C = Consequence

What was the consequence of the behaviour for the patient, for staff and for other residents? Was the patient told off, ignored, restrained, sedated, or guided back to where they started?

The consequence of the behaviour is very much dependent on the staff’s interpretation and reaction to the behaviour. At this stage, communication is the main factor to influence the behaviour and its consequence.

Remember the three parts of communication:

Body Language: 55% - Tone & pitch of voice: 38% - Words we use: 7%

The attitude and manner of the care staff are extremely important. People with cognitive impairment are extremely sensitive to non-verbal cues and mirror the affective behaviour of those around them. A patient, calm and gentle manner is contagious and has a positive effect. It is important to be aware that if body language indicates a feeling of tenseness, frustration or anger, it may contradict the words being used.

References & recommended reading

Alzheimer's Association Australia (2000) ‘Help Sheets for people with dementia and their families and carers’. Alzheimer's Association Australia. www.alzheimers.org.au

Robinson, A. Spencer, B. & White, L. (1991) Understanding Difficult Behaviours: Some practical suggestions for coping with Alzheimer's Disease and related illnesses. Eastern Michigan University, USA

Santo Pietro, M.J. & Ostuni, E. (1997) Successful communication with Alzheimer’s Disease Patients – An In-service Manual. Butterworth-Heinemann, www.bh.com/med

Smith, P.A. (1993) Professional Assault Training (PART) Manual – Revised, Australian version. Australian revisions by Reid, G.V. Sheahan, C. & Sheahan, P.

Teri, L. (1999) 'Latest advances in the assessment and management of behavioural symptoms: an international perspective'. Paper presented to a Symposium reporting the latest evidence-based practices in the care of behavioural symptoms of dementia, Melbourne.

Teri, L. (1999) 'State of the art strategies in approaching behavioural
disturbance and depression in dementia'. Paper presented to a Symposium reporting the latest evidence-based practices in the care of behavioural symptoms of dementia, Melbourne.