Behavioral Management for Dementia Caregivers
Rudolph C. Hatfield, PhD., edited by Kathryn Patricelli, MAThe term behavioral management refers to the use of techniques from the behavioral school of psychology to shape a person's actions. People with dementia often do not respond well to explanations and criticism. Instead, they simply respond to environmental changes that can increase the chances that they will respond or act in a certain way. Behavioral management techniques can be used to address many different situations including problems with aggression, wandering behaviors, and getting people to perform positive behaviors. However, it is not a magical technique that works by itself. Caregivers often must put in quite a bit of effort and be consistent.
Most behavioral management techniques are based on the classic notion of the A-B-C method of behavioral management. This method is based on behavioral psychology principles that were used to teach animals and even people to learn new skills by concentrating on specific aspects of their environment. A large amount of research has shown that the A-B-C method can be used to deal with a wide variety of behavior problems that occur in people with dementia. The method can be used to get them to perform actions that are desirable.
The A-B-C Behavior Chain
The A-B-C Behavior Chain can be used to track and analyze challenging behaviors to develop new ways to approach and respond to them. There are three components in the A-B-C Behavior Chain:
A = Antecedent: Antecedents are events or conditions that are present before a behavior occurs. These conditions "set the stage" for a behavior to happen. Antecedents can be:
- internal - inside the person such as thoughts or physical sensations occurring within the person with dementia. Examples could include hunger, pain, frustration at not being able to communicate, and many others.
- external - outside the person which would include environmental conditions. Some Examples could include loud noises, the temperature in one's room, a busy environment, unfamiliar surroundings, or overwhelming tasks.
B = Behavior: The behavior is obviously the action itself that one is observing or trying to change. These behaviors can be very specific such as types of aggression (hitting someone) or they can be very general (for example, someone is anxious or agitated in many different situations).
C = Consequence: The consequences of the behavior are the events that occur immediately after the behavior has taken place. Consequences can increase the chances or can decrease the chances that the person will repeat the behavior. You can set up consequences for outcomes that you wish to have happen more often. For example:
- If you wish to increase a certain behavior you use reinforcement. This is anything that occurs after the person performs a behavior that increases the chances that the person will perform that behavior again. Often these are rewards, but may not always be.
- If you want to decrease some behavior you use some form of punishment., This is any event that occurs after the behavior that reduces the chances that the person will repeat the behavior. Punishments do not need to be harsh. They just need to stop the person from repeating the behavior.
- The preferred approach is to reinforce behaviors that you want to be repeated instead of trying to punish behaviors. Behavioral management programs typically try and set up conditions where a person is rewarded for producing positive behaviors. Punishments should be used sparingly.
Resources
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Articles
- Introduction & Causes of Cognitive Disorders
- Dementia
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Alzheimer's Disease
- Alzheimer's Disease
- Prevalence and Causes of Alzheimer's Disease
- Causes of Alzheimer's Disease Continued
- Risk Factors for Alzheimer's Disease
- Symptoms of Alzheimer's Disease
- Warning Signs of Alzheimer's Disease
- Diagnosis of Alzheimer's Disease
- Diagnosis of Alzheimer's Disease - Imaging Procedures and Psychological Evaluation
- Diagnosis of Alzheimer's Disease - Neuropsychological Testing
- Treatment of Cognitive and Behavioral Symptoms associated with Alzheimer's Disease
- Research and Prognosis on Alzheimer's Disease
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Other Cognitive Disorders
- Vascular Neurocognitive Disorder
- Vascular Neurocognitive Disorder Continued
- Lewy Body Dementia
- Symptoms of Lewy Body Dementia
- Diagnosis and Treatment of Lewy Body Dementia
- Reversible Cognitive Disorder - Dementia Syndrome of Depression
- Neurocognitive Disorder Due to Another Medical Condition
- Reversible Cognitive Disorder - Delirium
- Prevention of Dementia and Other Cognitive Disorders
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Dementia Coping Skills & Behavior Management
- Coping Skills for Those With Dementia
- Coping Skills for Dementia Caregivers
- Services for Dementia Caregivers
- Communication Tips for Dementia Caregivers
- Behavioral Management for Dementia Caregivers
- Behavioral Management for Dementia Caregivers Continued
- Tips for Dealing with Specific Dementia Problematic Behaviors
- Tips for Dealing with Specific Dementia Problematic Behaviors Continued
- Traumatic Brain Injury (TBI)
- Conclusion and Resources
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News
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Questions and Answers
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Book & Media Reviews
- Alive with Alzheimer's
- Alzheimer's
- Days With My Father
- Decision Making, Personhood and Dementia
- Dementia
- Dementia Caregivers Share Their Stories
- Hearing the Person With Dementia
- How We Think About Dementia
- Inside Assisted Living
- Mild Cognitive Impairment and Early Alzheimer's Disease
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16 more
- Mom's OK, She Just Forgets
- My Book about Brains, Change and Dementia
- Nothing about us, without us!
