In 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, alz.org/safety, February 2012.