Addressing Behaviors in Residential Care Communities

shutterstock_61894663In 2004, approximately one-third (34%) of residents residing in Residential Care/Assisted Living environments exhibited one or  more  behavior  symptoms  at  least  once  a  week:  13%  had  aggressive  behaviors,  20%  had  physically nonaggressive symptoms, 22% had verbal behavioral symptoms, and 13% resisted activities of daily living and/or their medication.  In  2014,  the  National  Center  for  Health  Statistics  estimated  that  closer  to  40%  of  the  residential  care residents  have  either  Alzheimer’s  or  other  dementia  and  display  more  than  one  behavior  symptom  more  often  than once per week.  As the elderly population increases, it is predicted that the number of individuals entering residential care with behavioral symptoms and dementia diagnosis will rise. The behaviors are displayed through speech outbursts, as well as physiological, psychomotor, and/or social behaviors.

Managing behaviors requires staff to be educated and trained in specific behavior techniques. Once the data in the assessment tool has been gathered, an ABC technique can be applied. A, or antecedent, is the identification based on interview, observation, and review of the resident’s record over the time of the trigger preceding the behavior. B is the behavior that needs to be modified. C is recognizing the consequence of the behavior to the resident and others.

Once the behavior and cause have been isolated, treatment can be initiated. The Alzheimer’s Association published a paper in  2012  describing  a  list  of  responses  for  staff  to  try  when  the  resident  is  displaying  unpredictable,  specific behaviors.  In  the  article,  they  included  ten  quick  tips  for  caregivers  that  many  organizations  have  utilized  quite successfully.  These  are  visualized  in  employee  break  rooms  and  orientation  manuals  in  many  residential  care  (AL) settings. The caregiver response tips include the following:

  • Remain flexible
  • Explore pain
  • Respond to the emotion, not the behavior
  • Do not argue; use memory aids
  • Acknowledge requests and respond
  • Look for reasons behind the behavior and eliminate them
  • Consult with the physician
  • Don’t take the behavior personally
  • Attend all education and training sessions
  • Share your experience with responses with others

The caregiver must learn to interpret the communication and attempt to respond in a way that is appropriate. Responses are going to be varied depending on what the person is trying to communicate. Remember to look beneath just the words  or  behavior  and  try  to  understand  the  emotion  the  person  may  be experiencing before responding.

If your organization is looking for assistance in building a behavior program and/or educating and training the staff, contact an AssuredPartners NL Senior Living Agent.



  • Cornacchione DO, CMD, Mario, Assessment and Management of Behavioral Symptoms in Alzheimer’s disease: A Case Study, Assisted Living Consult; November/December 2005.
  • Sato, J., Nakaaki, S, Torii, K, and Oka, M, Behavior Management approach for agitated behavior in Japanese patients with dementia: a pilot study, Dove Medical Press, December 2012.
  • Alzheimer’s Association, How to respond when dementia unpredictable behaviors,, February 2012.
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