Meaning Behind the Behavior - by Karen Tyrell
Looking for the meaning behind the behaviour can dramatically assist caregiver of those with dementia, to determine effective solutions for difficult situations. This is what Karen Tyrell – Dementia Consultant and Educator from Personalized Dementia Solutions encourages in her workshops and in her book, “Cracking the Dementia Code – Creative Solutions to Cope with Changed Behaviours”.
Here is a story from Karen’s blog to help understand this concept better:
Generally, as a society, we can be very impatient. We strive for short, quick and to the point conversations. That’s when difficulties arise when we have to care for people with slow moving Parkinson’s disease, such as sweet and gentle Mr. Milos.
Mr. Milos lived in a care home and had been doing for years. He could walk on his own but was very frail and staff needed to accompany him on walks to help steady him. When he was not being monitored, he was sat in a tilted wheel chair, so that his head would be supported.
In the afternoons however, when Mr. Milos was not being monitored and was sitting alone in his wheelchair, he would slowly try to get out. He would throw one leg over out of the wheelchair, he showed anxiety, and his slippers always would fall off. Staff who were walking by were always kind and without a thought they’d say, “Oh, Mr. Milos, let me help you sit up in your chair,” and “Let me put your slippers back on, they’ve fallen.” They would help him straighten up in his chair and put his slippers back on and walk away. However, they didn’t ever stop to find out if he needed anything or why he wanted to get out of his chair.
Watching him struggle to get out, I knew there was a deeper reason behind his behaviour; I had to investigate why he wanted to get out of his chair. It was too much effort for him to do for no reason.
I decided to explore and talk with Mr. Milos. I went over and sat beside him, and made sure he could see me. I asked, “How are you doing Mr. Milos? I see that you want to get out of your chair, is there something you need to do?” Keeping in mind that with Parkinson’s disease, you need to be very patient when communicating, I asked one question at a time and gave him plenty of time to get his answers out. He informed me that he had to go to work, and he was concerned about his boss being tough on him for not going to work on time. He was showing anxiety about getting to work and not being able to go. I had to do some quick thinking and using therapeutic reasoning to help, and I said, “oh don’t worry, it’s a holiday today. The boss has given everyone the day off.” Mr. Milos relaxed immediately. He even said in his slow stutter, “oh, I forgot it was a holiday today.”
The challenge in working with people affected Parkinson’s disease, especially in later stages, is that you need a lot of time and patience to communicate with them, and understand them. When caregivers, busy with many tasks and many patients, don’t take the time to patiently wait while the person with Parkinson’s disease gets his or her message across, they’ll never know what the person might need and the person’s needs may go unattended. I’m a great advocate for using interpersonal therapy, which is take an extra few moments to connect with the person with dementia, to understand their needs, their message, and their situation. This will improve any difficult situation and the overall wellbeing of persons with dementia.