Challenges with Challenging Behaviors  

Lonely senior man feeling very sadBy Galina Markovich
Director, MMC

Dementia care is becoming ever more needed in an increasing variety of settings including nursing homes, assisted living facilities, boarding homes, rehab centers and of course, in the homes of friends and neighbors. It is crucial to understand what the best care setting is for someone with behavioral dementia.

In my support groups, I frequently meet caregivers who ask this very question. Many of them have already had experiences with facilities where it was handled inappropriately. For example, there was one woman whose mom was in 12 different communities and was even sent to psychiatric hospitals 4 times. What I often hear in my support groups is becoming a familiar refrain: a facility admits a resident with dementia and is aware that they have behavioral issues. When the facility can’t manage this challenging resident, they inform the families that they need to hire private aids. And that is the first mistake.

It is understandable that the family members and caregivers believe that their loved ones are so complex that assisted living is not the right environment for them. And so they rush to place their loved ones in long term care nursing homes. And that is the second mistake.

What happens next is also familiar. Because of their challenging behavioral issues, the patient gets overmedicated and that of course, gives rise to other problems.

As a dementia practitioner for many years, I can say for sure that people with behavioral dementia issues are better managed in a small setting where they get more individualized care and can be monitored closely for behavioral stimulation. Simply redirecting the energy of an aggressive resident or changing the timing of care and medications can make a huge difference in their behavior. People with behavioral dementia need comfort, skilled care and patience. Private aids, one-on-one care or psychiatric hospitals are often not the answer.