Behaviors and Unmet Needs

By Robert Elmer III on July 14, 2019 in Uncategorized

In past installments, we’ve covered the topic of behaviors but haven’t focused on specific behaviors. That is our mission today because a number of you have reached out to me to learn more.

Always remember that Alzheimer’s and other dementias can affect the following skills and abilities: memory, vision, language, movement, doing tasks with multiple steps, control of emotions, and insight. It can cause delusions or hallucinations, paranoia, aggression or sexually inappropriate behavior.

It should also be understood that underlying medical conditions, their environment and even  prescribed medications can cause behavioral issues or make existing ones worse.

Challenging behaviors are usually the result of an unmet need, so let’s look at some specific behaviors and some considerations in dealing with them.

Aggression? Rule out pain, ask what happened before the behavior, limit their distractions, be positive and reassuring, redirect them to their happy place and listen to them.

Confusion? (They don’t recognize family or a once familiar place.) Be calm, don’t overexplain, don’t correct them (I think he’s your grandson), don’t be hurt or take it personally.

Repetitive Actions? (They keep asking the same questions.) Try to find the reason, react to how they’re feeling — if they want to “go home,” for example, they may not feel safe. Make it an activity (if they want to clean, give them a cloth), remember therapeutic fibs or  redirect them.

They’re Suspicious: Don’t be offended, it’s the illness, don’t argue, acknowledge their concerns, offer a simple safe answer ( I love you and you’re safe), redirect them to a happy place. If they are hiding their wallet so well they can’t find it, have a duplicate wallet.

Wandering: Are they trying to go to work or school? Use a therapeutic fib, engage them in an activity, safe proof your home and know that if they say they want to go home they are usually thinking of their childhood home.

Sleep Issues? Make sure the room is warm, comfy and has a night light, follow a bedtime routine, manage naps, take them for a walk, avoid stimulants and avoid late evening drinks. With dementia with Lewey bodies, sleep disturbances are part of the disease so see their physician.

Eating: Could be too many colors or textures on the plate, Are they able to use utensils? It could be time for finger foods. Cut it for them and be aware of possible dental discomfort.

Bathing: Make sure the bathroom is warm, make sure they feel safe, allowing for their feeling modest and never hit them in the face with water.

Wearing the same clothes: Buy duplicates of the sweater, shirt or pants and switch them out when they are bathing.

It goes without saying that entire books can and have been written on dealing with the many behavior challenges you will face as a caregiver. As was mentioned earlier, drug interactions, a new environment they have a problem processing, perceived threats, fear and fatigue, vision and hearing loss, travel confusion, a hospitalization, the act of bathing or being asked to do something that’s too difficult for them can all contribute to behavior challenges.

Finally, I want to reinforce how important it is for you to know where their happy place is and know how to get them, there. Is it a piece of music? A photo album? Simply going to a quiet place and holding their hand? Our job is not to be confrontational and our focus should be to reduce their emotion. If they’re anxious, we should make them feel less anxious. We should be assessing their needs and meeting their needs.

There’s no such thing as a perfect caregiver so don’t beat yourself up if you don’t get it right the first time. Remember, you can always call the Alzheimer’s Association Hot Line 24/7 and get the answers to your questions in 170 languages. 800-272-3900.

Questions? Email me at Join the Journey.

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Robert Elmer IIIView all posts by Robert Elmer III