Difficult Behavior

What Can A Caregiver Do?

Photo by Katie Moum on Unsplash

One morning, as I sat at my desk working on the computer, Dan walked into my office, complaining about his stomach. Stomach aches were not new, but I thought this was my chance to get him to the doctor regarding his memory - a request he had rejected many times.

I grabbed the phone and made an appointment. I reminded Dan several times that I had scheduled it, and he was okay. Until the morning of the appointment! As we were getting ready, he was furious - and refused to go. There was no way I could get a 140 lb, belligerent man into the car and to that appointment. I canceled it.

As family caregivers, one of our biggest problems is managing a loved one’s behavior. They can be argumentative, resistant, and defiant.

In a previous article, I discussed a caregiver workshop that I attended. Managing challenging behavior was one topic.

In the workshop, the presenter suggested that we consider what happens before the behavior - the trigger, and what is said and done after the behavior - the response.

Triggers can include:

• a noise

• a demand

• a long physical illness

• reminders, such as seeing the keys to the car or another person

Responses include what we do, how we feel, and what our loved one does. Our reactions can increase or decrease the problematic behavior.

Thinking of the B-D-A chain is helpful. We can log and record the date/day of the week, the time, and what happened before, during, and after the behavior - similar to this chart.

Occasionally, we can’t change the triggers. So, how we react or respond can keep the situation from worsening.

When encountering problem behaviors, we can change:

• What happens before the behavior - the trigger.

• What comes after the behavior and our reactions.

• All of the above.

For example, seeing the car keys was a trigger for Dan. He wanted to drive but was no longer a safe driver. I couldn’t let him take the car, so we argued - the behavior. The logical change would have been to hide the keys - the trigger - or explain the situation, but driving was important to him, and no one was going to tell him he couldn’t use them.

So, our response was to take the battery out of the key fob and tell him it was dead. I promised to order a new one. Of course, he didn’t remember those conversations and would bring it up again - I said I’d check, which satisfied him temporarily.

This process can work well for caregivers. We can’t change someone’s behavior, but we can set things up to be less triggering and alter our responses.

Knowing what I do now, my responses would be different. When we were getting ready, I would have told Dan I had a doctor’s appointment and asked him to go along - he would have been very supportive.

I want to remind you of this resource for caregivers: The Family Caregiver Alliance.

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