offer several small meals throughout the day, rather than three larger ones.

Cut food into bite-sized portions. Finger foods are even easier — but avoid foods that can be tough to chew and swallow, such as nuts, popcorn and raw carrots.

Take Your Time

Don’t rush mealtimes. Remind your loved one to chew and swallow carefully, and allow him or her as much time as necessary.

Encourage your loved one to follow your actions, such as holding a fork or drinking from a cup — or gently place your hand over your loved one’s hand to hold a utensil and bring food to his or her mouth.

Sneak in Extra Nutrition

If you’re having a hard time getting your loved one to eat enough, prepare favorite foods. Avoid diet foods. Serve a filling breakfast or several light breakfasts in a row. You might also offer high-calorie snacks — such as protein milkshakes. Consult the doctor if sudden weight loss occurs.

Ensuring good nutrition in Alzheimer’s can be a challenge, but it’s worthwhile. Good nutrition can help your loved one better cope — both physically and emotionally — with the challenges of Alzheimer’s.


© 1998-2017 Mayo Foundation for Medical Education and Research (MFMER).