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Five W’s of Behaviors

Hitting, pacing, using foul language, chanting and wandering are just a few of the different symptoms that can be associated with someone living with Alzheimer’s disease or one of the other 70 different types of dementia.  These symptoms of the disease or “behaviors” can be an issue that many think will never happen to their loved one.

Unfortunately, at some point in the disease process an estimated 50 – 75% of those living with dementia will develop a behavioral symptom.

However, it is important that when a behavior occurs to not blame the individual for their actions, personality changes or unpredictable ways.   This behavior is not part of the person, but part of the disease process.  Just as Alzheimer’s disease steals the memory it can also take the person’s social skills, ability to cope, understand and communicate.

One of the main reasons why a person with Alzheimer’s disease develops a disruptive behavior is because they become upset or agitated and can no longer communicate these feelings in an appropriate manner.

At Azura Memory Care, we train our caregivers to recognize that these behaviors are a form of communication and to look for patterns in their behavior. We then equip them with the knowledge of the “Five W’s” approach to care, which helps to accurately investigate what is agitating the person and then develop and provide proactive interventions to help lessen or eliminate the behavior before it starts.

What? – Find out exactly what type of symptom or behavior your loved one is exhibiting.  This will help you understand the exact behavior that needs to be addressed and its severity. Example: Hank is refusing to take a shower or go to bed.  He has begun pushing and swearing at caregivers, something he has never done before.

When? – Find out exactly when the behavior is occurring.  This will help you determine if the time of day has any effect on the circumstances. Example: Hank’s shower time is scheduled for 7:00 am and bedtime is around 8:00 pm.  His behavior is occurring at both times every day.

Where? – Determine if the behavior is occurring in a specific location and if the location has anything to do with the behavior.  Example: Hank’s shower is given in his room, which is close to where his bed is located.

Who? – Find out if there is a specific person or persons who are regularly experiencing the behavior, as they may be unknowingly contributing to the agitation. Example: A female caregiver gives Hank his shower in the morning and a male caregiver helps him to bed.

Why? – Using Hank’s communication cues it is obvious that he is frustrated by something that is happening during his bathing and bedtime experience.  Now we use the person’s past history of likes, dislikes, habits and other personal information to narrow down what might be making Hank upset.

In this case, perhaps Hank always took his baths in the evening right before he went to bed, because morning showers made him cold.  At night the warm water helped him unwind and go to sleep.  By adjusting his shower time to the evening it may fit better into his “normal” routine and hopefully help his bathing and transition to bed go more smoothly too.

Granted not all of the behaviors associated with Alzheimer’s disease can so easily be fixed, but by taking a proactive approach you can help to alleviate some of these small frustrations from your loved one’s day.  In addition, when a more serious behavior develops you will be better prepared to handle the situation and able to work quickly with your loved one’s caregivers and medical physician to develop a game plan to address the behavior.

Remember your loved one’s behavior is not a reflection of who they are; it is the disease finding a way to speak for them.  We just need to use the what, when, where, who and why to listen.


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