Vail Daily column: How to deal with abusive behavior
December 23, 2013
When we hire caregivers, we often find that the applicants have a wide range of experiences. Some applicants have been nurses for many years and others are just beginning their nurse training. Regardless of medical training and life experiences, one thing we have noticed is that most persons are relatively unfamiliar with how to work with patients/loved ones that exhibit abusive behavior.
How would you explain the meaning of the following words to a grade school child?
Did you have to take a few moments to think about the meanings? What about a proper description using words appropriate for their vocabulary? This could be challenging, even frustrating.
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Have you ever awoken in your bed and briefly and felt you did not know where you were? If you have, was it briefly unsettling?
For persons with any type of dementia: Vascular dementia, Parkinson's disease, dementia with Lewy Bodies and Frontotemporal dementia, such frustrations and unsettling occurrences happen regularly.
Often, people with dementia may overreact to an inconsequential setback or minor criticism. This might involve them screaming, shouting, making unreasonable accusations, becoming very agitated or stubborn, crying or laughing uncontrollably or inappropriately. This tendency to overreact is part of the illness and is called a catastrophic reaction.
No Longer A Bystander
A caregiver's role, when dealing with abuse, will be vital. There may be occasions when the caregiver is no longer a bystander and must intervene in order to prevent an abusive situation from developing. The abuse can be physical, verbal or behavioral. If the caregiver acts to prevent abuse, then the caregiver should take the following steps.
When our prospective caregivers go through our training seminars, we educate them on a number of techniques to deal with abusive behavior.
• Deal with abusive behavior in the same way as aggression. The caregiver needs to stay calm and be clear in her directions. Do not get drawn into an argument or become aggressive, however, make it very clear that the abusive behavior will not be tolerated.
• The caregiver should only intervene directly if there is immediate risk. The caregiver will need to use their communication skills to ensure that they do not make the situation worse and to ensure the person at risk is protected.
• If the caregiver must intervene in an abusive situation, then they will need to act assertively. The caregiver must state firmly and clearly what they want to happen. Do not shout, panic or get into an argument. The caregiver can deal with the consequences later; the key is to stop the abuse. This is a time for action on the part of the caregiver, not the time for discussion (that can come later).
• If the caregiver has witnessed, or intervened in, an act of abuse which may constitute a criminal offense, then the caregiver must contact the police or when necessary, adult protective services must be called as soon as possible.
Expression can often be frustrating for persons with cognitive disabilities. You need to think out-of-the-box to find solutions that may aid them. We have found that using pictures and iPads are great tools. For persons with artistic abilities, painting and drawing can be not only soothing, but also a means of communicating feeling and emotions. Cooking and music are also great tools.
If you notice the onset of behavior changes with your loved one, then be aware of changes to the environment, social interaction and over stimulation. Think about the person's surroundings, as these will have an effect on their behavior. It may be that you can make small changes to the home that will make it a better environment for the person with dementia
There are many resources available to provide education both here in the valley and online. Locally, you can call Eagle Valley Senior Life (970-997-0188) or Eagle County Public Health — ask for Carly or Pat — at 970-328-8840. Online, http://www.mayoclinic.com and http://www.alzheimers.org are great resources.
Understanding what is causing the person's behavior can help you find a solution. Remember, the behaviors are symptoms of dementia and are not meant to deliberately upset you.
Judson Haims is the owner of Visiting Angels Home Care in Eagle County. For more information, go to http://www.visitingangels.com/comtns or call 970-328-5526.