How to Manage Repetitive Behaviors in Alzheimer's Disease

How to Manage Repetitive Behaviors in Alzheimer's Disease

Are you wondering why a person with dementia develops repetitive behaviors like asking you the same question, telling you the same story, or doing the same thing over and over again? Knowledge is power. In this episode, I’ll walk you through brain development, what’s lost and retained in Alzhiemer’s disease, and help you problem-solve how to manage repetitive behaviors in a person with dementia using the C3P Problem-Solving Framework to explain.

Part One of ‘How to Manage Repetitive Behaviors in Alzheimer's Disease’

To put it simply, your brain develops from the back to the front.
The back part of your brain is where your feelings and emotions are (the amygdala). The amygdala controls our emotional responses when we encounter anything threatening, and activates the sympathetic nervous system with the fight, fright, or flight response.

The front part of your brain is called your frontal lobe, and it doesn't fully develop until you're about twenty-five years old. This part of your brain is basically the “stop sign” - meaning when something comes to mind that you want to say, your frontal lobe might say, "No, don't say that quite yet (or don't say it at all)."
What happens with Alzheimer's disease is the brain loses its ability from the front to the back. So you lose your ability to control impulses, use and understand language but your emotions remain intact throughout the disease process.

“Focus on the emotion, not the behavior.” — Melissa Batchelor, PhD, RN, FNP, FAAN

To give you a visual image of what happens to the brain in Alzheimers. Imagine a grape, that's what a healthy brain looks like. When your brain is healthy, all of the messages can get back and forth without a problem. But what happens with Alzheimer's disease is the brain begins to shrink and shrivel.

Alzheimer's disease basically turns your brain into a raisin. Imagine a raisin. There are deep crevices, and those crevices make it hard for the messages to get back and forth. This is why people lose their memory, decision-making ability, and the hardest thing is that they lose their ability to use and understand language. So our words basically end up sounding like Charlie Brown’s teacher -

So words don’t work anymore; but the person does pick up on our emotions and our non-verbal behavior. They will “mirror” us.

Part Two of ‘How to Manage Repetitive Behaviors in Alzheimer's Disease’

Let’s talk about the C3P Problem-solving Framework focused on Changing the Person, Changing the People, or Changing the Place. The reason this is important is because there isn’t one thing that will work for any specific behavior. You will have to try different things for behaviors because what works today, may not work tomorrow. You need a “bag of tricks” and a way to think through the three levels that will help you find a solution.

Change the Person (with Dementia):

Look for a reason behind the repetition. Does the repetition occur around certain people or surroundings, or at a certain time of day? Is the person trying to communicate something? Is the person trying to do something? Trying to understand what the underlying reason is can be helpful.

Focus on the emotion, not the behavior. Rather than reacting to what the person is doing, think about how he or she is feeling. Try to figure out the root cause of his or her anxiety can help them manage their anxiety and maybe resolve it.

For example, if an older adult said something fifty times already, rather than saying “you’ve already told me that 50 times!” [in a frustrated voice], say something like, “It sounds like you’re anxious.” [in a calm voice].

Turn the action or behavior into an activity. Give them something to do and focus on, something meaningful. If they are picking at their skin or fiddling with their clothes, give them a laundry basket of things to clothes. Ask the person to help you get this “work” done.

Change the People (Caregiver Approach)

Stay calm, and be patient. One of the gifts that Alzheimer's gives people is that they live in the present moment. On the other hand, it's hard for caregivers to do that because they're living in the future thinking about all the things that they need to do.

Be aware of the impact of your own emotions in the moment. Caregivers may get very upset that this person can't do today what they could do yesterday. Patience is essential because while that person's feelings remain intact, their ability to pick up on your feelings also remains intact. If you express feelings of being frustrated or mad, that energy is in the room and they are also going to pick up on that.

READ THE FULL ARTICLE HERE - https://melissabphd.com/ep-42-how-to-...