Managing accommodating responsive behaviors dementia care


When viewed through the lens of an unnerving hotel encoun­ter, responding to the prospect of a shower with fear, resistance, and bewilderment seems downright normal.This basic understanding of behavior and its roots can be extraordinarily empowering for dementia care partners and can counteract initial inclinations to suppress, medicate, and sedate a person with drugs. More often than not, it’s a response to a person or a situation—and a communication that something is wrong.

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It has had a powerful and positive impact on many individuals with dementia whose communications have been misunder­stood.

I first came across this dynamic protocol long ago during the regular course of my consulting work and have since applied its principles in numerous care situations, becoming more adept at achieving transfor­mative outcomes with time and practice. First, we gather infor­mation about the person: their cognitive level, life history, priorities, preferences, relationships, personality, etc.

Other adverse effects linked to inappropriate antipsy­chotic administration include heart attack, falls, and hospitalizations.

Clearly, there are many reasons providers should resist the urge to reach for the prescription pad at the first sign of a person with dementia’s negative behav­ior expression.

If we stop seeing adverse behavior as a rote symp­tom of dementia, and start instead asking questions to affirm its validity—“Could this be a normal response to the situation?