WORKING WITH RESPONSIVE BEHAVIOURS
Responsive Behaviours Behaviour as a response to something in the residents environment (both external and internal), also known as triggers Ex: noisy environment lack of meaningful activities residents misperception of situation These behaviours are the person’s best attempt to respond to their current situation
Causes Physical changes associated with dementia taking place in the brain affect behaviour and emotional responses Characteristics of the social and physical environment affect behaviour and emotional responses Changes are the result of a unmet need and possible difficulty in expressing the need.
Behaviours should be interpreted as self- protective, defensive, or communicative strategies in response to unmet needs, which serve as an important way in which individuals with dementia express themselves
Assessment of Behaviour “Looking at the reason behind the behaviour” P. I. E. C. E. S. P Physical health (physical health issues) I Intellectual health (type of dementia and stage) E Emotional health (internal emotions, changes, etc) C Capabilities (current capabilities balanced with assistance needed) E Environment (both internal and external) S Social self (who they were, life story)
Physical Heath Physical triggers might include delirium, pain, disease, drugs and alcohol or disability. Many older people have other chronic conditions others?
Physical Changes that affect behaviour VISION loss of peripheral vision eventually will lose sight, brain can’t respond to all the stimulation PERCEPTION Lose depth perception
Intellectual/Emotional Intellectual refers to the type of dementia and changes in the brain, What triggers might there be? Emotional triggers may includes adjustment to relocation, loss of independence, and changes in caregivers, as well as depression, delusions, and hallucinations, boredom, loneliness, feeling of abandonment, and issues of spirituality
Capabilities Triggers can include not understanding loss of functional abilities and feeling invaded. Need to balance remaining abilities with needs that must be met.
Environment Triggers can be from both the physical and emotional environment. Require an environment which is flexible to address changing needs, respects needs for privacy, provides appropriate cues and is familiar
Social and Cultural Triggers may be memories that are brought on by the current situation. Includes life story. Life accomplishments, social networks, likes and dislikes, interactions with family, team members and other residents, and previous coping strategies.
Types of Behaviours Verbal Non-aggressive complaining/whining negativism constant unwarranted requests for attention repetitive sentences or questions Aggressive cursing verbal sexual advances screaming making strange noises
Types of Behaviours Non-aggressive Physical pacing or aimless wandering inappropriate dress or disrobing trying to get to a different place hiding things intentional falling hoarding things moving furniture Aggressive grabbing onto people scratching hitting throwing things kicking spitting slapping pushing
Effective Interventions when working with People who exhibit responsive behaviours SPEND TIME WITH THE PERSON TALKING WITH THE PERSON PROVIDING MUSIC PROVIDING STIMULATION IF LACKING PHYSICALLY REDIRECTING THE PERSON REDUCING STIMULATION IF TOO MUCH GOING ON 7. PROVIDING SOOTHING SOUNDS (SUCH AS NATURE SOUNDS) 8. HAND MASSAGE 9. REMINISCING 10. CONSULTING OTHER STAFF MEMBERS 11. CONSULTING PROFESSIONALS 1. 2. 3. 4. 5. 6.
The 10 absolutes for Caregiving for Persons with Dementia Never ARGUE instead AGREE 2. Never REASON instead DIVERT 3. Never SHAME instead DISTRACT 4. Never LECTURE instead REASSURE 5. Never say REMEMBER instead REMINISCE 6. Never say I TOLD YOU instead REPEAT 7. Never say YOU CAN’T instead say DO WHAT YOU CAN 8. Never COMMAND or DEMAND instead ASK or MODEL 9. Never CONDESCEND, instead ENCOURAGE and PRAISE 10. Never FORCE instead REINFORCE 1. From the Alzheimer’s Society