Oct 24, 2018

Caregiver Life - "How to Change Bad Behavior to Good Behavior"

Alzheimer's and dementia patients engage in all kinds of behaviors that we the caregivers find alarming, stressful, and wrong.

What can you do when an Alzheimer's patient does things you don't like?

Alzheimer's caregivers have great difficulty accepting the "normal" behaviors that are often expressed by Alzheimer's patients.

I use the word normal because what is perfectly normal behavior for a person living with dementia is not always "normal" to us.

We have difficulty accepting these behaviors.

By Bob DeMarco
Alzheimer's Reading Room

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  • When a person living with dementia believes something to be true it is true - is true as far as they are concerned. 
You might know that it is not true and you will probably try to correct them, or explain to them why they are wrong. You cannot convince an Alzheimer's patient that what they believe is untrue, because they believe it is true. Everyone is entitled to their beliefs regardless of disease.

Once you accept it is not about how your are feeling or your beliefs, it is about how they are feeling and their beliefs; you can put an end to a strategy that just won't work.

Go ahead keep trying to explain. Use as many words and ways that you can think of - it won't work. Go bang your head against the wall. That is what you are doing anyway.
  • It is possible to change the behavior of a person living with dementia. You can change almost any bad, or unsettling, by replacing that behavior with a new behavior. In other words, eradicate the bad behavior, and change that behavior into a new and good behavior.

You will accomplish this by substituting a new pattern of behavior for the bad pattern of behavior.

I could list all of the wacky and unsettling behaviors that my mother engaged in the eight and a half years that I took care of her, but all that would do is cause you to click out this article. The list is long and it continue to grow all the time.

1. 9:37 PM Every Night

  • My mother would get all crazy and bent out of shape every night around 9:37 PM. She would jump up convinced that she needed to clean our home.
When I tried to explain the time of night, or that it wasn't necessary the same think would happen every time - she would march off to her bedroom, curl up in a ball in bed, and refuse to come out or speak.

Finally I discovered a solution to the problem. What I did was changed the pattern.

Around 9:15 PM I would get my mother up, guide her to the bathroom, get her to put on her pajamas and robe, and guide her into the kitchen.

I would then give her some ice cream and talk to her. Later on we added Harvey - The greatest caregiver tool of them. So I would talk to my mom for a while; and then, I would leave her with Harvey for a while. Eventually I would guide her to bed for the night.

Amazingly, the pattern of her needing to clean was solved. She stopped trying to do it, and never brought it up again.

After about 2 months I thought - what will happen if I don't give the ice cream? I tired it.

9:15, 9:37 no problem.

And guess what happened next? At 10 PM, Dotty looked at me and asked, "did I have my ice cream tonight"? I answered no, let's go. I did give her a double dip of ice cream that night. I was so happy I couldn't see straight.

2. My Husband Says I Am Not His Wife

I met a woman that was having a really disconcerting problem with her husband who lived with Alzheimer's. He started saying, you are not my wife.

What did she do? She tried to explain to him that she was his wife. She would show him pictures of the two of them together. She tried every explanation under the sun.

I asked her, does it work? She responded, no. I then asked does it happen around the same time every day? She thought about it. She finally answered around 1:30 to 2 in the afternoon.

I suggested that she change the pattern. This meant doing something very different starting around 1:15 PM.

I suggested if possible that she take him out of the house. Does he like ice cream? How about you go to McDonald's and have ice cream - or coffee, or french fries, something he really likes.

As an alternative. How about you go visit a friend. Have the friend hug her husband (every time), and mention how nice it was to see him.

Have something ready to go, like listening to music or reading the paper, or just about anything that would fill up the time until around 2:15 or so.

On the way home take a drive. Go past some place her really liked. Dotty liked to look at the tall Banyon trees and remarked about them every time we drove past them (I used the trees quite often).

The funny thing about the Banyon trees. In the beginning, Dotty would act like she never saw the Banyon trees in her life - every time. This drove me a little crazy in the beginning. She said the same exact thing every time we drove by them (get it, patterns of behavior by dementia patients).

The Banyon trees finally became my friend. We would drive by them and Dotty would remark how beautiful and big they were. She would also mention every time, there was one Banyon tree that didn't look so good. I felt happy every time Dotty repeated herself. At least she was still noticing the trees, had awareness of them, and was still talking.

The best part. I actually started paying closer attention to the Banyon Trees. They are quite beautiful and amazing. Made me feel good once I started noticing thanks to Dotty.

Get a notebook. Look for the patterns. Note the time of day. When some thing is going wrong, do something different at that time of day.

Use the hooks. Ice cream, potato chips, candy, coloring books, puzzles and get your own Harvey.

Change the pattern, change your caregiver life.

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Bob DeMarco is the Founder of the Alzheimer's Reading Room (ARR). Bob is a recognized expert, writer, speaker, and influencer in the Alzheimer's and Dementia Community worldwide. The Alzheimer's Reading Room contains more than 5,000 articles and has been published since July, 2009.

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