I was watching television one evening when I came upon a movie called “The Accountant.” It starred Ben Affleck as a high functioning autistic man that has a number of special gifts including a bit of a dark side to say the least. You first meet his character as a young boy and learn very quickly his father is not going to give in to his son’s alleged weaknesses but teach him to adapt and overcome those weaknesses to make him a stronger person. The father has an exchange with one of his sons and makes it very clear to him that he is not weird like the other kids say, he’s just different. Dad goes on to say, “eventually different scares people.” When you look at some of the different behaviors that those afflicted with Alzheimer’s and other dementias display, I guess you could understand why many folks, especially those that don’t understand dementia, are indeed scared.
About 80% of those with Alzheimer’s will develop some form of challenging behavior with verbal aggression being number one on the list. There are many others of course that present the most experienced caregivers some real challenges. Maybe they refuse to shower, won’t get in the car, want to wear the same clothes, won’t eat or won’t stop eating, display inappropriate sexual behavior etc etc. Always remember my “three rules of the caregiver road.” 1. They are looking to us to feel safe. 2. You can’t reason with one that has lost the ability to reason and 3. It’s the illness that’s responsible for their behavior. Let’s drill down a little on these.
We need to be detectives and try to get to the bottom of why they are behaving the way they are. Remember too that their behaviors are more often than not, reactions. For example, is the reason they don’t like to shower because they don’t feel safe? Or they’re modest or don’t like being cold? Insuring the bathroom is warm, that they are covered with a towel and they aren’t walking on a wet slippery floor can go a long way. Telling them they’ve got nothing to worry about won’t work because as we all know, their perception is their reality.
The illness has taken away their brains boss and therefore whatever behaviors they are displaying make perfect sense to them. I’ve told you of the lady that almost killed herself and a few others in a car crash. Her response when they took her license away? “You’re taking away my independence.” Not, “good idea, I’m a danger to myself and others on the road.”
When determining what may be behind a certain behavior you should always be asking, is she in pain?, hungry?, thirsty?, constipated?, do they need the toilet or are they scared? Evaluate the environment. Is it too loud? Is it a new environment that they aren’t familiar with?
Some other causes of behaviors challenges can be drug interactions, a non dementia friendly environment, perceived threats, fatigue, vision or hearing loss, a hospitalization and being asked to do something they are not able to do. Like I said , we have to be detectives.
Please be aware of their potential communication challenges as well. Do they have trouble finding words so they can’t tell you what may be bothering them? (expressive aphasia) Or do they have receptive aphasia where they don’t always understand what you’re saying? It’s been said that having Alzheimer’s is like living in a foreign country and not speaking the language. Personally, I’ve been that guy more than once and it’s not fun.
Finally, do you know how to get them to their happy place or even what their happy place is? A t.v. show, a piece of music, photos of the family, the cat or dog? Knowing how to redirect them is a great tool when they go their dark place.
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