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Understanding the Brain-Behavior Relationship


Updated July 08, 2008

The key to effective caregiving is understanding the relationship between the brain and behavior. Once we understand this relationship, we can approach caregiving with compassion and courage. Consider these 10 tips your credo for being an Alzheimer's caregiver.

1. Appreciate the Power of the Brain

The brain is the source of our thoughts, emotions, personality, and behavior. Everything we experience in life, and every decision or action we make, can be traced back to our brain.

2. Remember that Alzheimer's is a Disease of the Brain

Although more and more people are recognizing Alzheimer's as a medical condition, many still believe that Alzheimer's is a mental illness, a psychological weakness, or simply what happens when we get old. This stigma is dangerous because it suggests that Alzheimer's is something people bring on or let happen to themselves.

3. Consider That Alzheimer's Affects Everything the Brain Controls

If the brain affects thoughts, feelings, personality, and behavior, and Alzheimer's is a disease of the brain, then Alzheimer's is going to affect how your loved one thinks, what he feels, who he is, and what he does. Don't underestimate the range of symptoms that can be traced back to what's happening in the brain.

4. Your Loved One Doesn't Have to Look Sick to Be Suffering from a Physical Illness

Although Alzheimer's disease is a physical illness, it often doesn't affect a person's appearance until the later stages of the disease. This might be confusing to you because your loved one may seem as healthy as ever -- she's just acting differently. Remember that you don't have to look sick to be experiencing Alzheimer's disease.

5. Prepare Yourself for the Unpredictable

Alzheimer's disease affects different parts of the brain at different times and at different rates. Have you ever had a loose lightbulb in the house? Sometimes it works; other times, it doesn't, even though you haven't touched the lightbulb since the last time it worked. That's kind of how Alzheimer's affects the brain. Although your loved one will go through some predictable stages, the stages are not clear cut and often overlap.

6. Break Tasks Into Smaller Steps

Tasks that seem simple to us actually are made up of many steps that may be overwhelming to your loved one. For example, we think of brushing our teeth as one task -- but if you think about it, tooth brushing is actually made up of many steps (picking up the toothbrush, taking the cap off the toothpaste, and so on). If Alzheimer's has affected the brain in such a way that your loved one doesn't remember all the steps or doesn't remember in what order the steps should be completed, then he won't be able to brush his teeth unless you break it down into smaller actions.

7. Remember What's Causing Difficult Behaviors

This is probably the most important thing caregivers should remember, and it builds upon the first six tips: Behavior problems among people with Alzheimer's are caused by damage to the brain and are not something that they can control or prevent. If your loved one accuses you of having an affair, it's hard not to take it personally. But that accusation was caused by damage to the brain, not logical reasoning.

8. Don't Argue

It is extremely difficult, if not impossible, for someone with Alzheimer's to learn, understand, reason, or remember. Because arguments can only occur between people who can reason and use logic, trying to convince your loved one that you are right is futile. Instead, address her feelings and provide comfort. You can also redirect her to a pleasant activity that you can enjoy together, such as taking a walk, watching a favorite movie, or reminiscing about old photographs or antiques.

9. Look for Signs of Distress

People with Alzheimer's experience a progressively lowered stress threshold, meaning that the amount of stress they can handle before experiencing discomfort or emotional upset decreases over time. Therefore, they become distressed more easily and are less able to explain why they are distressed. Watch for subtle signs of physical and emotional discomfort, such as pacing (he might need to go to the bathroom), rocking back and forth (he may feel hungry or nauseous), or fidgeting (he might be anxious or need something to do). Learn what may trigger your loved one's stress reactions.

10. Accept the Brain-Behavior Relationship

The key to effective caregiving is not only to understand the brain-behavior relationship, but also to accept it. Once you do, you can care for your loved one and cope with any circumstance with a compassionate, nonjudgmental attitude.


Charter of Principles for the Care of People With Dementia and Their Carers. Alzheimer's Disease International. May 25, 2005. http://www.alz.co.uk/adi/charter.html

Behaviors. Alzheimer's Association. December 12, 2006. http://www.alz.org/living_with_alzheimers_behaviors.asp

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