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Responding to concerning behaviour

Published on Friday 14th of August 2009

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Caring for people with dementia poses many challenges. As the disease progresses, personality and behaviour changes often occur.

Recreation staff and care staff need to use creativity, patience, flexibility and compassion to circumvent difficulties. When responding to difficult behaviour one should ask: ‘What triggered it?’, ‘Why is this happening?’

Behaviours can be triggered by an underlining medical problem (UTI) or the environment (not enough sensory stimuli or too much stimuli). I have read somewhere that repetitive behaviour can be a sign of boredom.

Research has shown that diversionary strategies can be very effective in dealing with concerning behaviour in residents with dementia.

Here are three strategies which may assist you:

  1. Accept the situation
  2. Validate and
  3. Distract

Accept - To accept the situation means to acknowledge the residents’ feelings without judgment. It helps if you present yourself in a positive mood for interaction. Often your body language and demenour will speak louder than your words. Using a soft tone of voice and some physical touch will add emphasis to the communication.

Validate - As you probably already know, Validation is a humanistic approach developed to treat people with dementia. It is a non-reality based form of communication e.g. if a 95 year old man is very agitated ands asks you whether you have seen his mother it is no use to point out to him that she is dead.  If you were to do so he could take it calmly or he could get furious or worse, depressed. Go along with him, say something like: ‘No, I haven’t seen her. Was she a great cook? What did she cook that you loved?’ Try to accommodate the behaviour by acknowledging his feelings which are real to him. Take the time to listen to him and make him feel that his point of view is valued. The ‘reality orientation’ approach is also valid to some residents but with dementia residents the validation approach is more appropriate.

Distract - This entails getting the person to focus on something else. The easiest way to do that is to provide an environment that is rich in incentives; tactile dementia specific material, music, decorated walls. A rich environment makes it easier for staff to divert the resident’s attention into something positive and engaging. Another ways to distract a person is by praising them (with sincerity) and commenting on something they are wearing, inviting them for a walk outdoors, offering a cup of tea, asking for their ‘help’.

You may be able to influence residents’ emotions through distraction. Just remember that communication is possible, concentrate on remaining skills and keep in mind that there is a person behind the behaviour.

This article has been updated, available here: How To Respond To Concerning Behaviour


Donna 12th Sep 2010

Posted in Responding to concerning behaviour

Hi Solange
One of my clients constantly calls out for attention non stop very loudly you can hear her all over the place. Once she knows your name or reads your name tag you are the next fixation. I have tried one on one visits, hand massages and reading to her but it's only calming her while she's getting the attention. I have over 115 clents I can't just stay with her, any suggestions?
HELP! going bonkers

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