Behavior is Communication
Introduction
Module 4 introduces the evidence-based unmet needs model and explains why we use this model to better understand behaviors commonly shown by persons with dementia and developmental disabilities.
Objectives
- Understand what a person's behavior is trying to tell us.
- Describe ways to anticipate and address behavioral expressions of needs.
- List ways to avoid unnecessary drugs.
- Describe communication techniques that prevent escalation.
Warm Up
- Make a list of what you observe in a person with dementia. Use your list from the previous lesson or make a new one.
For example, a person with dementia does the following:
- Wanders
- Calls out
- Is agitated
What else do you notice?
2. Now take a moment to consider what the person's behavior might be telling you.
Here are a few examples:
- Wanders - The person is bored and looking for something to do.
- Calls out - The person is lonely and looking to connect with someone.
- Is agitated - The person is overstimulated and may need solitude.
How can you verify your interpretation?
Dig In
A Review of Brain-Behavior Relationships:
Alzheimer's affects the hippocampus, the part of the brain needed for short-term memory. When short-term memory fails, it’s hard for a person with dementia to track what's going on around them. This confusion can cause a lot of frustration and even paranoia. It may be why people with dementia so often accuse people of stealing when they misplace something, even when there is no evidence a theft has occurred. Caregivers should not be offended. Sadly, there are those who exploit this very vulnerability and do steal. You must be vigilant on the behalf of the person in your care.
Paranoia may become even more pronounced when the person’s amygdala gets affected. The amygdala regulates basic emotions such as fear, anger, and cravings. It is affected quite early in Alzheimer's. Once Alzheimer's disrupts the brain's emotional center, a person may display apathy, emotional outbursts, and even inappropriate sexual advances. This knowledge may help you become less angry when a person with dementia behaves inappropriately towards you. This knowledge may also help family members feel less embarrassed on their loved one’s behalf.
The parietal lobe is important for keeping us oriented to where we are. Knowing this, we know how hard it must be for a person whose parietal lobe has been damaged to make sense of unfamiliar places. Knowing this may help us be more patient and compassionate.
The frontal lobe helps us carry out purposeful behaviors and complex reasoning. When any cause of dementia strikes the frontal lobe, people lose the ability to plan and initiate complicated activities. The frontal lobe helps us to shift gears when we have a lot of different things going on. The frontal lobe helps us make choices. We know making choices is important. It makes us feel good.
This is why we try to make decision-making easier for persons with dementia. Instead of opening a full closet and asking “What do you want to wear?” hold up two options and ask, “Would you like to wear this blue sweater or this red one today?” Frontal lobe problems, when combined with amygdala problems, also lead to a loss of inhibition. This may cause behaviors such as undressing in public, swearing and making inappropriate statements.
Wrap Up
Knowing how Alzheimer's and dementia affect areas of the brain helps you understand the cause behind the behaviors and feel more patient in understanding what a person is trying to communicate. Let's take a closer look.