Why is irritability more prominent in the morning in a dementia wife?

3 answers | Last updated: Jul 28, 2017
A fellow caregiver asked...

My wife is pretty far along with dementia. Most of the time she is pleasant and in a good humor. But often she starts the day hateful and uncooperative. This passes after an hour or so. Got any suggestions?

Expert Answers

For 20 years, physical therapist Connie Lambert has worked with individuals and families with Alzheimer's disease and dementia. As founder and CEO of Our Generations, LLC, she provides specialized dementia and behavioral management training for corporations, facilities, and groups.

Even though you hear a great deal about difficult behaviors in the late afternoon and evening, it is not uncommon to see unpleasant behaviors first thing in the morning. There are many causes but three come to mind immediately:

  1. Pain and stiffness from arthritis is most prevalent in the morning and usually requires at least an hour to resolve. You may wish to arrange your morning so your wife sits calmly with her breakfast for an hour before attempting anything else. Also, you may wish to discuss this possibility with her physician.
  2. Low blood sugar levels and hunger can cause behavioral problems first thing in morning. Having breakfast or a glass of juice immediately may help improve her humor.
  3. Waking up and orienting to a new day is hard enough for those with dementia. Few demands, like dressing, bathing, brushing hair and so forth, should be required prior to sitting quietly with breakfast.

You have a very difficult job. I wish you the best as you care for your wife.
Connie Lambert, PT, CCM, PhD

Community Answers

Love riot answered...

I care for my dementia Mom and I have found that the power of loving touch upon awakening, with pleasant, but quiet voice is most helpful. Simply touching or gently stroking her arm, or whisking a stray hair out of her face can make a big difference in starting the day on a good note. Speaking of note, if we have a doctor appointment or other less joyful tasks to do that day, I play music that has no lyrics as soft background pleasantry. I also allow her a full 30 minutes just for getting out of bed and heading to the bathroom, so she can wake up at her own pace.

A fellow caregiver answered...

This is a similar recommendation to 'Love Riot's answer. I don't know if you can remember waking your small children from a deep sleep or nap? It's VERY NICE where they were, and they often didn't want to leave that peaceful dream state. A soft, gentle voice and a loving stroke on the face or upper arms went far to bring them into the present reality of [school, getting dressed, etc.] Another thing: as a sufferer of arthritis and fibromyalgia, I can tell you: Morning pain and joint aches REALLY take the joy out of any new day. I know to make my body stretch and move, to get my blood-flow going. I don't know how bad-off your spouse is, but if you two old-timer's could do some minor stretches together - maybe she would see it as a new fun time with her favorite husband.