Our behavior is typically a result of our environment or the people around us. For people with dementia, whether it’s Alzheimer’s disease or another type of cognitive impairment, it’s no different. However, the way their brains process sensory input is not within their control.
This often leads to a double standard when people with dementia exhibit behaviors that are deemed inappropriate. The same actions, when exhibited by someone without dementia, might be frowned upon, but are often accepted.
Once a person with dementia is exhibiting what we deem an undesirable behavior, it generally takes a mix of empathy and skill to alleviate the situation. But often, care partners don’t have this ability, or the patience, or the access to the dementia training for CNAs
and nursing staff that is provided to Dementia Capable Care facilities
As a result, instead of helping the person work through the behavior, an all-or-nothing approach to care is implemented:
“You can’t do that, you can’t go there, you have to stop.”
Infringing on someone’s will to do something, or treating them in a condescending manner, will only escalate the issue.
Other times, to avoid these behaviors and to compensate for the inability to work through the behavior, antipsychotic medications
are inappropriately used.
These approaches can have a negative impact on the individual’s wellbeing.
However, if the “undesirable,” and sometimes aggressive, behavior can be avoided in the first place, everyone will have a more pleasant interaction, medications can be minimized, and the wellbeing of the individual can be maximized.
Typically, but not always, something in the environment triggers the behavior. Identifying this trigger, or triggers, is key to eliminating the cause of the behavior.
Whether you’re helping a family care for a loved one at home or you’re helping residents in a care home, becoming a dementia detective is a skill worth developing.
Start by observing the individual’s surroundings. Pay attention to noises, sounds, air temperature, people, and the demeanor of those around them. This includes the caregivers.
Note anything that may be affecting the person. Behaviors often repeat in dementia care, so keep a log of what you’ve observed. Note things such as:
- The time of day
- What they were just doing
- Who they were with
- What they ingested—food, medication, liquid, etc.
Compare your notes and look for patterns. Discuss the information with other care partners.
It’s also very helpful to review the individual’s profile to help you better understand their likes and dislikes. This, coupled with their life history
, will often help provide clues.
Triggers can result in behaviors we would rather avoid, such as anger and aggression, or exiting the home and becoming lost. Sometimes there are safety concerns, such as when an individual wants to leave because they just saw a bus pull up, or they don’t feel at home
Another example is when someone constantly wants to use the bathroom. I know of one family that, due to incontinence issues, placed a portable commode in eyesight so their loved one could quickly find it, and hopefully avoid embarrassing accidents.
However, this caused her to constantly want to use the commode because she was always seeing it. The simple fix was to move the commode a few feet away where it was no longer within her line of sight.
Some triggers, such as this example, are easily remedied, while others will take considerable observation, analysis, and creativity. Remember that all situations take considerable empathy. Remember to respect the individual as you would want to be treated. This will allow your heart to stay open as you work hard to help them.
Taking the time to understand how the environment is affecting the person with dementia is essential to creating a dementia friendly home
, where triggers have been minimized. When you do, you will see fewer undesirable behaviors, everyone’s wellbeing will benefit, and you will avoid a potential crisis.
Mike Good is the founder of Together in This
, an online community helping family members who care for someone with Alzheimer’s or another dementia. Through online classes; short, informative articles; and easy-to-use tools such as the Preparing Your Home for Someone With Alzheimer’s
guide, Mike helps you take control and have peace of mind that you’re doing the right things. See what he has to say about music and dementia