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The Baycrest Quick-Response Caregiver Tool was created to help caregivers/care partners respond to challenging behaviours expressed by persons living 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 case scenarios involving actors. It is best to watch the “Introduction” video first. The 3 case scenarios involve a caregiver and a person living with dementia. In each situation, the caregiver tries to respond to a challenging situation using the tool Baycrest Quick-Response Caregiver Tool.

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. This way you can 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.
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Baycrest Quick-Response Caregiver Tool TM: Instruction Manual

Being a primary caregiver to a person living with dementia can present unique challenges. The person living with dementia may have changes in behaviour such as getting easily upset, wanting to leave, yelling, anger, and even physical behaviours such as pushing or hitting. These behaviours are not intentional, but rather a way that the person is trying communicate their needs or how they are feeling. Caregivers may feel overwhelmed and under-equipped to respond to these types of behaviours. To make matters more complicated, the person living with dementia will react based on how the caregiver responds to them causing behaviours to further intensify as illustrated in the following cycle:

In this example of the cycle shown above, the person living with dementia is yelling and the caregiver does not know why. The caregiver becomes frustrated and irritated. This reaction by the caregiver causes more yelling and agitation in the person living with dementia, causing the cycle to continue. The Baycrest Quick-Response Caregiver Tool tries to prevent this cycle from developing in the first place. The behaviour of the person living 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 living with dementia may not be able to explain why they are upset and yelling.

The key is for the caregiver to not react immediately. That is where the Baycrest Quick-Response Caregiver Tool comes into action. By following a few steps, the caregiver may be able to better understand what is going on and address 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 (self-talk)
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 (self-talk)
    We are all human and have feelings. We all react to situations and to other people’s feelings. The first step is to take a moment to try to calm down so that we avoid making the situation worse. Of course, this can be hard to do. The caregiver may step back, 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 living with dementia is distressed. It is a matter of slowing down and taking a break before reacting to the person living with dementia. It is a time to remind oneself that the person living with dementia has an illness – their brain is not working properly and it is not their fault. The behaviours are not intentional. The person living with dementia may have a very hard time describing what they need. The caregiver must remember this: this person has a brain illness who is 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 has an illness that effects their brain, it is time for some self-talk. This is called “reflection.” The caregiver will ask himself or herself some questions:

    1. What am I feeling? (e.g., angry, frustrated, worried, sad)
    2. 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 and response can affect the person living 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 living 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 living with dementia is feeling. Some more self-talk:
    1. What is the other person feeling?
    2. 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 living with dementia (step 4), the caregiver can now try to understand what the person living with dementia wants or needs and respond in a helpful, compassionate way.
  • Step 5: Respond
    The caregiver can now try to understand what the person living with dementia wants or needs and respond in a more supportive and empathetic manner.


Videos

 

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.