What I Know Now: A Look Through The Lens Of A Behavior Therapist

 

 I Wish I Knew Then What I Know Now….

 

As a therapist for over 20 years, I’ve not only heard my clients make this statement but also helped numerous clients to determine how to use their experiences to bring greater awareness to themselves and others. As the youngest of five girls, I’ve always had an inquisitive passion to discover what triggers people, what causes people to react unpredictably when put under extreme pressure and I strove to understand how to best help them manage change.

 

A pearl of wisdom that I discovered early in my career is that despite the situation, regardless of the person or environment, there are threads that cause behavior. The key is to identify and focus on the triggers by asking questions, maybe even five questions deep, to get to the root. It is there buried underneath those questions where I’ve been able to provide the most value to others.

 

As a human race, we are all people who need to feel loved, accepted, and respected.

 

In 2006, I found my passion for geriatrics and long-term care by accident. A friend offered me an opportunity to get in on the ground floor of a new health plan. While untrained in the space, I jumped in and found I had a gift. I also noticed a trend that our members were being placed in higher levels of care for 'behaviors'. It was my responsibility to not only assess for proper placement, but that our members were being treated with the best care.

 

A second pearl of wisdom I learned is that behaviors typically do not happen overnight, but rather over a pattern of time or occur due to triggers that cause the reaction. Even for those who face cognitive impairments like Dementia, 'bad behaviors are from unmet needs'.

 

And so the question becomes, “Why is a person behaving in a bad/negative way” or “acting out?”

 

Alzheimer’s caregivers, families, therapists, social workers, nurses, and certified assistants must all become curious.  All involved in patient care must become committed to ask, “Why?”

 

Why is my loved one behaving this way? What is triggering it and how can I help?  

 

Changing our own patient care perspective and looking at human behavior differently allowed us to see high success. It allowed us to keep people in a lower level of care and keep them at home.  It also gave us the chance to reduce the use of psychotropic medications.

 

Over the years, I have had the powerful opportunity to be a part of some of the most amazing, awe inspiring and life transforming patient stories.  I recall one such story that sticks out in my mind.

 

We had a male dementia patient man living in a nursing facility who kept wandering over to the secured doors of the unit.

 

He would begin adamantly pounding on the door and yelling loudly!

 

At the time, he was in the moderate to severe dementia stage. The staff would attempt to ask what he needed, if he was hurt and if he was ok. He could not put together an answer and continued with his behavior.

 

Nothing stopped him.

 

Curious, I asked the staff to send all documentation on him asap.

 

After thoughtful analysis, I realized a pattern.  This incident always occurred around the same time of day.

 

As I looked deeper into his history taking the extra step of calling his 86 year old wife, what I learned was astounding.

 

His wife shared an important missing component...her husband grew up on a farm.

 

She shared that when her husband was young, every day he came home from school he had to round up the livestock in the barn to eat.  To do this, he would yell out to the farm animals to get them to the troughs.  This patient’s outbursts and behavioral issues, kept happening around 3:00 pm. 
 
I read further in the documentation that he also worked in construction in his adult career. At that moment, the lightbulb went off in my head.
 
I was determined to develop the most customized, effective behavioral plan possible. Here’s what we did:  We suggested staff bring the patient into the day room, give him his cup of coffee with cream and distract him with legos or lincoln logs to tap in to a more construction type mindset.

 

What we all discovered is that his ‘internal clock’ was telling him it was time to wrangle up the livestock!  As a result, we were able to intervene, divert his yelling behavior by distracting him and and reframe his internal clock!  

 

It was wonderful!  We intercepted the need to move to a higher level of care, prevented psychotropic medication, and eliminated staff and other resident fear. It was a shorter time investment to prevent the behavior than a longer time one spending energy to stop the behavior.

 

Many ask me if working with LifeGuides has changed me. Working with LifeGuides hasn’t changed me....it excites me!

 

I have worked my entire career at trying to find a way to get to reach more people and help the masses.

 

We as humans need to feel heard, listened to, valued....and of course also my personal mantra of feeling loved, accepted and respected.  

 

LifeGuides is that large platform I’d been looking for and being able to figure out how to do such an extraordinary outreach is completely in line with my life’s work and vision.  

 

 

You might have received the best and widely know resource with advice on how to help when dealing with the difficulties of living with Dementia, but always keep in mind it is incredibly important to know as much as you can about “your loved one!”

 

The more information we know about your loved one the better. Things like hobbies, habits, interests information about their background is critical because tapping into their long-term memory is key!

Throughout the moderate to late stages of dementia it is best to strive for prevention and distraction.

 

Remember, “YOU” are the intervention. The person with dementia does not know or if told, won’t remember.  

 

Over the coming weeks, we’ll discuss other important questions a caregiver should ask and other elements that must be considered when crafting a behavioral plan for your loved one.

 

Until then… don’t forget to keep cherishing the memories, honoring your loved one, getting what you need to be the best caregiver you can be and if needed connecting to a LifeGuide today!

 

 

 

 

 

 

 

 

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