We revisit an important topic shared with our caregivers by Greg Fowers with Provo Canyon Behavioral Hospital regarding dealing with difficult behaviors in caregiving. 

  1. Be prepared before you go in and have a plan in place.
    • Before visiting a client, know what your goal is and what you need to accomplish.
    • Remember to keep your goal in mind, but be flexible if needed.
    • Have a backup plan A, B, and C.
    • Don’t be so task-oriented that you forget your primary goal keeping your client happy.
    •  Understand when it is time to take a different approach and when to redirect.
      • Keep an eye out for escalation signs — Do not get into an argument because you will lose. Your client is more likely to shut down, and it will become more difficult to get them to do anything. They are trying to retain control of their lives where they feel they have lost control. Try giving two simple options and let them make a decision. Many challenging behaviors start because the client feels they are being forced to do something.

2. Know your clients well — What brings them joy and happiness?

  • Learn as much as you can about your client.
  • Find commonalities between the two of you.
  • Knowing what they enjoy can help when they are resistant to a task. (Example: Do they like bananas or apples?) It can be difficult for some to be able to make complicated decisions, but they do know what they like and what they do not. 
  • Multiple options can be overwhelming, so present the client with 2 simple choices. (Example: Do you want to wear the red shirt or the blue shirt?)
  • Speak in low tones.
    • As we age we lose the ability to hear high-pitched tones.
    • People with dementia have a difficult time with hearing aids and can lose them.
    • Speak slowly and in a low tone. Give the client time to process your simple request and to respond. Sometimes it can take 20-30 seconds to process a request. Remember to go at their pace, not yours.
    • Sometimes they have trouble relating to or processing what is going on in the moment and need longer to make sense of the situation. 
  • Don’t ask “Why” questions. Ask “What, Where, When” open-ended questions instead. (Example: Where did this happen?)
  • Because they are often being told what to do, clients may feel that “nobody is listening to me”. Take time to stop and listen to show that you really care about them and their experiences. 
Dealing with Difficult Behaviors in Caregiving — Part 1