As part of ongoing education, Springwell employees recently attended a training titled, “Understanding and Responding to Dementia Related Behaviors,” presented by Lisa Sobhian, LICSW and Certified Dementia Practitioner from the Alzheimer’s Association. The training will help Case Managers in their interaction with individuals with dementia and will help them advise family caregivers. Behavior changes most often occur during the middle stages of the disease and have many triggers both physical and emotional. Pain or discomfort are some causes of physical triggers. Emotional triggers might include over stimulation or boredom, fear or frustration or unfamiliar surroundings. Whatever the trigger, behaviors are often the result of unmet needs that the person can’t express.

Sobhian shared a three-part strategy to address behaviors that can be remembered as detect, connect and reassess.  The strategy starts with some detective work on the part of the caregiver. First, detect the behavior and then connect with the person in their reality. Try to see the world through his or her eyes. Understand the context of when the behavior occurs. Is it at a certain time of day? What took place before the behavior started? Approach the person calmly and respectfully- treat them as you would like to be treated. Eye contact, tone and body language may have can have great impact. People remember how we make them feel. This can be challenging if the behavior is difficult.

When dealing with the behaviors that are concerning, first try to determine if there are physical problems that are bothering the person.  Some common physical problems that might need addressing are medical issues, hunger, thirst, lack of social interaction, pain from an undiagnosed urinary tract infection, medication interactions, arthritis pain, signs of injury that is uncomfortable such as a bruise, poorly fitting dentures, constipation, or a full bladder. Physical problems may also be environmental. Lighting in the room may be too bright or there might be a glare. Room temperature may be too warm or too cold for the person to be comfortable. If the behavior represents a sudden change for the person, it is best to consult a doctor to help with diagnosing physical problems.

After considering physical problems then address emotional needs advises Sobhian. “Focus on the person’s feelings not facts. Use knowledge of the person’s preferences to provide effective interventions. Redirecting energy from the behavior to a more soothing activity like taking a walk or providing a hand massage. It is important to help caregivers recognize that it is not about who is right and wrong in a factual way but rather to validate the person’s emotion. The approach of validating the person’s emotion lets them know that you are trying to understand.”

When you are beyond the behavior, reassess your strategy and plan for next time. What went well? What didn’t go well? How can you make adjustments? Sobhian emphasized the importance of knowing what to do if the behavior escalates and you need assistance.

Part 2 of this blog will discuss common behaviors that occur with dementia and share ideas about how to relieve the issues that may be causing the behavior.

The Alzheimer’s Association has many resources to help caregivers. Learn more by visiting their website at www.alz.org or calling their 24/7 help line at 800-272-3900.