Question

You have a client who has a diagnosis of dementia. During the period of care, you have never faced any problem from your client. But suddenly, one day your client showed an aggressive behaviour. When you were administering medication to her , she threw away the medication. Answer the following questions

13.1) What you understand by challenging behaviour.

13.2) Describe the management of challenging behaviour(30-40 words)

Answer 1

• Changes in the behaviour of people with dementia are very common. Sometimes this can include aggressive behaviours such as verbal abuse, verbal threats, hitting out, damaging property or physical violence towards another person.
• There are many reasons why behaviours change. Every person with dementia is an individual who will react to circumstances in their own way. Sometimes the behaviour may be related to changes taking place in the brain. In other instances, there may be events or factors in the environment triggering the behaviour. In some instances a task may be too complex. Or the person may not be feeling well.
• It is important to try to understand why the person with dementia is behaving in a particular way. If family members and carers can determine what may be triggering the behaviour, it may be easier to figure out ways to prevent the behaviour happening again.
• Some frequent causes of agitated behaviours are Health issues, Fatigue, Disruption of sleep patterns causing sleep deprivation, Physical discomfort such as pain, fever, illness or constipation, Loss of control over behaviours due to the physical changes in the brain, Adverse side effects of medication, Impaired vision or hearing causing the person to misinterpret sight and sounds, Hallucinations.
• Aggressive behavior can include shouting, cornering someone, raising a hand to someone, or actually pushing or hitting. Unfortunately, aggression among people with dementia can happen suddenly and seemingly without warning. Try to identify what triggered the aggression so that the antecedent can be eliminated or modified as soon as possible. As difficult as it may be, react in a calm, reassuring way and focus on the person's feelings. Reduce environmental distractions as much as possible, such as loud noises or potentially frightening shadows or movements. Redirecting an aggressive person to an enjoyable activity can be remarkably effective.
• When aggressive behaviours occur:

Stay calm. Speak in a calm, reassuring voice

1. Address the underlying feeling if possible.
2. A simple suggestion such as having a drink together, going for a walk or looking at a magazine together may help. Distraction and avoidance are often the most useful approaches.
3. If you feel unsafe, stand out of reach. Closing in or trying to restrain the person, unless absolutely necessary, can make matters worse. You may need to leave them until they have calmed down.
4. If you have developed some strategies for managing aggressive behaviours try to make sure that they are used by any other people who are also caring for the person with dementia.
5. There are a number of simple non-drug treatments that may help. These include life story work and reminiscence therapy, social interaction, aromatherapy, talking therapies, animal therapy, music and dance therapy and massage.
6. Aggressive behaviours can be very difficult for families and carers. The behaviours are symptoms of dementia and are not meant to deliberately upset you.