Try: Disinhibition is a term used to describe behavior that shows a lack of restraint or is inappropriate disinhibited behavior is observed in some elderly individuals because of decreased cognitive and mental capabilities disinhibited behavior is often associated with dementia and is a symptom of the disease disinhibition in an elderly individual can result in reduced ability to control an instant impulsive response to a situation or stimulus an individual with disinhibited behavior lacks the ability to maintain appropriate social responses or appropriate restraint on emotional or verbal behavior elderly individuals who show disinhibited behavior often can demonstrate other related behaviors including verbal physical aggression socially inappropriate behavior and sexually inappropriate behavior information references

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Categories: Behavior Challenging, Cognitive Intellectual, Medical Physical, Some Supervision, Maximum Supervision

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Keywords: Disinhibition self-control out of control combative inappropriate behavior mental health

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Don’t always assume that a person is simply ignoring you he she may not be able to hear you as well as he she used to gradual hearing loss — presbycusis prez-buh-kyoo-sis — is common among older adults tinnitus tin-ny-tus also common among older adults is a ringing hissing or roaring sound in the ears that is usually triggered by a loud noise or by certain medications signs of hearing loss here are some common signs that an older person may have a hearing problem asking others to speak more slowly clearly or loudly or to repeat things trouble understanding words in a restaurant in a crowd of people or if more than one person is speaking muffled speech or mumbling needing to turn up the volume of the radio television or music trouble understanding people on the telephone difficulty follow a conversation misunderstanding responding inappropriately or saying that others speech sounds distorted complaining of a ringing roaring or hissing sound difficulty understanding the speech of women and children saying that some sounds seem too loud reading lips or more frequently watching people people’s faces when they speak walking away from or avoiding conversation unexplained irritability anger stress nervousness negativity embarrassment or depression information references adapted from sarah henry 2010 "signs of hearing loss " available at www caring com

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Categories: Sage, Topic, Behavior Challenging, Communication, Emotional Psychological, Maintenance, Medical Physical, Social, Hearing, So-So Hearing, Poor Hearing

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Keywords: Hearing loss hearing hear listen irritable angry stress nervous nnegative embarrassed depressed

*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Description the behavior of people with dementia can be the most distressing part of the disease the following are some guidelines to assist in the management of difficult behaviors caregivers have found these six r’s helpful in thinking through a problem the six r’s of behavior management 1 restrict the first thing we often try is to get the older adult to stop whatever he she is doing this is especially important when the person might harm himself or someone else but trying to make the person stop may upset him her more 2 reassess ask yourself might a physical illness or drug reaction be causing the problem might the person be having difficulty seeing or hearing is something upsetting him her could the annoying person or object be removed might a different approach upset the person less 3 reconsider ask youself how things must seem from the patient’s point of view people with dementia are often unaware of the extent of their impairment when you try to bathe or dress someone who does not understand that he needs help he may get upset the person’s anxiety is understandable when things are going on that he can’t make sense of 4 rechannel look for a way that the behavior can continue in a safe and nondestructive way the behavior may be important to the person in some way that we cannot understand one man who had been a mechanic continued to take things apart around the house but he could not get them back together his wife had an old automobile carburetor steam cleaned and gave it to him he was able to enjoy taking it apart for several months and he left the household appliances alone 5 reassure when a person has been upset fearful or angry take time to reassure him her that things are all right and that you still care for him her while the person may not remember the reassurance he may retain the feeling of having been reassured and cared for putting your arm around the person or hugging him her is a way of reassuring him her if you’re a family caregiver this works okay but if you’re a home care provider some older adults may become offensive if you touch him her take time to reassure yourself as well you are doing the best you can with a demanding and difficult job give yourself a pat on the back for surviving one more challenge if possible find some time away from the person to regain your energy 6 review afterward think over what happened and how you managed it you may face this problem again what can you learn from this experience that will help you next time what can yhou learn from this experience that will help you next time what led up to this behavior how did you respond to it what did you do right what might you try next time

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Categories: Behavior Challenging

