Your father was always a perfect gentleman; he prided himself on his even temperament and the fact that he’d never been in a fight. He now has advanced dementia, and recently, he’s been striking out at the staff in the nursing home where he lives. You’re mortified because this is not at all like your father.
It’s important to recognize that his new behaviour is not “aggression”. He is not being “violent” or attempting to harm anyone. It is more likely that he is attempting to protect himself. That begs the question—from what/whom is he trying to protect himself? While you might know logically that he is safe and well cared for, he understands the situation differently than you. He perceives that he is at risk and needs to protect himself.
Someone who is experiencing dementia may exhibit behaviours that we do not understand. These behaviours have been labelled
‘difficult’ or ‘disruptive’ or ‘challenging’,
but is that really a fair assessment
of these behaviours?
For those who have dementia, living in retirement or long term care or being admitted to hospital can be frightening. Suddenly, they are in an unfamiliar environment with new sights, sounds and smells.
They may feel overstimulated by all of these new senses and become fearful. Fear is sometimes expressed through behaviour rather than words, especially if someone’s language abilities have been impacted by dementia. This is sometimes referred to as “responsive behaviours”—someone is responding to their environment and it is evidenced in their behaviour.
Instead of merely seeing the ‘challenge’ or ‘difficulty’ that these behaviours cause for us, or assuming that all behaviour is attributed to disease, we need to reframe these behaviours as a form of communication. Behaviours are a form of personal expression, a unique way of communicating needs. We should then seek to understand the meaning behind the personal expression.
People with dementia are constantly communicating. They may not be using words, but their behaviours and reactions are all a form of communication. It is our responsibility to try and understand what they are communicating.
We must remember that people who have dementia were all unique individuals prior to the onset of their illness. They continue to be unique individuals with different personalities, communication styles, interests, life histories, etc. We must never lose sight of the fact that a person with dementia is first and foremost a person who requires love, care, and understanding, not just a disease or a ‘case’ that needs to be managed.
When someone with dementia responds to their environment with a particular behaviour.
When someone with dementia is attempting to express a need or
communicate without using language.
Warm Embrace caregivers are able to spend extended lengths of time with each client, getting to know and understand their unique forms of communication. When visiting your father, our role would be to determine what makes him feel safe and secure. We would be watching for things like: when does he seem most content? Are there triggers that seem to agitate him? Are there ways to avoid those triggers? Does he have a non-verbal way of communicating his needs that we can share with the care team?
It can take time and one-on-one attention to decode expressive communication.
Staff in a retirement home, long term care centre, or hospital may not be able to provide the exclusive attention and care to help determine what your loved one is expressing. A Warm Embrace caregiver offers the time and attention to help your loved one feel heard and understood.
Interpreting expressive communication and responsive behaviours takes time and patience and that’s exactly what Warm Embrace caregivers can provide. One-on-one companionship can reduce the fear associated with a new environment and provide a stabilizing presence to help every day be a better day.