JOAN’S BLOG – TUESDAY, SEPTEMBER 4, 2007 –CONTROLLING TEMPER TANTRUMS – AN OUNCE OF PREVENTION…………..

Except for the basic memory loss, nothing, absolutely nothing about Alzheimer’s Disease was expected. (Not to me, anyway) How could we have known about the deteriorating relationship; the loneliness; the loss of companionship; the mood swings; the anger; the resentment?  There was no preparation for this. It is the temper tantrums, however, that raise my stress to the Xanax level.
I have learned not to argue back; I have learned to walk away and wait until he calms down. Walking away eats away at my insides and makes my head feel like it will burst. But it does de-escalate the tantrum.
Even better would be to prevent the tantrum in the first place. As a teacher and therapist of Special Needs and disturbed students, I used to deal with violent, volatile, impulsive kids all day long. I learned very early, after chair throwing, screaming, swearing, and fist fights, that my life would be a whole lot easier, and my blood pressure a whole lot lower, if these behaviors could be prevented before I had to deal with them.
The same can be said of your AD spouses’ tantrums.  Preventing them, if possible, will lower your stress level, blood pressure, and relieve your spouses’ frustration.
The road to accomplishing this is, as always, paved with your hard work of anticipation and planning. The two basic plans are WARNINGS and SETTING THE PROPER ENVIRONMENT.
Warnings: (Note: This works for AD patients who are still cognitively able to control their impulses to a certain extent) In most cases, you know what will set off your spouse. There are always surprises, of course – it wouldn’t be Alzheimer’s without them, but you pretty much know what is going to light the fuse.  In a calm, matter of fact voice, warn them of what is to come, explain that you know it usually upsets them, but the event (whatever it is) is going to take place, and you will be with them to smooth the way. An example from my life is:
When we travel, Sid gets EXTREMELY upset and throws tantrums if his laptop doesn’t work on the hotel’s system. He can ruin a trip by pouting, whining, stomping around, and complaining all day, every day to the point that he obsesses about it, and cannot enjoy any part of the trip. Now, before we pack that suitcase, on the way to the airport, and when we check into the hotel, I remind him that the system may not work, there is nothing he can do about it, he doesn’t need his laptop for work (he doesn’t work), and he will have to adjust to the situation. Since he has been reminded right up to the point of plugging in the laptop when we get settled into the room, if the system doesn’t work, and he feels a tantrum coming on, he tries very hard to control it. So far, it has been working.
I use the same method before going to restaurants, because he is prone to tantrums if the service isn’t as he expects; when we go to the pool in our development because, he is prone to impulsive outbursts if kids are not behaving as he expects.
Setting up the Environment
More work for you, to be sure, but I prefer the extra work and preparation to the tantrums.  Sid is prone to “sundowning”, which means everything gets worse at night – his ; his control; his comprehension. If we have had a very late lunch, as is often the case on weekends, I leave a big salad in the refrigerator, along with cut up chicken or cold shrimp, or some kind of protein in a zip lock bag in the deli pan. The plan is when one of us gets hungry, we go into the refrigerator, put salad in a bowl, throw in the protein, add some dressing, and we have a light late evening meal.  Before AD, this worked fine.
Due to the “sundowning”,  and AD in general, Sid will open the refrigerator, never find anything he needs. He screams and stomps and has an out-of-control tantrum directed right at me, because it’s my fault he has nothing to eat.
To prevent these episodes, I make up his supper with salad and the protein, cover the plastic container, and LABEL it – “Sid’s supper”. I place the container right in front on an upper shelf, so he does not have to look for it. Tantrum prevented.
Only you know what will cause a tantrum, so it is up to you to anticipate, warn, and plan. Oh, yeah, you’re probably saying – MORE work for me, as if I’m not overworked enough. I agree, of course, but I weighed resenting more work against dealing with tantrums, and the extra work and a little resentment won out over the tantrums. And you know what? We’ve had two such pleasant weeks that they outweigh the extra work, and I find the resentment has waned. I can only share what worked for me and suggest you give it a try.

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