Understand, accept, and manage difficult behaviors.
Behavior Management of Mountain View Centers Cottages provides care to residents who have problems with short-term memory loss or who exhibit behaviors such as confusion, wandering, depression, anger, tantrums, agitation, and combativeness.
Mountain View Centers Cottages uses a positive behavioral assessment and a behavioral support plan to assist our residents in acquiring replacement behaviors. This approach utilizes a proactive antecedent-focused functional assessment to identify antecedents that may trigger challenging behaviors.
Solution for each behavior:
Wandering & Pacing
Lucille’s family spent $60,000 a year to keep Lucille home with a caregiver, but she wandered and jumped the fence. She came to MVC with her dog “Tinker.” She still looked for her mother every day, but the 8’ fence provided safety, while daily supervised walks and weekly outings provided freedom.
Our Solution: It’s important to balance safety vs. freedom. Physical and chemical restraint is not the answer.
Frustration & Anger
Staff at other assisted living facility called Darlene’s daughter regularly for help with her bathing. Darlene would not allow staff to touch and clean the feces from her body and hair. When she came to MVC her daughter never had to come to help shower and she had her hair clean and set regularly.
Our Solution: Our caregivers have patience and are trained to deal with these behaviors.
Sundowning
Gene will wait for her husband to come for dinner because she forgets that her husband died a few years ago. She would like to go home because her kids are waiting for her. She does not remember that they have grown up. She will say she is going to see her mom, but her mom has died 30 years ago.
Our Solution: Trained staff will validate her feelings and redirect her to help her calm down.
Combative & Agitation
Dorothy did not like someone giving her a bath, so she would scream, spit and scratch. Initially medication was prescribed to manage her behavior, but once the caregiver learned how to give her shower, we managed her care without using any psychotropic medication.
Our Solution: Training in memory care and discussion among caregivers allowed them to find a solution to the problem behaviors.
Repetitive Stories
Janet will repeatedly tell a story about her brother. At other large assisted living residents were ignoring her and labeling her as crazy. At MVC when she repeated, other residents did not remember that she was repeating the story. When other residents do not remember, no one is judging her, so it provides a non-threatening environment.
Our Solution: Memory impaired only environment and trained staff foster true companionship and restores self-confidence.
Sexual Inappropriate Behavior
Bill & Elizabeth believed they were high school sweethearts and married. If you turned your back,they both were in a bathroom or bedroom. Both of their spouses disapproved. The decision was made to separate them, moving one to another MVC location, instead of using psychotropic medication.
Our Solution: Some of the sexual issues are either dealt with supervision, activity or psychotropic medication.
Hallucination & Paranoia
Gus always talked about being in China or Australia, where he’s never been. He also talked about someone being in the front yard and killing his daughter or talking to the mirror in the bathroom as if he was talking to his friend. Gus would hide his dentures in a safe place and could not find them; then, he would blame that someone had taken them.
Our Solution: Many of these behaviors were harmless, and the caregiver addressed them by redirecting or validating his feelings.
Finger Painting
When Alma had an accident, she would wake up in the middle of the night and would want to clean herself, but she did not remember how. So she would try to clean herself with her hand, the comforter, wall, and floor and sometimes in the closet.
Our Solution: This kind of behavior requires an understanding of the problem and the solution was to help her to the bathroom at 4 a.m.
Resistance to Shower
Clifford does not like anyone to touch him, and no one dares to force him. It took a few days before we succeeded in showering him. But that was not acceptable when he would have accidents. We initially used medication, but now chocolate candy will allow us to shower him. We are getting better by knowing the cultural tradition and his habits.
Our Solution: Understanding his past and giving respect to him for his privacy and modesty helped us to help him.
Depression
Mike slept for 15 hours in a SNF. The doctor told his family to find funeral home. His friends decided on MVC, the next 1 ½ years he enjoyed parties, shows, horse racing, lunches and dinners at his favorite restaurants with family and friends. Once he was comfortable, he laughed, joked and thought he owned the facility, trying to sell it.
Our Solution: Activities & pleasant surrounding environment at MVC helped him overcome his depression.
Not Eating or Swallowing
Lester had lost 25 lbs within a month between the hospital and the nursing home. The family did not want a feeding tube, so he was moved to MVGH in Diamond Bar. We fed him each meal & snack. It took about 1 hour every meal, but he gained 32 lbs in 21/2 months.
Our Solution: Feeding may mean chopping, finger food, or pureeing the food and hand feeding with encouragement. Sometimes it takes an hour for each meal to feed, but our staff does it with patience.
Not Sleeping at Night
Thomas would nap during the daytime and would not sleep at night. He was mixed up with day and night, because he could not recognize the difference. He would want to take a shower at 1 am and get ready to go to work, asking for breakfast at 2 am.
Our Solution: Participation in activities with their peers during the daytime stimulate their mind and help them to sleep during the night.
Over Medication/Chemical Restraint
Janet was at assisted living with a private nurse who monitored blood pressure and medication doses. Side effects were numerous, so with her doctor’s help most of the medications were discontinued. Since then she lived for 8 ½ years.
Our Solution: Most of our residents are not on psychotropic medication. So the resident and family can enjoy the quality of life at every stage of the disease.
Physical Restraint
In her previous facility, Alice used a wheelchair and was heavily medicated because she was going out the door. When she moved to MVC, she wanted to walk constantly but was very unsteady on her feet. After very close supervision for about a week, Alice’s balance improved, and she was walking again.
Our Solution: Locked perimeter provides security, but the floor plan of the facility allows indoor and outdoor enjoyment without any concern.
Hospice Care
Margaret was sent to hospital and then to a SNF. She was weak and not eating. Her family had to choose between feeding tube or hospice. Her family decided to bring her back to MVC under hospice. She was fed what she liked, meaning all sweets. It took time to feed every meal. Once she got energy, she was off of hospice for about a year.
Our Solution: We have helped many who were candidates for feeding tube or hospice and brought them back toeating regular meals.
Side Effects of Medication
Dorothy was given several psychotropic medications because of her combativeness and not sleeping at night. When she was taking medication, she was more confused and could not find the bathroom so she had more accidents, she started to fall and broke a hip. She had surgery and could not walk. It was not Alzheimer’s but the medication that caused her decline.
Our Solution: Working with the physician to determine the need for medication, allows us to reduce the psychotropic medications and the side effects of it. Staff knowledge about what is usual behavior and how to manage the behavior will provide the best solution for memory care resident at the Mountain View Center.
Find out the impact of behavior management on our senior residents when you contact us.