Table 2. Nonpharmacologic Interventions for Reducing Behavioral Disturbances in Alzheimer Disease (AD)6,95
  • Reduce choices

  • Provide the patient with a predictable routine (eg, exercise, meals, and bedtime should be routine and punctual)

  • Avoid relocation; if necessary bring familiar items

  • Allow the patient to dress in his or her own clothing and keep possessions

  • Use calendars, clocks, labels, and newspapers for orientation to time

  • Use color-coded or graphic labels (eg, on closets, table service, drawers) as cues for orientation in the home environment

  • Do not be overly concerned if they are not distressing to the patient

  • Consider antipsychotic agents where necessary, but fully inform family and caregivers of the risks/benefits of these medications

  • Redirect and distract the patient

  • Consider using antipsychotic medications

  • Answer decisively, then distract

Lack of motivation
  • Ensure tasks are simple so that the patient can complete them; break up complex tasks into smaller steps

  • Before performing all procedures and activities, explain them to the patient in simple language

Wandering (usually occurs later in the disease, ie, moderate to severe AD)
  • Register the patient in the Alzheimer's Association Safe Return Program

  • Secure the environment with complex handles

  • Equip doors and gates with safety locks

  • Inform neighbors

  • Use distraction and redirection of activities to divert the patient from problematic situations

  • Reduce excess stimulation and outings to crowded places (overexposure to environmental stimuli can lead to agitation and disorientation)

  • Use lighting to reduce confusion and restlessness at night

  • Avoid glare from windows and mirrors, noise from a television, and household clutter

  • Provide a safe environment (eg, no sharp-edged furniture, no slippery floors or throw rugs, no obtrusive electrical cords)

  • Install grab bars by the toilet and in the shower

Ensure that comorbid conditions are optimally treated
Consider using a day care program for patients with AD