Challenging Behavior Challenging Behavior in the Dementia in the Dementia PatientPatientClaire M. Henry, M.Ed.,CDPClaire M. Henry, M.Ed.,CDP

Caring Resources, The Dementia Caring Resources, The Dementia Educators.Educators.

Rummaging and Rummaging and HoardingHoarding

Approaches to UseApproaches to Use Ignore the behavior unless it becomes Ignore the behavior unless it becomes

problematic.problematic. Try a diversional activity.Try a diversional activity. Remove to replace the behavior.Remove to replace the behavior. Avoid scolding, punishment, or talking Avoid scolding, punishment, or talking

down to the patient.down to the patient.

Rummaging and Rummaging and HoardingHoarding

Use the ABC behavior model to redirect Use the ABC behavior model to redirect the behaviorthe behavior

Supple the resident with things to hoard Supple the resident with things to hoard and rummage.and rummage.

Give the resident a shopping bag to Give the resident a shopping bag to hoard itemshoard items

Track the behavior on the behavior log.Track the behavior on the behavior log.

SundowningSundowning

Increased confusion and agitation in the Increased confusion and agitation in the afternoon hours.afternoon hours.

Assess for sleep disturbanceAssess for sleep disturbance Encourage an afternoon napEncourage an afternoon nap Close drapes and shades in afternoonClose drapes and shades in afternoon Encourage quiet activity programming.Encourage quiet activity programming.

Activities of Daily Living Activities of Daily Living ChecklistChecklist

Assess the environmentAssess the environment Assess the person’s moodAssess the person’s mood Assess the steps involved in the task.Assess the steps involved in the task. Assess communication techniques involvedAssess communication techniques involved Assess your level of stressAssess your level of stress Prepare in advance for the task.Prepare in advance for the task. Always remember…if you feel unsafe doing Always remember…if you feel unsafe doing

something, do not do it, and call for help.something, do not do it, and call for help.

Helping the Alzheimer’s Helping the Alzheimer’s Patient to Bathe.Patient to Bathe.

Evaluate which type of bath causes the least Evaluate which type of bath causes the least anxiety.anxiety.

Gain trustGain trust Assess steps involved in the task.Assess steps involved in the task. Prepare for the task in advance.Prepare for the task in advance. While washing, distract the patient with While washing, distract the patient with

conversation or singing.conversation or singing. Beware of communication techniques.Beware of communication techniques. Respect his or her privacy.Respect his or her privacy.

Sleep DisturbancesSleep Disturbances

Medical causesMedical causes Chronic conditionsChronic conditions Acute ConditionsAcute Conditions Psycholoigal conditionsPsycholoigal conditions Disruptive sleep patterns due to Disruptive sleep patterns due to

progression of disease.progression of disease.

Sleep DisturbancesSleep Disturbances

EnvironmentalEnvironmental Noise LevelNoise Level Unable to find his/her room.Unable to find his/her room. Recent return from hospital.Recent return from hospital.

Other CausesOther Causes Going to bed earlyGoing to bed early Too much sleep during dayToo much sleep during day Family visits too lateFamily visits too late Agitation and restlessnessAgitation and restlessness

SuspiciousnessSuspiciousness

Approaches to use when the resident Approaches to use when the resident shows suspicious behavior.shows suspicious behavior.

Expose the resident with dementia to Expose the resident with dementia to fearful situation slowly.fearful situation slowly.

Discuss what frightens him.Discuss what frightens him. Don’t argue reality.Don’t argue reality. Report signs and symptoms.Report signs and symptoms.

Wanting to Go HomeWanting to Go Home

Approaches to use when the resident wants to Approaches to use when the resident wants to go home.go home.

Acknowledge the resident’s feelings.Acknowledge the resident’s feelings. Take the resident for a walk or a drive.Take the resident for a walk or a drive. Distract the resident with reminiscence.Distract the resident with reminiscence. Ask the family members to help.Ask the family members to help. Spend one-to-one with the resident.Spend one-to-one with the resident. Put away belongings that are used to “go Put away belongings that are used to “go

home”.home”.