OTs as Detectives: Problem-Solving Dementia-Related Behavioral Triggers

Description: Many people with dementia demonstrate a pattern of behaviors that are perplexing and risky. It turns out there is often a trigger causing the issue. Occupational Therapy (OT) Practitioners are great at investigating the issue, then finding & removing the trigger, therefore extinguishing the behavior.

(I am on a Gerontology Listserv for Occupational Therapists (through the American Occupational Therapy Association), and I’ve gotten to read some really interesting posts lately by OTs about behavior in dementia they have encountered in practice, and how even bizarre behavior typically has a trigger that can be figured out.)

Example 1: There was a woman who kept on climbing on her chest of drawers and was at a high risk for falls, obviously. The OT assessed the situation and found out it mostly happened in the afternoon, and observed the woman. It turned out the woman’s roommate had a crystal in the window and around 2pm the sun would hit it in such a way as to make a kaleidoscope of dazzling colors on the chest of drawers. This was the trigger for her climbing. The crystal was moved and the problem was solved.

Example 2: An older man who fell constantly. The OT did research and discovered he loved biking. She also discovered that he needed a lot of vestibular input and sensory integration-based interventions, or he’d start trying to self-stimulate and would end up falling.

Example 3: A man always groped his caretaker at nighttime during bath time. It seemed like a huge problem, but the OT discovered that historically, the man had always bathed with his wife at night before lovemaking. By moving the bath to the morning, the problem was solved.

Basically, the OT is often an investigator. There were other stories involving men urinating in potted plants and the like. I really liked the discussion because they talked about validation theory, retrogenesis, behavioral triggers, and more. It’s amazing to me.

*I originally wrote this way back in 2008…just stumbled across it again.