Chapter

The treatment of challenging behavior in care facilities: Ellen

Ian A. James

in Casebook of clinical geropsychology

Published on behalf of Oxford University Press

Published in print September 2010 | ISBN: 9780199583553
Published online February 2013 | e-ISBN: 9780191754678 | DOI: http://dx.doi.org/10.1093/med/9780199583553.003.0009
The treatment of challenging behavior in care facilities: Ellen

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The various forms of behavior that constitute the label “challenging behavior” are not diagnostic categories, although they are sometimes treated as such particularly by the medical profession when using psychotropics. These behaviors are usually elicited by residents when they are distressed, confused, disinhibited, misinterpreting situations, deluded, or hallucinating. The behaviors are often transient, but need to be dealt with when they place the resident or others at risk of physical, emotional, or psychological harm. Often the causes are multifactorial, although some can be directly linked to physical problems (delirium, infection, and pain). Owing to the complex nature of many of these behaviors, a comprehensive assessment of the potential causes should be undertaken. This should be done prior to the administration of medication. Once the causes have been identified, individualized approaches aimed at reducing the relevant distress (e.g. improved communication, use of aromatherapy, music, etc.) or confusion (use of memory aids, signage, environmental changes) have been shown to be helpful. However, such strategies need to take account of the needs of the individual with dementia, the staff, and the resources within the care setting. The present case illustrates an approach used by a clinical team that fulfills the above requirements, and the processes by which successful outcomes can be achieved have been illustrated.

Chapter.  9691 words.  Illustrated.

Subjects: Psychiatry ; Geriatric Medicine

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