Behaviour Management
What do they mean by "all behaviour has meaning"?
Those with brain damage usually have difficulty verbally expressing themselves, leaving them with only one option - to act out their feelings, needs and desires. Behaviour is a way of communicating.
When a patient is hallucinating, do you try and convince them what they're seeing is not real?
No. Accept it and realize that it is the residents reality. Give simple reassurance. If you can figure out the delusion, the persons behaviour may suddenly start to make more sense. Do not argue with them. Just help them to feel safe.
A change in mood in which a person loses interest in, or pleasure in life.
What is Depression?
What is the DOS? and what is its purpose?
Direct Observation System. An objective tool, used to assess a person's behaviour over a 24-hour period for a minimum of 3 days to determine the occurrence, frequency, and duration of behaviours of concern.
What is most important when considering the persons preferred choice of their living environment?
People with Alzheimer's disease need to live in the environments that best support their safety and quality of life.
Perseveration
When individuals may repeat a word, story, or activity. As well they can become clingy, shadowing the person caring for them and even follow them to the bathroom.
Can the attitude of the caregiver affect the client's behaviour? Why/whynot?
Yes. Your own "baggage" affects your ability to cope effectively. Your negative attitude can be another stress in the life of someone with dementia.
What is the difference between delusions and hallucinations?
Delusion - A fixed false belief that is not based in reality but are believed to be true by the person experiencing them
Hallucination - Seeing, smelling, hearing, tasting or feeling something that is not there.
A feeling of apprehension, worry, uneasiness or dread.
What is anxiety?
What is the CMAI and what are the two categories for the specific Physical behaviours?
Cohen-Mansfield Agitation Inventory of behaviours
Physical/Aggressive
Physical/Non-Aggressive
When working as a CCA in a persons home, you are working as part of a team. List two ways you can build a partnership with the families.
1. Keep lines of communication open
2. Try not to impose ones values and judgements
3. Recognize that each family is unique
4. Learn as much as you can about the person with dementia
5. Be sensitive to the families needs and feelings
6. Earn the trust of the family (maintain confidentiality)
7. Be dependable and prompt, setup and keep routines
8. Be flexible and patient
Elopement
When someone leaves a special care home/day home without anyone knowing.
What is wandering? and how is it beneficial?
The most common behaviour associated with dementia. it is described as endless walking/roaming, seemingly with no goal. While wandering occurs, circulation is stimulated as is the supply of oxygen to the brain cells. Bones and muscles are also more likely to remain functional with exercise.
"The overreaction of people to situations with which they cannot cope" This behaviour is not deliberate, and the person is probably quite frightened by themselves.
ex. Abrupt mood swings, anxiety, agitation and anger. Screaming. making unreasonable accusations. Crying or laughing uncontrollably and inappropriately.
The "fight or flight" response is caused by what nervous system in the body?
What is the sympathetic nervous system?
Every person diagnosed with ADRD has the right to... (list 3/4)
1. To be treated as an individual with dignity and respect
2. To be informed of ones diagnosis
3. To have appropriate, ongoing assessments and medical care
4. To live in an enviornment designed for an individuals abilities and interests
Summarize the most important aspects of a special care home.
Respect and dignity for the client
cleanliness
feeding routines
trained staff
communication
programming
individualized care
safety
Define "Vocally Disruptive Behaviour"
Screaming, yelling, repetition of recognizable/nonrecognizable sounds, talking incoherently, abusive language and/or moaning
The 4 principles of behaviour management
1. Prevention is the most effective approach
2. The attitude of the caregiver may affect client behaviour
3. Be client focused
4. Remember that time and effort will be required
What are the 3 principles of dealing with aggression?
1. Aggression is nearly always explainable
2. Aggression often contains a message
3. Prevention is the key
The last phase in the Assault cycle is post-crisis depression, what is this?
When the person is fatigued after the physical and emotional exertion expended during the episode. Behaviour might include sleeping, crying, blaming themselves, or avoiding others.
The Alzheimers Society of Canada has identified 10 signs of caregiver stress. List 4.
1. Denial
2. Anger
3. Withdrawing socially
4. Anxiety
5. Depression
6. Exhaustion
7. Sleeplessness
8. Emotional reactions
9 Health Problems
10. Lack of concentration
What is the homecare program? and what kind of services do they provide?
Provides support necessary for qualifying individuals and their caregivers to remain in their own home for as long as possible. They can provide respite care, adult day programs, meals on wheels, health care, funding
What is a contradictory behaviour?
Behaviours which make us wonder just how disabled the individual is. Example, one day people cannot feed themselves and the next day they can.
There are a number of specific behaviours that are common in clients with a dementia. Give 5 examples from LO6
- Wandering
- Repetitive behaviour
- Inappropriate sexual behaviour
- Vocally disruptive behaviour
- Wanting to go home
- Rummaging and collecting
- Agitated and restless
- Assault
What are some reasons a person may wander? List 5
- Effort to familiarize self with the environment
- Lifelong patterns of coping with stress
- Searching for security
- Response to boredom
- Response to crowding/too much stimulation
- Response to strict rules
- Excess energy
- Agitation
- Discomfort/pain
- Confusing day/night
- Confusing dreams/reality
- Tension in their environment
What are the 5 phases of the Assault Cycle?
1. The triggering event
2. Escalation
3. Crisis
4. Recovery
5. Post-crisis depression
When an individual enters a carehome, they are usually observed for 1-2 weeks in order to get information needed to establish their baseline status. What type of information is gathered? list 5
- History, religious background, personality, coping skills, likes dislikes, daily routine
- Ability to do activities of daily living
- Degree of cognitive functioning inc. level of brain damage
- Habits of daily living
- Physical exam and lab tests
- Recreational interests
- Medications
LO7 lists 6 ways that family caregivers can care for themselves. What are they?
1. Seeking information
2. Dealing Effectively
3. Setting goals
4. Maintaining Their Own Health
5. Dealing Effectively with Family Members
6. Coping with the Holidays
What is "sundowning"?
The marked increase in confusion, disorientation and possibly agitation in a person with dementia. These behaviours usually occur in response to changes in the environment and fatigue. This usually occurs when the sun begins to go down.