“An individual might not be acting out aggressively or violently, but acting from a place of fear or confusion.”
This is Kathy Hickman talking. She’s the Knowledge Mobilization Lead with brainXchange, and the Education Manager for the Alzheimer Society of Ontario. To her, understanding and exploring this distinction between aggression and fear is essential.
“It’s important to reframe the behaviour this way, and to create strategies to make them more comfortable and relaxed, and to reduce their fear, which will in turn reduce the behaviour,” she says.
People living with Alzheimer’s and dementia can exhibit a broad range of responsive behaviours, such as wandering, verbal repetition, sexual behavior or angry outbursts.
For caregivers, dealing with responsive behaviours can be a frustrating and exhausting task. But there are answers.
A provincially funded project in partnership with the Ontario BrainXchange, a project called Behavioural Supports Ontario (BSO), is dedicated to enhancing the quality of care and support for those exhibiting responsive behaviours associated with dementia and other neurological conditions.To date, more than 475 new front-line staff have been hired across Ontario. Follow on Twitter @brain_Xchange
Responsive behaviours are not simply random or meaningless acts of aggression or agitation. They are known as “responsive” behaviours because they caused by circumstances related to a person’s condition or a situation within his or her environment.
Drawing from formal research, practice-based field knowledge, and information provided by other care partners, the BSO network focuses on knowledge sharing, relationship building, and providing caregivers and support workers with the right strategies for addressing responsive behaviours.
The BSO has produced a number of free resources for caregivers that provide concrete strategies for understanding and dealing with dementia behaviour.
Shifting Focus is an accessible and comprehensive guide for caregivers, offering practical solutions and handy tips for dealing with common responsive behaviours.
For example, exploring the difficult topic of sexual responsive behaviours, such as masturbation, the guide reminds caregivers to restrain from admonishing or restraining their loved one, suggesting instead that they provide the individual with privacy, or facilitate an alternative activity to occupy the individual’s attention.
“All behaviour has meaning behind it,” explains Hickman.
“If someone can’t communicate verbally what their needs are, they tend to express their needs through their behaviour, whether that is pacing or repetitive behaviour, or wandering. If we understand behaviour as them trying to communicate something to us then we can step back and say what does this mean? What is the bigger picture?”
The guide, which was created in partnership with informal caregivers, is available online, in print, and as a video series. Other resources are available on the BSO website. NEXT