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Behavior Management

Behavior Management Strategies For Alzheimer’s



Wandering & Pacing

Lucille has a common and potentially, very dangerous disability associated with Dementia, wandering and pacing. Lucille’s family spent $60,000 a year to keep her home with a caregiver, but she wandered and jumped the fence. She came to MVAC with her dog Tinker. She still looked for her mother everyday, but the 8’ fence provided safety while daily supervised walks and weekly outings provided freedom while helping ease her family’s angst regarding her disposition to wandering and pacing. back to top
 
Our Solution:

We understand that it is important to balance safety vs. freedom. Physical and Chemical restraint is not the answer.

 

Combativeness & Agitation
Dorothy did not like someone giving her a bath. When approached with the proposition she would scream, spit and scratch. Initially, medication was prescribed to manage her combative behavior and agitation. However, once our skilled caregivers gained familiarity with her bathing needs, we managed her care without using any psychotropic medication. Dorothy is a wonderful example of how our caregiver’s advocate to understand our elderly who express combative and agitated behaviors.

Our Solution:

Training in Alzheimer’s care and discussion among caregivers allowed them to find a solution to the problem behaviors.

 


Hallucination & Paranoia

Gus always spoke of being in China or Australia; sadly he had never been to either and was displaying symptoms of hallucination and paranoia. Gus experienced terrible hallucinations and paranoia in which he believed someone was in the front yard and killing his daughter. In other instances he would speak to the mirror in the bathroom, as if he is was conversing with a friend or hide his dentures in a safe place and when he consequently couldn’t find them later, he would make accusations that someone took them.

Our Solution:

Many of these behaviors were harmless and the caregiver addressed it by redirecting or validating his feeling.

 


Depression

Mike would sleep for fifteen hours while at SNF. Apprehensive, his doctor suggested that his family prepare themselves and even make funeral arrangements. Mike suffered from depression. Thankfully His family and friends turned to MVAC and Mike spent his last years enjoying parties, shows, horse racing, lunches and dinners at his favorite restaurants experiencing camaraderie with his friends and relatives. Joyously comfortable, and relieved of depression, he laughed, joked and thought he owned the facility, even making attempts to sell before he died.

Our Solution:

Activities & pleasant surroundings helped him overcome his depression.

 


Frustration & Anger

Darlene exhibited frustration and anger in which she would not allow staff to touch and clean the feces from her body and hair. While at her previous assisted living home the staff would feel inclined to disrupt Darlene’s daughter regularly with the task of bathing her mother. When Darlene came to MVGH her hair was clean and set regularly and her daughter never had to come to help bathe her again. Instead of visits filled with frustration and anger Darlene and her daughter were able to share there time together enthusiastically.

Our Solution:

Our caregivers have patience and are trained to deal with these behaviors.

 


Repetitive Stories

Janet would repeatedly tell a story about her brother. Other residents at assisted living became tired of her repetitive stories and ignored her or even labeled her as crazy. At MVAC when Janet told her stories more than a few times, other residents didn’t remember that her stories were repetitive and even welcomed them as much as she loved to tell them. When settled in the proper amicable living arrangements, like Janet was at MVAC, where other residents do not remember, and her abilities aren’t judged or questioned, it creates a tranquil and non-threatening environment.

Our Solution:

Dementia only environment and trained staff foster true companionship and restores self-confidence.

 


Not Sleeping at Night

Not sleeping at night properly can be an issue at any age. Thomas would nap during the daytime and then consequently, was not sleeping at night. Because of his confusion he became incapable to decipher between night and day which made him want to take a shower at 1 am and get ready to go to work, asking for breakfast at 2 am. At MVAC our caregivers are prepared for situations like Thomas’s and are attentive to make proper arrangements to create healthy schedules.

Our Solution:

Participation in activities with their peers during the daytime stimulate their mind and help them to sleep during the night.

 


Sundown Syndrome
Sundown syndrome causes recurring confusion and agitation in the late afternoon or early evening and is an uncomfortable disruption to an elderly person’s life. Gene suffers with Sundown syndrome and will wait for her husband to come for dinner because she forgets that her husband died a few years ago. She would like to go home because she believes her children are waiting for her and forgets that they have grown up. She will say she is going to see her mom, when in reality her mother passed 30 years ago.

Our Solution:

Trained staff will validate her feelings, but redirect her to help her calm down.

 


Sexually Inappropriate Behavior

Bill & Elizabeth believed they were high school sweethearts and married. If you turned your back, they would escape into a bathroom or bedroom together. Sexually Inappropriate behavior can be a health issue as well as exasperating to staff and loved ones. Both Bill and Elizabeth had spouses who understandably disapproved of their sexually inappropriate behavior. Eventually the best decision for everyone involved was to separate the Bill and Elizabeth, moving one to another MVGH location, instead of using psychotropic medication.

Our Solution:

Some of the sexual issues are either dealt with increased supervision, activity or psychotropic medication.

 


Resisting Personal Care

Clifford does not like anyone to touch him and no one dares to force him. Resisting personal care from the caregivers can be a serious issue. It took a few days before we even succeeded in giving Clifford a shower. Even after accidents, Clifford would resist personal care. Initially we used medication, but after our caregivers had a chance to connect with Clifford, they found with a chocolate candy incentive he would allow us to give him a shower. We are continuously improving Clifford’s care through compassionate perception of his cultural traditions, habits and personal values.

Our Solution:

Understanding about his past and giving respect to him for his privacy and modesty helped us to help him.

 


Not Eating or Swallowing

Lester lost 25 lbs within a month between the hospital and nursing home due to not eating or swallowing. Lester’s family did not want a feeding tube, so he was relocated to MVGH in Diamond Bar. There, our caregivers where able to successfully and non-invasively feed Lester each meal and snack. It took willing patience and about one hour every meal, but Lester gained 32 lbs in two and a half months and not eating or swallowing started to seem like a bleaker issue for him, his family and our staff.

Our Solution:

Preparing food appropriate to individual needs: chopping, finger food, or pureeing the food and hand feeding with encouragement are a few way to ensure good nutrition and a healthy balanced diet. Sometime a little patience, a smile and encouragement is all that needed.