1) Define the problem: Look at the problem which is driving you crazy, such as threatening, verbal abuse, roaming, sexual behaviors and demanding.
2) Look for the trigger: there are two areas to consider.
a) Medical: Are the medications the right ones and at the right level for the diagnosed condition? Are they even necessary for Pick's, or are they exacerbating the behavior problems? Is the patient sick? Are there medical issues that may be contributing to the behavior problem, such as urinary tract infections, upper respiratory tract infections, etc. And the most important part of this section is the identification of pain, which the patient may not be able to identify accurately.
b) Other: Anything that attacks the senses, such as overstimulation, confusion, depression, frustration with communication, loss of personal space, need to control, anger, grieving, fear, anxiety, boredom, intrusive thoughts, loneliness, change in routine, or lack of impulse control (characteristic of frontal-lobe damage)
3) When does it occur?: Is there a pattern? such as time of day, change of season, cyclical pattern, reacting to stimuli such as fear or confusion, etc.
4)Warning signs: Notice body language especially, such as facial expressions, physical movements, louder or softer voice; the non-verbals are the best clue.
5) What makes it worse? Confrontation, over-stimulation, change in temperature, anything that attacks the senses, changes in routine, rushing or hurrying, making demands that they can't understand, reacting to their abuse, trying to reason with them-they can't; trying to make them do something they don't want to do: is it really important?
6) What can make it better? Keep a sense of humor, perhaps with a change of subject or a treat; keep decision-making at a minimum; try to find purposeful activities; exercise; check medical condition; validate their feelings; allow flexibility of routines, behavior, desires; assure a feeling of safety by consistency and continuity; don't try to change their patterns, allow them to do what makes them content. In short, back off, try later. Don't push - be flexible.
