Using Redirection to Deal with Problematic Behaviors in Seniors with Dementia

Dealing with the frequently difficult and sometimes inappropriate behaviors that can result from a dementing illness or condition can be difficult. There are various techniques that can be useful and can help when dealing with these things. Redirection is a useful and important technique as it  helps steer the older adult’s attention away from the stressful, problematic behavior to something that is more pleasant, less distressing. By using these techniques, it can be possible to delay or possibly even avoid the troublesome behaviors from occurring. 

It is very important, when caring for an older adult with dementia, that if there is a sudden change of behavior to notify their doctor, a nurse or a consult Geriatric Care Manager. This is important because a sudden change can be evidence of an acute medical issue, such as dehydration, a urinary tract infection, etc. The differentiation between an acute issue and a general worsening of their dementing illness has absolute influence of how, or even if, it would be treated and dealt with.

There are several techniques that can be used to redirect the older adult. It is important to remember the safety of all involved when contemplating a technique to utilize.

I will share 4 specific techniques, then discuss various troublesome/problematic/inappropriate behaviors that are frequently exhibited in older adults with dementia and finally some techniques to use and keep in mind (these tips are provided in a chart and can be printed, cut out and taped to a cabinet or the refrigerator for easy access when things get stressful).

*Please keep in mind that while these techniques can be helpful, they may or may not work. They may work one time and not another. Dementia and the related behaviors can be so different and varied depending upon the individual and it is important to keep that in mind when reading or utilizing these tips*

Join in the person’s reality. People with dementia frequently regress to past years, as people often lose their short-term memory first, they are able to recall things from further back in their past. Let’s say for example that our older adult states that they are wanting to find their mother. Do not tell them that due to their own advanced age that their mother wouldn’t be alive at this point. Instead, tell them that you want to help them look. Ask for stories about their mother. Get into their reality by interacting with them, as long as it is still safe for all involved.

Distract. When a behavior is negative, try to find something else to utilize their energy and take the place of the problematic behavior. For example, if the older adult is rummaging through the closet of their neighbor, offer them a task to do. Ask them to help you find an empty box, or find something for them to sort. Giving them a task (something simple as to not incite any frustration that could accompany not being able to successfully complete was is asked of them) to do to distract them but keep them busy at the same time.

Validate the older adult’s emotional state. If you notice the older adult feeling sad or angry, engage in a conversation that shows them that you understand what they are feeling. You might ask, “You look worried, is there anything I can do to help you?” or “You seem sad today? Would you like to talk about anything that may be on your mind or leading you to feel upset?”

Redirection. When the older adult is trying to get out the door, suggest going to get a snack, or participating in an exercise class, something, and say “How about having lunch before you go? The chicken smells so good, let’s go get some lunch!”

There are a variety of inappropriate and problematic behaviors when it comes to older adults with dementia. Here are some:

-inappropriate activities (sexual comments, asking for sexual favors, removing clothing when it is not appropriate to do so, etc)

-hiding, hoarding

-sundowning (agitation that begins or increases late in the afternoon as the sun goes down and the day progresses)

-aggressiveness (verbally, physically abusive, combative)

I wanted to provide a quick reference list to keep handy in case you ever need the information:

Dealing with Problematic Behaviors that Frequently 

Accompany Dementia in Older Adults

-it is important not to overreact

-do not argue or scold the person

-provide activities that have a purpose

-if the older adult seems lonely or scared, hold their hand or ask if they would like a hug

-remind them that they are safe

-provide a rummaging box that they can keep their hands busy with but is only filled with safe objects (nothing too small that could be swallowed, 

nothing sharp and nothing that could be used as a weapon)

-If the weather is appropriate, provide some time outside

-approach the older adult with only one caregiver at a time, it can feel intimidating if more than one person approaches someone 

at the same time

-monitor, possibly eliminate, caffeine intake

-when talking to the upset person, stand to their side, where you are out of their reach

Dealing with these behaviors can be frustrating, scary, overwhelming and no matter how you deal with it, please remember YOU ARE DOING THE BEST YOU CAN. There is no perfect way to deal with it and there isn't a 'right' or 'wrong' way- I only offer these tips to help alleviate any stress and to offer support!

Please feel free to reach out either by commenting on this blog post, on our Thrive GCM Facebook page or by sending me an email, if you need any assistance or would like to share (thrivegcm@gmail.com)

Please check in for our next blog post coming SOON.

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This blog series is designed to help you 

and your loved ones 

Knowledge is Power!