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Two choices are available for those whose loved one has been diagnosed with Alzheimer's disease: care for them within the home or having them cared for in a nursing facility. Eventually they will be completely unable to care for themselves. Either way, ignoring memory loss, confusion, and agitation in the Alzheimer's patient will bring about their premature placement in a nursing facility and eventually developing health problems for the caregiver due to stress and frustration.

In the middle of the Alzheimer's disease the stage of agitation will develop, along with psychosis or depression. The agitation can take many forms and is the most difficult to handle: non-aggressive verbal behavior; non-aggressive physical behavior; aggressive verbal behavior; and aggressive physical behavior—with degradation of certain parts of the brain causing all forms of aberrant behavior. Things like soft lights and music therapy are known to work wonders in relieving stress to the Alzheimer's individual, bring calmness to the agitated individual. Part of the music therapy can be mood music or mediation tapes kept on hand for evenings, drawn drapes as evening comes, slow movements and easy voices, along with lower or dimmed lights in the rooms—all depending on the individual involved.

Experts feel that the agitation behavior is caused by "the inability to deal with the stress"—with the individual unable to communicate how they feel.  There are certain rules to follow for the caregiver, all built upon sharp observations and remaining aware of the individual's moods and emotions:

·         Identify whether their behavior is event-related.

·         Determine whether the agitation is sudden or an unexpected outburst.

·         Is the behavior escalating, or a "catastrophic" spiral of outbursts

As stated, the environment can be modified to reduce excessive stressors, such as dimming lights, putting calm music on, removing loud noises, or covering nearby mirrors (they will appear to be moving strangers or people they do not know).  Observe the individual's pattern of behavior and clues that their agitation or tension is increasing, shown in pacing, loud or agitated vocalization which becomes garbled or incoherent. Most behavior has been known to develop after 3 pm or toward the end of the day as the individual becomes tired and the stress is building for many reasons:

(1)    Experimenting with fatigue is a good way to begin with avoiding stress, with end-of-the-day fatigue or agitation excellent signs the agitated is fatigue-related—offer naps, avoid caffeine, short activities for exercise during the day, etc.

(2)    Routines and sameness are best with few environmental changes.

(3)    Certain feelings or memories are still perceived by the Alzheimer's individual as preferred activities, and can still be present somewhere in the mind—similar safe activities should be offered to replace them if they accept them.

(4)    Agitation behaviors are triggered by excessive noise, people, or commotion—holiday groups or dinners with more than 23 people are to be avoided—loud television shows with large groups of people in it should be avoided, remove lots of figurines, mirror images, or dolls which represent massive strangers to them.

Alzheimer's caregivers should take breaks and get as much rest as possible. By the time most caregivers bring their family member to the nursing facility, they are beyond exhaustion and almost mindless with worry, ending up feeling tremendous amounts of guilt for "giving up" on their loved one. An overwhelming job, Alzheimer's caregivers face a new challenge every day with their individual, themselves facing depression and illness from the sheer magnitude of the task. Support from family, friends, community and the medical field are the only things that can save them regardless how strong they think they are.

Basic steps for the caregiver are to remain flexible and to grab at moments when the individual is the calmest, recognizing that this will change from day to day. The person may not recognize anyone in their family or the caregiver on any given day, so establish eye contact on a daily basis and begin each day as if it were brand new. The individual will need to be reminded on a daily basis—similar to "50 Dates" with the memory leaving every night—who people are around them. Nothing they say or do can be taken personally, and by becoming angry or frustrated the caregivers are only hurting themselves.  Take breaks and have someone come in and help care of them, coming back in fresh and brand new. Always get support, including offering it to yourself. Remember, with Alzheimer's disease the caregiver is a patient also.