When most people think of Alzheimer's disease, the symptoms that typically come to mind are those relating to cognitive functioning: memory loss, word-finding difficulties, poor judgment in decisions, and disorientation regarding the day, time or place. While these are hallmarks of Alzheimer's and other dementias, there's another symptom that can be challenging for family and friends to cope with: personality changes.
Personality changes are a frequent result of Alzheimer's disease, and one that can be hard to accept for loved ones. Some examples of personality changes include:
- Freda has been the most caring, friendly and positive woman around. She always wants to know how others are doing and how she can help. Since she developed Alzheimer's, she no longer asks people how they're doing and seems to just ignore them all. Instead, if anyone asks how she's doing, she constantly complains.
- Sam, who has always adored his wife and been faithful to her, now makes sexual advances to the nurse aides who care for him.
- Fred, a retired psychologist who had a very successful practice, now makes rude and cruel comments to those around him. One of his strengths before Alzheimer's had been his kindness and ability to relate to others.
- Sally is a deeply religious woman who has always been careful with her words. She now frequently fills her conversation with offensive, foul language.
- Martha, the matriarch of the family, has been the informal social director of the extended family, frequently organizing reunions. Now that she has Alzheimer's, she shows no interest in getting the relatives together. When someone else coordinates it, she is apathetic and no longer seems to care about connecting with the family.
Causes of Personality Changes in Dementia
There are several possible causes of personality changes. The most prevalent factor is changes in the brain — which is physically altered by the disease — that can change the person's characteristics and personality.
How to Cope with Personality Changes in Dementia
- Remind yourself that the changes are due to the disease. She is not purposely trying to hurt your feelings or annoy you.
- Don't argue with him. It won't help.
- Focus on her feelings, not her words.
- Set reasonable expectations.
- Use redirection instead of attempting to reason with the person.
- Address any physical, environmental or psychological causes of challenging behaviors.
- If the personality change is sudden, you may need to contact the physician to consider if the sudden changes could be caused by delirium.
National Institutes of Health. National Institute on Aging. Alzheimer’s Disease Education and Referral (ADEAR) Center. Alzheimer's Caregiving Tips: Managing Personality and Behavior Changes. Accessed March 28, 2013. http://www.nia.nih.gov/sites/default/files/Alzheimers_Caregiving_Tips_Managing_Personality_and_Behavior_Changes.pdf
Alzheimer Scotland. Behaviour that challenges - understanding and coping. Accessed March 28, 2013. http://www.alzscot.org/pages/info/behaviour.htm