Frontotemporal Dementia Caregiver Support Center

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Caregiver Issues - Managing Behaviors

The information on this page is for reference and educational purposes. There is no substitute for seeing a doctor.
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The Family Caregiver Alliance offers a web page called, "Caregiver's Guide to Understanding Dementia Behaviors" and offers ten tips for communication with a person with Dementia. The article also says, "Caring for a loved one with dementia poses many challenges for families and caregivers. People with dementia from conditions such as Alzheimer’s and related diseases have a progressive brain disorder that makes it more and more difficult for them to remember things, think clearly, communicate with others, or take care of themselves. In addition, dementia can cause mood swings and even change a person’s personality and behavior. "

Listed below is a form I created from a slide I found at the University of Washington. Rebecca Logsdon, Ph.D, at the University of Washington talked about behavior problems in dementia patients.

ABC's of Treatment for Behavior Problems in Dementia

A
Identify the Antecedent

The Triggering Event

My brother sees a man who is over 6 feet tall. He will go up to the stranger and ask how tall he is.
B
Describe the Behavior What, when, where, whom
What: Walk up to male strangers that are 6 feet tall or taller
When: Anytime out in public
Where: Anywhere out in public.
Whom: Any male over 6 feet tall
C
Identify the Consequences Result of the Behavior
The stranger may feel uncomfortable, but when he has walked up to strangers with me I never got the impression that the stranger felt threaten. My brother will tell a story about a man who was over 7 feet tall that he saw in the mall in Missoula and then walks away.

Now we have to look at the behavior and how it affects the pFTD, the caregiver, and anyone else who is involved.

Example #1. Eats too much bad food like candy.

Is this a bad thing or good thing. I ask myself: What is it going to hurt the pFTD? Whether you give them candy or not, it is not going to change the outcome of their final days. Sure they could potentially develop diabetes and gain some weight, but at least to them they are enjoying life. You do not have to set up a bowl of candy on the kitchen table, but a daily ration of candy each day is not going to hurt.

How Can You Change a Behavior

Eliminate the Antecedent(s)
  • In the example of the talking to male strangers 6 feet or taller, we could not go to the mall and use an old hiking trail. This is feasible, but not realist.
  • In the example of the candy, you could take the candy away, or replace it with sugar-free candy if possible. Or create a veggie tray to snack from.
  • There are some behaviors we cannot change and we have to just monitor and intervene when needed.
Change the Consequences
  • In the example of the talking to male strangers 6 feet or taller, we could hand them a information card (business card) identifying that my brother has a brain disorder please excuse his behavior, and to understand the situation.
  • In the example of the candy, maybe limit the amount of candy per day.

One thing to remember is that what works for one family may not work for another family. Each pFTD is unique and may not respond to changes that another pFTD did. Do not be discouraged by this. It only means you need to find an alternative way of getting the same results.

One of the biggest difficulties caregivers have with a pFTD is they want this FTD world the caregiver's way. Some or most of the time it is going to be the pFTD way or no way at all! The caregiver has to work on acceptance!

Best FTD Resources



What If It's Not Alzheimer's
© 2003 by Lisa Radin and Gary Radin

Chapter 5
Pages 73-90

Association of Frontotemporal Dementia (Website)

Managing Behaviors

Pick's Disease Support Group (Website)

Challenging Behaviors
Obsessions - A to Z
How To Deal With Apathy

University of California, San Francisco (Website)
Family Caregiver Alliance (Website)
National Institutes of Health (Website)

 

Other Internet Articles



Family Practice Notebook Website (Interesting information. Need more research)

http://www.fpnotebook.com/NEU19.htm

The Postgraduate Medicine website offers this report called,
"Managing common behavioral problems in dementia"

http://www.postgradmed.com/issues/1999/10_15_99/morgenlander.htm

The Postgraduate Medicine website offers this report called,
"Behavioral problems in dementia"

http://www.postgradmed.com/issues/2004/06_04/smith.htm

Managing Difficult Behaviors in individuals with Dementia (University of Washington)

http://faculty.washington.edu/logsdon/orcas/index.htm

Behavior Disorders of Dementia: Recognition and Treatment from the American Family Physician

http://www.aafp.org/afp/20060215/647.htm

Using Validation Therapy to Manage Difficult Behaviors (Elder Care Online)

Using Validation Therapy to Manage Difficult Behaviors

The Star Bulletin website in Hawaii offer this article called,
"Descent Into Dementia." It is a two part article.

http://starbulletin.com/2006/09/19/news/story04.html

http://starbulletin.com/2006/09/20/news/story04.html

+11/25/06 (Don B.)



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