In dementia care, medications are often used after a behavior occurs—but by the time a PRN (as-needed medication) is administered, the moment of distress has already passed. Instead of waiting for agitation or anxiety to escalate, caregivers become detectives, identifying unmet needs before behaviors arise. This is the essence of person-centered care—a non-pharmacological approach that focuses on understanding the individual, their triggers, and what brings them comfort and joy.
Behavior Is Communication: Identifying the Antecedent
Behavior doesn’t happen in a vacuum. There’s always a reason—an antecedent—that triggers distress. The key to preventing challenging behaviors is to ask:
- Start a journal.
- What happened right before the behavior?
- Is this a pattern? Does it happen at the same time each day?
- What could be changed to prevent it?
By recognizing patterns, we can proactively meet needs, reducing the reliance on medications.
Common Antecedents & How to Address Them
1. Time-Triggered Behaviors
- Example: A former schoolteacher becomes agitated every day at 3:30 PM, pacing and asking for her car keys.
- Why? That was the time she used to pick up her children from school.
- Person-Centered Solution: Instead of trying to correct her reality, validate her feelings. Engage her with an activity during this time—perhaps a “help me sort these papers” task to align with her teaching background or a relaxing cup of tea to redirect her focus.
2. Environmental Cues That Signal Routine Changes
- Example: A retired nurse becomes upset at 7:00 AM when she sees caregivers changing shifts and putting on their coats.
- Why? This reminds her of leaving work, which may bring anxiety about missing responsibilities.
- Person-Centered Solution: Involve her in “rounds” before shift change—walking with a caregiver to check on “patients” (even if they’re just plants or stuffed animals) to ease the transition.
3. Undetected Pain or Physical Discomfort
- Example: A loved one suddenly lashes out while being assisted with dressing.
- Why? Their Tylenol wore off, and they are experiencing pain but cannot communicate it. (Previous injury, arthritis, etc.)
- Person-Centered Solution: Anticipate pain needs. Offer pain relief before dressing routines, incorporate slow and gentle movements, and allow the individual to participate in as much of the activity as possible.
4. Hunger, Thirst, or Fatigue
- Example: Someone gets irritated mid-morning and refuses care.
- Why? Their blood sugar may be dropping, or they may be dehydrated.
- Person-Centered Solution: Offer small, familiar snacks throughout the day, ensure they drink fluids, and build breaks into the routine.
5. Loss of Purpose or Meaning
- Example: A former farmer repeatedly tries to go outside in the evening.
- Why? They used to check on their animals at sunset.
- Person-Centered Solution: Instead of stopping them, go with them for a walk, or drive. If that is not possible redirect with a familiar farm-related task, such as looking at livestock pictures or engaging in a simple chore like folding towels.
The Prescription for Person-Centered Care
Caregivers have the power to prevent agitation, anxiety, and distress—not with PRNs, but with personalized approaches that honor the individual. Instead of waiting for behaviors to escalate, we must:
✔ Observe patterns – What triggers distress?
✔ Meet needs proactively – Can we change the environment or routine?
✔ Engage in meaningful activities – What brings them joy?
✔ Validate emotions – Instead of correcting, enter their reality.
The goal is to keep individuals at their best for as long as possible—not just with medications, but with understanding, patience, and creative care solutions. PRNs are often too late, but person-centered care is always on time.
If your loved one is experiencing dementia-related distress, our trained caregivers at Home Care Partners can help. Contact us to learn more about how we bring Memory Care Home. Call or text us today to schedule a free consultation. 402-780-1211
Our Caregiving team provides personal one-on-one attention for your loved one. When you are ready to begin your care journey, we are the experts that will answer your questions and help you implement a plan.
Home Care Partners is locally owned and committed to providing Thoughtful, Quality, and Dedicated Care.
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