My husband has Alzheimer's and his mood swings are difficult to deal with!

3 answers | Last updated: Oct 18, 2016
A fellow caregiver asked...

My husband is in the early stage of Alzheimer and the main problem at this time is mood change. He takes Aricept for memory help but his mood eruptions at the least little thing is something I haven't been told how to deal with. Any ideas will be so appreciated.


Expert Answers

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

The physical and chemical changes in the brains of people with Alzheimer's often affect mood, energy and spirit. Serious mood swings and personality changes are common. This is true of other dementias as well, especially Frontotemporal Dementia, which damages the frontal and temporal lobes of the brain, areas that affect judgment, moods, language and behavior control.

The early stage of Alzheimer's is typically the most stressful for the person with the disease as well as caregivers and family. The person in the early stage of the disease is powerless as his world changes and his self-determination slips away. It's no wonder he experiences mood swings, some may even be bordering on depression. At this point your husband is aware of his decline. He's no longer able to perform many of the things that made him feel accomplished. His confusion and forgetfulness may feel like failure to him. His generation was indoctrinated with a "stiff upper lip" approach to feelings, so he may not be able to express his fears to you except through these explosions.

Now, knowing this does not make your life any easier. One thing is to understand logically what's happening; quite another to deal with your own emotions. These outbursts feel like personal attacks, and yet it's important not to take any of them personally. Try to remember that it's the disease acting out and do your best to change the situation into something positive. This is important, because feelings, good and bad, linger much longer in people with dementia and Alzheimer's. When cognitively able people experience sadness or grief, strong feelings fade pretty quickly. However, in people with dementia, these feelings last a lot longer, often unchanged in intensity. Sadness and anger tend to linger longer than happy and joyful feelings. With that in mind, you can see the importance of keeping him in a positive space. When he has one of his outbursts, you can validate his anxiety with a simple remark: "It sounds like you're really upset." Before he has a chance to pursue his complaints, offer him an alternative. This could be a bowl of ice cream or a request to help you with something that he used to do particularly well, which allows you to compliment him, boosting his ego.

The most important piece of advice sounds a lot easier than it is: DON'T REACT TO THE ATTACKS, don't justify or explain, and don't try to reason - - - and above all, DON'T ARGUE. Reacting or arguing will only escalate the situation. Instead, you may validate his expression briefly, but quickly change the subject to something unrelated to the subject of his rage.
If it's a particularly intense event or your first attempt fails, pretend that you must use the bathroom immediately and exit the room. When you re-enter, be smiling and cheerful as you ignore his ranting and present him with an enticing diversion.

A couple of typical scenarios and suggestions on how to handle them: He mentions a particular gadget and yells at you, "I've gotta have it. It's mine! You stole it!" This particular item was thrown out years ago, but if you try to convince him of that, he won't believe you and you'll probably only agitate him even more. Instead, you may answer like this, "I'm right in the middle of something, but in a few minutes I'll be glad to help you look for it. - Oh, you know what? The dog probably needs water. Would you mind checking?" You have validated his notion, but immediately diverted with something you know he'll be interested in.

Another scenario: You enter the room and he greets you with an accusation, "Where have you been? Why did you leave me here all alone? You said you'd be right back. You lied."

People with Alzheimer's often lose the sense of time and space; when you've been out of sight, your husband may not be able to gauge how long you've been gone. Two minutes may feel like an hour to him. However trying to "set him straight" is an exercise in futility. Instead, you may simply say, "I'm sorry I took so long. I'm so glad you waited for me. Thank you. (And then the diversion:) "“ I'm starved. How about our favorite grilled cheese sandwiches for lunch?"

In the two examples above you've deflected his outbursts without accusing him of lying. Thus you have maintained his dignity. As much as possible use compliments and let him know that you're happy to be there with him. With practice, this approach will become second nature to you. Your husband will reach a point in the mid stage when he's no longer aware of his condition. He will be living in the moment and with your positive attitude you can help him make the moments special and your own life much easier.

A few rules of thumb:

"¢ DON'T ARGUE OR ADMONISH

"¢ USE COMPLIMENTS

"¢ ASK FOR HELP(don't worry if he's not really able "“ it's the thought that counts)

"¢ USE DIVERSIONS

"¢ Humor, laughter, music and physical activity are very important

And for you:

"¢ RESPITE (ask friends and family to step in)

"¢ JOIN A SUPPORT GROUP (contact your local Alzheimer's Association "“ alz.org)

You may also want to go to AlzheimersAtoZ.com for more detailed advice.


Community Answers

Garage answered...

this is easier said than done. If he wont do it where do I go from there?


Katherinebuck answered...

Thank you - for both the question and the answer. I really feel for you. This is something I am also struggling with at the moment.

Although we have not had a diagnosis as yet, I have been attempting the types of positivity suggested in the response in terms of not taking things personally (once I realised he wasn't doing and saying things deliberately), but its difficult to sustain when my husband then accuses me of treating him like a child when trying to deflect or redirect him. I try to say nicely, 'please dont speak to me like that' etc, and change the subject.

Occasionally though I 'lose it' - recently during an escalating rant on the phone when he finally yelled f#@ off, as calmly as possible I replied OK and hung up.

It's hard without a diagnosis. My mid-50's husband has only just agreed to have some tests done at the suggestion of his psychologist (although he says he has no idea why he should bother because he's fine). The aggression and anger are what I find most difficult to deflect, particularly as the outbursts have increased over the last couple of years, along wiith other signs & symptoms that I'm suspecting are more FTD than Alzheimer's type. At least, finally, I have spoken with both the GP and psychologist privately and they agree that testing should be done, and that they would manage it. Now we have got him to agree to go ... Going is the next step. And, finally, he voiced his fear about testing - his mother is likely to have undiagnosed dementia which she showed signs of at least in her early 60's, and he is worried he could have it too. To me that's a breakthrough. The first time in several years of symptoms that he has said it out loud. I want to cry, but I'm so relieved at the same time .... And we haven't started testing yet. The mood might change again before we get there, but I have my fingers crossed.

Good luck and best wishes for your journey

K