The Baycrest Quick-Response Caregiver Tool TM was created to help caregivers manage challenging behaviours in persons with dementia. The written material that follows is an explanation of the tool and how it is to be used. There are also 4 videos. There is a video called “Introduction” and 3 vignettes involving actors. It is best to watch the “Introduction” video first. The 3 vignettes involve a caregiver and a person with dementia. In each video, the caregiver tries to manage a challenging situation using the tool Baycrest Quick-Response Caregiver Tool.
It is strongly recommended that you download the pocket guide version of the Baycrest Quick-Response Caregiver Tool TM. This way you refer to it quickly and easily when you need to use it. It can be printed out or you may consider saving it to you handheld device, tablet, or computer. Click here to download the Baycrest Quick-Response Caregiver Tool TM Pocket Guide.
This tool is to be used for informational purposes only and is not intended as a substitute for professional medical advice. Please consult with a health care provider for advice about a specific medical situation.
Baycrest Quick-Response Caregiver Tool TM: Instruction Manual
It can be very hard to be a caregiver to someone with dementia. Alzheimer’s disease is a common type of dementia - a disease of the brain. The person with dementia may have changes in behaviour such as agitation, wandering, yelling, anger, and even aggression. These behaviours are not intentional. Caregiver’s will often feel overwhelmed and under-equipped to deal with the behavioural symptoms. To make matters more complicated, the person with dementia will react based on how the caregiver responds to them. It is a vicious cycle:
In this example of the vicious cycle shown above, the person with dementia is yelling and the caregiver does not know why. The caregiver gets irritated and agitated. This reaction by the caregiver causes more yelling and agitation in the person with dementia. Then the cycle continues on and on.
The Baycrest Quick-Response Caregiver Tool TM tries to prevent this vicious cycle from developing in the first place. The behaviour of the person with dementia can be very difficult to understand – why is the person yelling? Is there some need that isn’t being met? Do they want something? Are they too hot? Are they too cold? Are they in pain? Are they scared? Are they bored? The person with dementia may not be able to explain why they are yelling.
The key is for the caregiver to not react immediately. That is where the Baycrest Quick-Response Caregiver Tool TM comes into action. By following a few steps, the caregiver may be able to better understand what is going on and deal with the situation more effectively.
Baycrest Quick-Response Caregiver Tool TM
The tool uses the acronym CARER to help remind caregivers of the 5 steps. Please see below:
C - (Step 1) Calm down
A - (Step 2) Attend to the interaction without immediately reacting
R - (Step 3) Reflect on your own feelings
E - (Step 4) Empathize with the other person’s feelings
R - (Step 5) Respond
Please click on the (+) sign below to see an explanation of each step.
Step 1: Calm down
We are all human and have feelings. We all react to situations and to other people’s feelings. The first step is to calm down so that we avoid unintentionally escalating the situation. Of course, this can be hard to do. The caregiver may take some deep breaths, or use some positive self-talk to calm down and then do the next steps. Most of us can tell when we are getting angry or frustrated. The trick is to catch yourself right away and then step away.
Step 2: Attend to the interaction without immediately reacting
This step is meant to help the caregiver to remember that the person with dementia is unwell and distressed. It is a matter of slowing down and taking a break before reacting to the person with dementia. It is a time to remind oneself that the person with dementia has an illness – their brain is not working properly and it is not their fault. The behaviours are not intentional. The person with dementia may have a very hard time describing what they need. The caregiver must remember this: this person is unwell, distressed, and can’t explain why.
Step 3: Reflect on your own feelings
Now that the caregiver has calmed down and has taken a short break to recall that the person is sick, it is time for some self-talk. This is called “reflection.” The caregiver will ask himself or herself some questions:
- What am I feeling? (e.g., angry, frustrated, worried, sad)
- Why do I feel this way?
This is a very important step. Caregivers need to think about their own emotional reaction to what is going on. This involves reflecting on how one’s feelings can affect the person with dementia. By trying to answer these two questions, the caregiver can begin to think through the situation and then consider how to best respond to the person with dementia.
Step 4: Empathize with the other person’s feelings
Empathy is when someone tries to understand what the other person is feeling. Now it is time to consider what the person with dementia is feeling. Some more self-talk:
- What is the other person feeling?
- Why is the other person feeling this way?
Now that the caregiver has become calm (step 1), remembered that the behaviours are unintentional symptoms of an illness (step 2), and considered his or her own feelings (step 3), and the feelings of the person with dementia (step 4), the caregiver can now try to understand what the person with dementia wants or needs and responds in a helpful way.
Step 5: Respond
The caregiver can now try to understand what the person with dementia wants or needs and respond in a healthier and more helpful way.
Baycrest Quick-Response Caregiver Tool TM Pocket Guide
It is strongly recommended that you download the pocket guide version of the Baycrest Quick-Response Caregiver Tool TM. This way you refer to it quickly and easily when you need to use it. It can be printed out or you may consider saving it to you handheld device, tablet, or computer.
© 2019, Baycrest Centre for Geriatric Care. All rights reserved. A single copy of these materials may be reprinted/downloaded for non-commercial personal use only.