In this post, we are going to talk about the first and most important step to actually solve a difficult dementia behavior.
If you would rather watch a video on this topic, click here.
Before any problem can be solved we first have to identify what exactly the problem is. This is actually the most important step and it sounds simple, but after working with thousands and thousands of careblazers this first step is more often than not done incorrectly and it lowers the chances of any behavior change from happening.
So grab a piece of paper, we are going to get really clear on step one.
I want you to write down on your paper or in the comments what is one thing or one behavior you are trying to change or would like to see change in your loved one with dementia?
Now take a look at what you wrote down. The very first step in solving a problem is to get clear on what that problem is and in order to do that, you can’t have your own judgements and interpretations on the behavior in this first step. Your interpretation and judgment is likely going to block you from being able to figure out what it is that is actually happening.
You have to describe the behavior they are doing objectively, without bias. Without interpretation. When you interpret a behavior from your point of view, you miss the boat and are likely to miss the solution to the problem.
Here’s an example I use in one of my behavior classes:
There was a careblazer whose mom would take tissues that were sitting next to her and throw the tissues on the ground and put the tissue box on her feet.
This caregiver thought her mom was wasting tissue. If i asked her what’s the issue, the caregiver would say her mom is wasting tissues.
Now, notice how that’s not objective. That’s not without bias. This caregiver is interpreting the behavior as wasteful and so long as she describes this as the behavior then all of this caregiver’s efforts will be around getting her mom to stop wasting tissue.
But what we discovered is that her mom wasn’t trying to waste tissue at all. Her mom wanted something on her feet and for her that’s what she was trying to communicate with the tissue boxes, but so long as she is thinking her mom is being wasteful, she wasn't’ able to view this objectively and she wasn’t able to solve this problem. Instead they continue to argue and the relationship gets worse. She was never going to be able to get to the place of realizizng her mom wanted something on her feet from trying to solve waste. It doesn’t even make sense.
Now, how many of you are trying to solve a “problem” but in your head you’ve already come up with the problem, you’ve already interpreted and judged what you think is happening.
You think they are lying. They are being resistant, they are being argumentative. So long as you're labeling the problem, right away you’ve already put blinders on and won't see any other possibility. You will instead try to come up with solutions for why they are resistant and argumentative or why they are lying when that might not actually be the problem at all. Perhaps they are confused, they are scared, they aren’t hearing things properly, they may be seeing things…so many things that can actually be causing the behavior and so many potential solutions that can work. But if you start out saying they are argumentative, resistant, etc., you automatically label the behavior. Which means you automatically judge why they are doing. Which then means any of your solutions you try to get rid of the argumentative, lying, etc won't be effective because that’s not what they are actually doing anyway.
So if your love done with dementia says you are stealing their money when you aren’t, the behavior is actually - what exactly person with dementia says, “You are stealing my money”. You write down exactly what they said. No interpretation. Everyone in the world can look and listen and agree on what exactly happened.
The behavior isn’t “my loved one is a liar” or “My loved one is accusing me of things that aren’t true.” Those are all interpretations.
If you are interpreting and judging what’s happening in this first step, you are going to close yourself off to other possibilities that could just be the answer to solve what’s happening.
Let’s do another example:
Let’s say the person with dementia is refusing to bathe.
Refusing to bathe doesn’t belong in the first step. Because refusing is interpretation. We all have different definitions of what that means and how that looks. What is something that we could all agree on? You would instead write down what exactly is the behavior: “my loved one says they bathed today but they didn’t.” “or my loved one says they will bathe later but they haven’t bathed in 3 weeks.”
It’s very important only include the facts here.
How do you know it’s a fact? You can play a recording of what happened and every single person would agree that is exactly what happened.
"My loved one doesn't trust me." This is vague. It is full of interpretation and we wouldn’t necessarily all agree on this. What is the actual behavior? Choose just one situation to work with here in this first step. It might sound like "my loved one told me I was having an affair."
Avoid using words we can’t all agree on or have the definition for. Instead of they always argue - write down exactly what they said in the situation. Instead of resiting or refusing write down exactly what they did. What were their movements? What were their actions?
Notice how difficult this will be for some of you because you’ve been looking at their behaviors through your own lens, are probably frustrated with how long it’s been going on so it’s no wonder you’ve started to guess what’s happening.
The problem with this is that by not being objective in this first step, you’ve inserted some highly charged and emotional stories, thoughts, words that will make it hard for you to stay the Dementia Detective you will need to be to solve a behavior. Just notice the difference between the two examples of “my mom keeps wasting tissues” and “my mom takes tissues out of the box and puts the box on her feet.”
One is highly charged likely will easily come with some frustration. The other is more factual, less emotinally charged. And if there is anything we can learn from a good detective is that the more emotional the detective is when tyring to solve a mystery, the less likely they will actually solve that mystery and the more likely they will miss the clues all around. What clues are you missing that are all around because you haven’t been able to look at the actual situation clearly yet?
Just like the first example with the tissue box. The caregiver would’ve never solved the behavior she was trying to solve by thinking her mom was wasting the tissues. That was the caregivers interpretation. But for the person with dementia that wasn’t what they were trying to do at all.
Okay, that’s the first and most important step. Take some time to write down your newly revised “problem behavior” following these guidelines and notice how by just being objective in your description of what they are doing, you are less emotionally charged.
I’ll be back next week Careblazer, in the meantime keep up the great work and I can’t wait to teach you how to become your own dementia detective.