Moderating Challenging Behaviors--Sept. 13, 2012

“I am NOT getting in there. How do I know that is our car? You get in there and I will walk next to you.”  His voice is loud, his hands are waving; he is standing in the parking lot. We are outside the new Express Library which is located in a mall a few miles from the memory care center. What do I do now?

Challenging behavior of an Alzheimer diseased person number what? Where do I have the solution to this problem in my own memory bank? Once before, my husband refused to get into our car and I quietly walked him around to the other side and he was willing to climb into the back seat. All he refused that time was to be belted in and I agreed to that moderation, locked the child proof doors and drove him home. Now this tactic does not work. As I stand with him on the sidewalk next to the car, thinking, Bob states “I am going to pee on that bush.”

I was so happy because he turned the situation around for me. Refusing to let him urinate outside, we slowly walked back into the mall as he stopped like a puppy by every bush. After he used the bathroom, washed and dried his hands, he climbed into the car willingly, completely unaware of his prior refusal.

Yes, this confrontation had a satisfactory outcome, but only medication can moderate agitated behavior in a person with moderate to late stage dementia. My husband was showing signs of anxiety, due to his increased loss of being able to situate himself in space.Although the behaviors look similar to those of a toddler, they are entirely different because the toddler is practicing his new set of awareness-of-self skills. The toddler is practicing independence by his refusals to get into the car.
Bob has also been refusing to disrobe, to shower and sometimes to eat. His paranoid reactions are off-putting to the care workers who cannot react to each person’s sudden changes of mood. They just let him be. Bob’s meds will now be increased but we will have to be patient for a few days until the medications take effect.