Presentation on theme: "Behavior Changes: Causes and Techniques"— Presentation transcript:
1 Behavior Changes: Causes and Techniques Yolanda Wright, MSWEarly Stage/ Support Group CoordinatorAlzheimer’s Association- Greater Maryland Chapter
2 CommunicationCommunication is so much more than just the exchange of wordsWhen we communicate a message to others, it consists of three parts:Words 7% Voice 38%Body Language 55%93% is conveyed NON VERBALLY
3 Communication Challenges Speech- Word finding- Repeating wordsReading and Writing- Reading small print- Comprehending groups of wordsLanguage- Vocabulary skills, may revert to native language- Ability to convey ideas- Ability to understand- Ability to speak, use words correctly
4 Expressive Methods Used to Communicate ScreamingRepetitionNonsensical verbal noisesConfabulation
5 Strategies: Verbal & Non-Verbal Volume of voice, soft pleasantWord choicesIdentify yourselfOne-step directionsDon’t argueNon-threatening body languageEye contactFront approachStoop, squat or sitSlow movementCueing, pointing, demonstratingTouch
6 Strategies: Verbal & Non Verbal Provide the solution rather than the questionAvoid confusing expressionsAvoid vague wordsAlways try to turn negatives into positivesAvoid quizzingUse simple written remindersUse pictures to replace written remindersRefrain from discussing plans until just prior to event
7 Understanding Behavior Changing caregiver behaviors to better meet the needs of the person with dementiaTreat the CAUSE of the behavior, NOT the behaviorCorrectly identifying what has triggered agitated behavior can help in selecting the best intervention
8 Triggers Environment - Change in living arrangements - Travel - Hospitalization- Presence of houseguests- Bathing- Being asked to change clothes- Noise- Boredom
9 Additional TriggersMedical Conditions - Poor sensory functions - Impaired mobility or pain - Infections - Dehydration - Toxic effects of medications Human Factors - Caregiver approach - Communication challenges - Fail to understand the person’s habits, likes, dislikes and routines
10 Goals in Behavior Management Decrease stress in patient and familyIncrease patient’s self-esteemTap into individual’s talents and strengthsMaximize independenciesImprove quality of lifeValidate behaviorsIncrease sense of fellowship with other peopleMaintain social skills
11 Catastrophic Reaction Definition:Overreaction to a minor problemCause:The patient feels…OverwhelmedFrightenedFrustratedOver stimulated
12 When is behavior a problem? If it violates the rights of othersIf it poses a threat to someone’s health and safety (including their own)
13 Common Challenging Behaviors AggressionAnxiety or agitationConfusionRepetitionSuspicion/delusions/paranoia/hallucinationsWandering and getting lostTrouble with sleepSundowning
14 AggressionAggressive behaviors may be verbal (shouting, name calling) or physical (hitting, pushing). These behaviors can result suddenly, with no apparent reason, or can result from a frustrating situation. Whatever the case, it is important to understand what is causing the person to become angry or upset.
15 How to respond Try to identify the immediate cause Rule out pain as a source of stressExplore environmental changesFocus on feelings, not factsDon’t get upsetLimit distractionsTry a relaxing activityShift the focus to another activity/redirect
16 Anxiety or AgitationA person with Alzheimer’s or another dementia may feel anxious or agitated. He or she may become restless and need to move around or pace. Or, the person may become upset in certain places or focused on specific details.
17 How to respond Listen to the frustration Provide reassurance Involve the person in activitiesModify the environmentFind outlets for energy
18 ConfusionA person with Alzheimer’s or another dementia may not recognize familiar people, places or things. He or she may forget relationships, call family members by other names or become confused about where home is. The purpose of common items, such as a pen or fork may also be forgotten. The situations are difficult and require patience and understanding.
19 How to respond Stay calm Respond with a brief explanation Show photos or other remindersOffer corrections as suggestionsTry not to take it personally
20 RepetitionA person may do or say something over and over again- like repeating a word, question or activity. In most cases, he or she is probably looking for comfort, security and familiarity They may also pace or undo what has just been done. These actions are harmless yet stressful for caregiver.
21 How to respond Look for a reason behind the repetition Remove things in the environment that may trigger repetitive questionsFocus on the emotion, not the behaviorTurn the action or behavior into an activityStay calm and be patientProvide an answerDistract the person with a favorite activityUse memory aids- reminder notes or picturesAccept the behavior. Work with it. If it isn’t harmful, don’t worry about it. Find ways to work with it.
22 Suspicion/delusions/paranoia/ hallucinations Memory loss and confusion may cause a person to perceive things in new, unusual ways. Individuals may experience false ideas (delusions) and become suspicious of those around them, accusing others of theft, infidelity, and other improper behavior. Sometimes a person may misinterpret what he or she sees and hears; see and hear things that are not real (hallucinations).
23 How to respond Rule out physical/medication problems Provide bright, evenly-lit living spacesDon’t take offenseDon’t argue or try to convinceOffer a simple answerSwitch the focus to another activityDuplicate any lost items
24 Wandering and getting lost It’s common for a person with dementia to wander and/or become lost. In fact more than 60% of individuals with Alzheimer’s will wander at some point. They may try to go home when already there or attempt to recreate a familiar routine such as going to school or work.
25 How to respond Encourage activity Inform others Make the home safe Sign up for Alzheimer’s Association Medic Alert + Safe Return and Comfort Zone
26 Trouble with sleepPeople with dementia may have trouble sleeping or experience changes in their sleep schedule. Scientists don’t completely understand why these sleep disturbances occur. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain.
27 How to respond Make a comfortable environment Maintain a set bedtime and waking routineGet the person up earlier or keep them up laterTalk to a doctorAvoid stimulantsConsider accommodating the person’s need to be up at night
28 SundowningSundowning occurs in the afternoon/evening. Disorientation, confusion, anxiety, pacing and agitation are common problems. Causes can include mental and physical exhaustion, increased noise and busyness at home, and reduced lighting and increased shadows.
29 How to respond Reduce noise and activity levels Have the person engaged in appropriate physical activities during the dayMonitor your exhaustionPlan ahead for calm eveningsIdentify triggersPlan for light dinnersKeep the home well lit in the early eveningDon’t physically restrainChannel restlessnessPlan a medication scheduleUse pharmaceutical intervention as a last resort
30 10 Quick Tips: Responding to Behaviors 1. Remain flexible, patient and calm2. Explore pain as a trigger3. Respond to the emotion, not the behavior4. Don’t argue or try to convince5. Use memory aids6. Acknowledge requests, and respond to them7. Look for the reasons behind behavior8. Consult MD to identify causes related to meds or illness9. Don’t take the behavior personally10. Share your experience with others