🧑‍🎓 Experts Weigh In on Behavior Changes 🧑‍🎓

This week’s Newsletter is all about the behavior changes that come with dementia. Here are some articles from different experts that will give you additional resources.

• Stages and Behaviors (Alzheimer’s Association): this page from the Alzheimer’s Association gives detailed information about the needs of people at different stages of dementia and answers to many questions about specific behaviors.

• Caregiver’s Guide to Understanding Dementia Behaviors (Caregiver.org): another take on different behaviors and some methods for responding.

• Dementia: Coping with common, sometimes distressing behaviors (Harvard Health): the experts at Harvard tackle the difficult subject of coping with personality changes.

Caregiver’s Corner: 5 Things to Check First—Understanding Dementia Behaviors

When I started training caregivers almost 25 years ago, I taught them how to deal with “difficult behaviors.” It was just what we called them, and industry standard. Some people still call them that.

Then my company hired a Director of Memory Care who thought about behaviors differently. She called them “responsive behaviors” and changed the way the company thought about dementia care as a result.

When we call behaviors difficult, usually what we really mean is that they’re difficult for us. We’re describing our own feelings and reactions. Those are completely valid feelings: I’m not saying your struggle isn’t real or that you should ignore your feelings.

The other idea that this “difficult” word encourages is that the person is being intentionally difficult. Again, this could be the case: your feelings and experiences are valid, and that evaluation could be correct.

However, neither of these feelings—focused on your own difficulty—lead to a solution. These interpretations of events are all about how things “should” or “should not” be. If you’ve been reading the newsletter for very long, you know how I feel about “shoulding all over yourself.”

The problem with “should” is that it never deals with the actual issue. It’s a wish, not an action plan. Even if something should be different than it is, it’s not. So where do we go from here?

When we’re dealing with behaviors, understanding them as “responsive” is a critical first step. The central concept here is that behaviors don’t simply spring into the world on their own. There is always a cause, and behaviors are an effect, a response.

Calling a behavior responsive puts the focus on the needs of the person exhibiting the behavior. What are they responding to in their environment, in their own bodies, or in the people around them?

When we assume a loved one is simply being difficult, what can we do other than believe that they shouldn’t be? It can feel utterly powerless because there isn’t much to do about a “should,” a fantasy of a better world that’s impossible.

However, if your loved one is responding to something, we can start to claim some power over the situation. We can fire up our inner Sherlock Holmes, grab our detective’s magnifying glass, and start looking for clues to the cause. What might your loved one be responding to, we can ask, and can you give them something different to respond to instead.

Responsive behaviors might include:

• Resisting Care

• Wandering and Elopement

• Changing Sexual Behaviors

• Sleep Disturbances

• Bathing Resistance

• Aggression

(Incidentally, I have training available on each of these behaviors at my main website, elumenEd.com.)

If you’re assisting someone who is experiencing responsive behaviors, there are five key things to check for before anything else.

1. Take them to the restroom.

2. Assess the environment for anything that would cause discomfort: too noisy, too hot or cold, too many people talking at once, etc.

3. Are they hungry or thirsty?

4. Are they bored? (Most of us can get fidgety when we’re bored. I know I do.)

5. Are they tired? If they have become fatigued, they may need an opportunity to rest.

These are the easy answers to look for first. Give these a shot and if they don’t work then keep digging until you find your answer. Get creative. Some situations can feel impossible, but looking for causes is always more empowering than wishing life were different than it is.

If you want to download my free guide on this subject, follow this link.

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