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*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Possible causes physiological medical causes o fatigue at the time of the request activity or event o disruption of sleep pattern such as the reversal of day and night causing sleep deprivation o physical discomfort such as pain fever illness constipation fecal impaction expressed as anger o loss of control over behaviors due to changes in the brain o adverse side effects of medications such as psychotropics sedatives or tranquilizers o impaired vision or hearing causing misinterpretations of sights and sounds o hallucinations environmental causes o sensory overload such as noise activity clutter or too many people in the environment o unfamiliar people place or sounds o sudden movements or startling noises o feeling lost insecure forgotten or abandoned o difficulty adjusting from darkness to well lit area and vise versa other causes o being asked to respond to several questions or statements at once o responding to arguments between other people

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Categories: Behavior Challenging, Emotional Psychological

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*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Possible causes italic text 1 physiological or medical causes – fatigue at time of request activity or event disruption of sleep pattern day and night reversal causing sleep deprivation physical discomfort such as pain fever illness constipation fecal impaction expressed as anger loss of control over behaviors due to physical changes in the brain adverse side effects of medications such as psychotropics sedatives or tranquilizers impaired vision or hearing causing the older adult to misinterprets sights and sounds hallucinations 2 environmental causes sensory overload such as noise activity or clutter or too many people in environment unfamiliar people place or sounds sudden movements startling noises feeling lost insecure forgotten when familiar person is out of sight the older adult may feel abandoned difficulty adjusting to darkness from well lighted area and vice versa 3 other causes being asked to respond to several questions or statements at once responding to arguments between other people response to caregiver’s impatience stress irritability person scolded confronted contradicted surprised by unexpected physical contact inability to perform what was once a simple task buttoning clothing instructions unclear or too complicated change in schedule or routine attention span too short for task task not broken down into manageable steps activity perceived as too childlike insulting coping strategies italic text 1 begin with medical evaluation to rule out physical and or medication problems 2 discuss possible adverse side effects of current medications with physician 3 have vision and hearing checked 4 alternate quiet times with more active periods 5 plan outings activities when person is rested 6 make sure person is comfortable – clothes are not tight older adult is not too hot or cold 7 simplify environment by reducing noise number of people and clutter 8 keep daily routine consistent if a change in routine in necessary determine an appropriate amount of time for the older adult to adapt to the change 9 keep furniture and objects in the same place at all times 10 orient older adult to time by using calendars and large numerical clocks as the person may lose a sense of time because of the disease 11 make sure the person is protected from hurting him herself remove sharp utensils tools and objects from the environment 12 remove the person from stressful situations 13 distract the older adult with favorite food or activity to reduce agitated feelings distraction and avoidance are often the most useful approaches to handling agitated or angry behaviors 14 exercise regularly such as walking or dancing to help in reducing stress 15 music massage and quiet readings may be used in calming the older adult 16 use gentle physical touch to clam person holding hands and hugging may be comforting for some people with dementia but perceived as restraint by others 17 some communication techniques to try include the avoidance of questions that rely on memory try not to reason with the older adult reasoning or rationalizing with the person frequently leads to frustration and anger try not to express your anger or impatience speak slowly and clearly approach the person slowly and from the front approaching from side or behind can startle the older adult 18 use repetition frequent clearly stated reminders are needed to reassure the person with dementia 19 for tasks or activities try to allow adequate time for the older adult to respond to directions requests etc limit choices such as with food activities or clothing give clearly stated directions for each step other considerations italic text 1 it is important to recognize that angry or agitated behaviors are often symptoms of dementia and are not deliberate responses 2 sometimes keeping a log or a journal can be helpful in identifying why the person becomes angry or agitated 3 the way in which caregivers approach the older adult with dementia is a critical part of avoiding angry behaviors a gentle supportive simple approach will almost always be more successful than commands or rationalizing dementia victims will often sense a caregiver’s frustration or anger and become anxious or angry themselves 4 anger and rage are often signs than the person is feeling loss of control of his her life calmly acknowledge feelings even when you do not understand what is being said or why the person is angry 5 medications can often reduce agitated behaviors for some patients with dementia however medications can have adverse side effects or can cause agitation 6 if you feel your physical safety is threatened 7 after episode is passed try not to remind person of incident he she will probably soon forget caregivers should carefully consider what can be changed to avoid another reoccurrence in addition caregivers should work out an emergency procedure for themselves in the event of physical danger

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Categories: Behavior Challenging, Cognitive Intellectual

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*This information is listed as a Fact Sheet and is not explicitly medically licensed

