People afflicted with Alzheimer's disease find it increasingly difficult to deal with constant changes brought about by every stage of the disease. One of the most alarming changes that occurs in many Alzheimer's patients are mood and behavior swings that cause a great deal of alarm and concern in family members involved in the care giving process.

For many caregivers, sudden changes in mood and behavior are startling and disturbing.  For example, a daughter who heretofore has dealt with the parent who has a history of gentle behavior, excellent etiquette and intellectual speaking patterns may be horrified to find her father issuing expletives or making rude and hurtful comments on a daily basis when agitated.

Other caregivers may deal with increasing situations in which arguments over everything cause tension and stress in family members as well as increasing agitation in a loved one.  By improving our understanding of what may cause such mood swings and behavior problems, family members and caregivers can learn how to not only tolerate some of these behaviors, but also head them off before they occur.

Complicating medical problems as well as drug reactions may often cause changes in behavior and moods. In such situations, it is important for the caregiver to remain calm and not to provoke situations that may lead to outbursts or incidents. Issues such as fatigue, dehydration, and even constipation may initiate such mood changes in many patients, so watching for physical signs is as important as recognizing emotional ones.

One of the most common factors in such incidents of agitation and difficult behaviors expressed by Alzheimer's patients is when instructions are not clear. For many elders suffering from dementia or varying stages of Alzheimer's, following multiple directions or requests at one time may prove overwhelming. Seemingly difficult tasks compounded with any other type of health problems often leads to communication breakdown between caregiver and patient.

What may not seem difficult for a caregiver may seem an insurmountable obstacle to someone suffering from Alzheimer's disease. Something as simple as getting dressed may cause agitation, confusion, and emotional outbursts. To limit such incidents, it is often necessary for a caregiver to limit choices and to reduce stimulating factors such as a full closet or overflowing drawers to a minimum of necessities and choices.

Instructions need to be broken down into manageable steps. Saying, "Why don't you get dressed?" to someone with Alzheimer's can lead to frustration, belligerence, and downright refusal to do so. Placing one item at a time within reach of a loved one will help to alleviate the pressure of such a complicated process and relieve the stress of making such decisions.

It is up to the caregiver to avoid arguments. In many cases, rephrasing a request or giving your loved one a moment or two to process the request or direction is extremely helpful.  The Alzheimer's Association suggests a three-step process to manage difficult behaviors

1. Identify the behavior
2. Understand the cause
3. Adapt

When dealing with a difficult situation, a caregiver may try to defuse the situation by turning on the television or the radio. Because many Alzheimer's patients who are agitated do not like to be touched, it is suggested that a caregiver try talking to them in a calm and soothing tone of voice. Never raise your voice, as this will only increase tension and agitation.

Some caregivers find that taking care of someone with Alzheimer's is much like taking care of young children, and the same types of parenting skills that got them through child rearing can be applied to parents suffering from Alzheimer's. Many people who have cared for parents with Alzheimer's agree that trying to argue or disagree with the delusional parent is often a fruitless and frustrating endeavor.

In order to avoid battles, it is important for a caregiver to remember to focus on the person, and not on the specific request or task on hand. For example, if getting a parent to bathe is your goal, and you see that they are not in the mood and are going to refuse, it is best not to waste your time arguing, but to wait for another point in time to suggest that bath. As long as the person is not in any danger, make it a point to avoid arguments whenever possible.

While it is certainly never easy for children to watch a steady decline in the cognitive abilities of the parent, it is essential to remember that most mood swings and behavioral changes are not the fault of the person suffering from Alzheimer's disease, but the fault of the disease process. Patience, compassion, and understanding go a long way toward providing the care and love that your parent deserves.

The bottom line toward dealing with behaviors such as confusion, repetition of actions or speech, as well as the wary suspicion that is often expressed by Alzheimer's patients is to:

• Stay calm
• Try not to take it personally
• Be patient
• Don't take offense
• Don't argue
• Attempt to switch focus to a new activity

Avoiding reactions such as frustration, tension, and hurt feelings helps a caregiver to focus and maintain on what they are trying to provide for someone with Alzheimer's disease, wh