A Functional Assessment of Behaviour is the process of understanding why certain behaviours are happening and what can be done to manage or reduce them. It involves observing the behaviour in context and asking questions.
For example, if a person with dementia becomes agitated at a certain time of day, a functional assessment would look at factors like the room’s noise level, lighting, or temperature, as well as their physical and emotional state. This helps caregivers identify what might be contributing to the behaviour and find ways to improve the person's comfort or wellbeing.
Key questions to consider include:
- Location and time: Where and when did the behaviour occur?
- Prior activities: What was the person doing before the behaviour started?
- Environment: What was happening in the environment at the time?
Assessing Environmental Factors:
- Noise: Is the TV or music too loud? Could staff shift changes or mealtime clatter be disruptive?
- Clutter: Are pathways clear, with enough space for purposeful movement?
- Lighting: Is there distracting glare on the floor or bright lights in the room?
- Mirrors: Are mirrors positioned appropriately and are they necessary?
- Temperature: Is the room too hot or cold?
- Recent changes: Have there been renovations or changes in staff/residents?
- Safety: Does the environment allow for safe walking and movement?
- Independence: Does the environment promote dignity, mobility, and independence?
- Preferences: Does the environment accommodate the person’s preferences, routines, and habits?
Assessing Physical Factors:
- Following a full medical review, consider the person’s physical health and any underlying issues.
Assessing Psychological Factors:
- History of psychiatric illness: Does the person have a past history of mental health conditions?
- Recent losses: Have they experienced a recent loss or a series of losses?
- Mood: Do they seem sad, tearful, or withdrawn?
- Past events: Are past experiences, such as trauma, influencing current behaviours (e.g., post-traumatic stress)?
- Hallucinations or delusions: Are they responding to hallucinations or delusions?
Lowered Stress Threshold
People with dementia may find it harder to handle stress because their ability to cope with stressful situations is reduced. This can lead to behavioural changes like agitation or withdrawal. By making changes in their environment to reduce stress, such as reducing noise or clutter, we can help them feel more comfortable and behave in a way that’s easier for everyone to manage.
Sensory Stimulation
Sensory stimulation refers to using the senses – taste, smell, sight, hearing, and touch – to interact with the world around us. As dementia progresses, people become less able to experience and respond to these senses, which can make them feel isolated and confused. In the later stages of dementia, physical challenges like difficulty moving can also make it harder to engage with their surroundings. By providing appropriate sensory activities, we can help people with dementia stay connected to the world and feel more comfortable.