Try: Try gentle touch soothing music reading walks a snack and so on to redirect cr cr’s attention speak in a reassuring voice do not try to restrain cr keep dangerous objects out of cr cr’s reach acknowledge cr cr’s anger over the loss of control in his or her life tell cr that you understand his or her frustration reduce cr cr’s intake of caffeine sugar and junk food reduce noise clutter and the number of people in the room maintain structure and keep the same routine with cr keep household objects and furniture in the same places allow cr to do as much as possible for own self

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Categories: Behavior Challenging, Emotional Psychological, Some Supervision, Maximum Supervision, Fully Aware, Somewhat Aware

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References: Adapted from www caregiver org

Keywords: Upset acting out excited restless

*This information is listed as a Tip and is not explicitly medically licensed

Try: Place the brightly colored tape at the bottom of the stairs so cr does not wander up the stairs it also helps if cr can see the bottom step when going down the steps use the brightly colored tape to mark around doors that cr should not wander through sometimes putting the stick down that looks like a black hole on the floor next to the door will prevent cr from going through the door cr may really believe that there is a black hole like in bugs bunny cartoons placing bells that make a loud noise when the door is opened may alert you that cr is going through the door make sure that any mats on the floor are the no-skid type and not very high this will keep cr from dragging toes when walking on the mat

Materials: Brightly colored tape stick down that looks like a black hole yellow no crossing tape that is used in traffic and construction areas

Categories: Behavior Challenging, Cognitive Intellectual, Some Supervision, Maximum Supervision, Fully Aware, Somewhat Aware, So-So L T Memory, Poor L T Memory, So-So S T Memory, Poor S T Memory

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Keywords: Elopement pacing lost

*This information is listed as a Tip and is not explicitly medically licensed

Try: First check to see that all basic needs of the cr have been met if the cr is hungry thirsty wet or in pain address this first buy a white noise machine or an alarm clock that also plays white noise these are available at most large retail stores wal-mart target and so on if you have a smart phone or mp3 player you can also download a white noise program onto the device many of these programs are free place the white noise machine near the cr if the cr is hard of hearing ensure that hearing aids are in place or turn up the volume of the white noise to a level that is loud enough for the cr to hear play the white noise program for the cr you may need to try various sound programs to find one that is most comforting to the cr when you find the most effective program sound write it down and share with the cr’s other caregivers

Materials: White noise machine alternatively you could download a white noise app onto a smart phone or mp3 player

Categories: Behavior Challenging, Emotional Psychological

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References: n/a

Keywords: Screaming shouting

*This information is listed as a Tip and is not explicitly medically licensed

Try: First check to see that all basic needs of the cr have been met if the cr is hungry thirsty wet or in pain address this first try rearranging the cr’s bed chair and other furniture so that he or she is near others and can see or hear what is going on try rearranging the cr bed chair and other furniture so that he or she can look out a window for stimulation place familiar items around the cr for example pictures books hobby supplies and so on

Materials: Personal items that the cr finds comforting and familiar

Categories: Behavior Challenging, Emotional Psychological

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References: n/a

Keywords: Screaming shouting

*This information is listed as a Tip and is not explicitly medically licensed

Try: If the cr cannot remove clothing sometimes the stripping behavior can be diverted to a more appropriate behavior both you and the cr should be rested free of pain and calm before outings outings should be short in duration outing should be in a quiet calm environment immediately before leaving home make sure the cr goes to the bathroom before putting on the jumpsuit coverall provide a wheel chair for the cr’s comfort provide the cr with a small lap pet that enjoys constant stroking assess the pet beforehand to insure safety compatibility and appropriateness or provide a favorite soft item for the cr manipulate in his or her hands a treat in each pocket is a nice distraction for example a small rubber toy or stuffed animal do not mention the clothing removal behavior to the cr or within ear shot of the cr do not tell the cr not to remove clothing instead re-direct the cr’s attention to the pet or lap item each time he or she starts to pull at clothing

Materials: Stay-dressed style one piece jumpsuit overall with a long back zipper and a snap-over tab at the top specialty catalogs carry a variety of reasonably price easy care stay-dressed style jumpsuits and coveralls that give the illusion of two-piece outfits wheel chair small pet or one of the cr’s favorite soft object or item

Categories: Behavior Challenging, Emotional Psychological, Social, Fully Aware, Somewhat Aware

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Keywords: Taking off clothes removing clothes naked

*This information is listed as a Tip and is not explicitly medically licensed