- Remembering Home
- Rights, Risk and Restraint-Free Care of Older People
- Speaking Our Minds: Revised Edition
- Still Alice
- Telling Tales About Dementia
- The Almost Moon
- The Emotional Journey of the Alzheimer's Family
- The Enduring Self in People with Alzheimer's
- The Story of My Father
- Voices Of Alzheimer's
- When It Gets Dark
- When Someone You Know Is Living in a Dementia Care Community
- Wrinkles
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Links
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Videos
- Overview of Dementia with Lewy Bodies
- Common Challenges: Driving
- Diagnosis and Management of Vascular Dementia
- Difference Between Alzheimer's and Dementia
- Why Early Detection of Alzheimer’s Disease Matters
- Looking Beyond Alzheimer’s Disease: An Overview of Other Major Forms of Neurodegenerative Disease
- New Definition of Alzheimer’s Changes How Disease Is Researched
- Lewy Body Dementia: Most Common Disorder You’ve Never Heard Of
- Living With Traumatic Brain Injury
- Early Detection of Alzheimer's Disease
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37 more
- Seeing Alzheimer's in a New Way
- Inside Alzheimer’s disease
- Alzheimer's Screening
- Neurology: Testing for Alzheimer's
- Alzheimer's and Dementia Caregiver Training: Sexually Inappropriate Behaviors
- Alzheimer's and Dementia Caregiver Training: Depression/Apathy
- Alzheimer's and Dementia Caregiver Training: Agitation and Anxiety
- Alzheimer's and Dementia Caregiver Training: Aggressive Language/Behavior
- Alzheimer's and Dementia Caregiver Training: Sleep Disturbances
- Alzheimer's and Dementia Caregiver Training: Repetitive Phone Calls
- Alzheimer's and Dementia Caregiver Training: Home Safety
- Best Practices & Emerging Therapies for Patients with Alzheimer’s Disease
- Recognizing the Early Signs of Dementia
- Effective Treatments and Prevention of Alzheimer’s Disease: The Time is Now - Research on Aging
- Dementia – it affects us all
- Falls Prevention in People with Dementia
- Caregiver Training Part I: Introduction
- Caregiver Training Part II: Hallucinations
- Caregiver Training Part III: Refusal to Bathe
- Caregiver Training Part IV: Refusal to Take Medication
- Caregiver Training Part V: Repetitive Behaviors
- Caregiver Training Part VI: Repetitive Questions
- Caregiver Training Part VII: Sundowning
- Caregiver Training Part VIII: Wandering
- The Benefits of Early Detection of Alzheimer's Disease
- A New Way To Look At Alzheimer's
- The Healing Power of Music
- Falls Prevention in People with Dementia
- Falls Prevention in People with Dementia
- Protecting & Caring for Patients with Dementia
- Dementia 101 in 101 Seconds
- Normal and Abnormal Aging and the Brain
- Alzheimer’s Disease and Parkinson’s Disease
- Aggressive Behavior in People with Dementia
- Diagnosing Alzheimer’s
- Signs of Alzheimer’s
- Practical Tips for Travelling with a Loved One with Alzheimer's Disease
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