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Four models may assist in understanding the causes for changed behaviour associated with dementia. It may be necessary to use more than one of these models to gain greater insights into why the behaviour is occurring.


Unmet needs

TheoryDiagram showing Maslow's Hierarchy of Needs

A person may exhibit behaviours when their needs are not met eg: hunger, thirst, toilet, pain, fatigue, temperature, over/under stimulation, social engagement. Maslow’s hierarchy of needs is one way of conceptualising the priority of needs, with the needs fundamental to survival being the foundation for higher order needs.

Strategy

Attempt to understand which individual unmet needs are contributing to behaviours and manage these needs prior to behaviours occurring.


ABC model

Theorydiagram-2-models-for-understanding-behaviour 01

Antecedents > Behaviour > Consequences.

The ABC model focuses on triggers (antecedents) that precede behaviours, with the subsequent consequences reinforcing the behaviour.

Strategy

Problem solve to determine antecedents that may have triggered the person’s behaviour. Identifying the ABC’s can help to target interventions aimed at reducing the antecedents, or in some instances modifying the consequences.


Progressively lowered stress threshold

TheoryGraph showing the progressively lowered stress threshold model

Dementia lowers a person’s ability to deal with daily stress and increases the susceptibility to environmental stressors.

Accumulated stressors such as noise, temperature and light can contribute to behaviours of concern.

Strategy

Identify and remove cumulative stressors from the environment to reduce the likelihood of stress related behaviours. Schedule rest breaks to allow the person to cope with daily stress more effectively.


Biomedical model

TheoryDiagram showing pathological changes to the brain with Alzheimer's

Pathological changes to the brain in dementia impair normal brain functions and cause behavioural symptoms. Behaviours of concern are a part of dementia.

Strategy

Manage reversible causes of confusion and behaviour related to treatable biological and physiological conditions.

Understand that treatment resistant behaviours are caused by the disease and not an intentional or malicious act.

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