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Healthcare professionals refer to three models to help explain changes in behaviour

A thorough assessment is critical in determining which approach is most appropriate when dealing with difficult behaviour(s). Healthcare professionals refer to three theories, or models, to help explain changes in behaviour:

  • Unmet Needs.
  • Progressive Lower Threshold.
  • Learning (ABC) Theory.
  • Unmet Needs
    When a person has needs that cannot be expressed, they often communicate by actions. Babies are unable to communicate their needs so they use actions until they get what they need such as:
    •     Crying.
    •     Tantrums.
    •     Throwing things.

    Individuals with dementia face similar situations because the illness affects their ability to organize their thoughts or find words quickly. Unable to express their need to their caregiver they may use other strategies including:
    •     Yelling.
    •     Agitation.
    •     Aggression.

    The action could be an expression of pain, loneliness, boredom or something uncomfortable on their body.

  • Progressive Lower Threshold
    Everyone has a point when they become agitated at something within the environment or something internal. Some have a higher threshold for stress than others.

    For people with dementia the threshold for agitation is very low. When dealing with stress in their environment the person with dementia can become overwhelmed and act out as a result.
  • Learning (ABC) Theory
    This theory focuses on the impact of a caregiver’s response to the behaviour of a person with dementia and how that response can potentially perpetuate the behaviour(s).

    This theory looks at:
    •     Antecedent (triggers) for the behaviour – what happened before the behaviour;
    •     The behaviour(s);
    •     The consequence or what happened after the behaviour and caregiver’s response to the behaviour(s).

    The response from another person or the caregiver can make the behaviour better or worse. The ABC method gives clinicians an idea of what could be causing the behaviour and how the behaviour might be reduced or maintained depending on the responses of others.