1. Nursing Assistant Monthly Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012 Challenging behaviors Strategies for caregivers

2. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors Types of dementia-related behaviors  Verbal or physical aggression  Resistance to care  Conflict between residents  Wandering  Unwelcome or inappropriate sexual behavior

3. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors What does the behavior mean?  Dementia can cause difficulty: –Interpreting the environment Examples: sounds from television, water running, alarm ringing –Interpreting spoken language or body language Examples: caregiver greetings, explanations –Expressing needs Examples: need to go to the bathroom, hunger, feeling too cold/hot, loneliness, boredom

4. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors Looking beyond the behavior  Learn about the resident –Preferences about food, bathing, bedtime rituals, daily routines –Try to honor them  Pay attention to physical needs –Toileting, feeding, positional comfort, good skin care  Pay attention to emotional needs –Interact with resident directly, calmly –Be gentle in your voice and actions

5. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors Promote the feeling, “I’m safe”  Calm environment  Basic needs met –Food, rest, comfort, cleanliness  Address the need for human contact –Use pleasant voice –Use gentle touch –Encourage family involvement

6. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors Bathing can be scary!  Some residents with dementia may feel: –The water is too deep! –A stranger is attacking me! –I don’t understand what is happening! Where am I?  Or there might be a real problem –I’m cold! –I have to go to the bathroom! –I’m hurting!

7. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors Bathing tips  Prepare the environment –Warm towels, warm room, warm water, dim lighting –Hint: If you are comfortable it is probably too cold  Meet basic needs first –Recently toileted, rested, fed  Consider alternative bathing techniques –Bed bath, towel bath with no-rinse soap

8. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors A word on wandering  May be due to an unmet need –Hunger, need for toileting, loneliness, boredom –Try to determine and meet the need  Safety is key –Learn your facility’s policies and procedures for keeping wandering residents safe

9. Copyright © 2012 Delmar, Cengage Learning. All rights reserved. May 2012Challenging behaviors When to call the nurse Always inform the nurse about:  Sudden changes in behavior –Agitation, withdrawn, anger  Resident to resident conflicts –Safety is a key concern –Don’t try to handle an aggressive resident on your own  Any injury to yourself, another staff member, or a resident