Managing Behaviors

Dealing with Oppositional Behaviors

A Caregiver Perspective

The first clue that this was not going to be a normal trip to the grocery store was when Joe and I stood in front of the frozen foods.  I had been buying some frozen dinners so that he could fix himself a meal safely.  I pointed to the ones that were on sale and asked which he wanted.  He looked at me, stamped his foot and said, “I don’t want those.”  My automatic response was, “Why not?  They are ones that you like.”  He again said, “I don’t want those,” but this time he pushed me.  I was so surprised by this exchange, I just simply said, “Okay.  Let’s go.”

We all know oppositional behaviors

After raising our daughters I thought I’d be finished dealing with “terrible twos” and “rebellious teen” behavior.  Trying to figure out how I could have these exchanges without devolving into an impatient, screaming shrew was going to be a challenge. I know I am not alone in this: finding ways to manage oppositional behaviors is a daily reality for many people who know FTD first hand.

Refusing certain types of food is a situation familiar to many FTD households, but we each have our unique challenges as well.  We have the demands of having discussions about certain topics such as politics and black holes in the universe.  Of course the discussions occur after I’ve been at work all day.  If I am completely honest, I will tell you that I often hear myself screaming in my head.  I can feel myself getting tense and so I start by taking a number of deep breaths.   

“Part of the FTD”

The first thing I do is remind myself that these are not the behaviors of the patient, thoughtful man I married.  These behaviors are a result of an illness–FTD.  I recognize that I label behaviors as “part of the FTD,” separating the disease from this person I love. If I can rationalize the situation in that way, it helps me not react.  Feeling frustrated or angry is only natural, but putting things in perspective can make it easier to respond more positively. 

When I am at my best, I can engage in some conversation: “What makes you think that?” or “I think your view is interesting.”  I often chuckle to myself when I hear Joe say, “Does that make sense.”  I say “yes” when what I’m thinking is “yes, on some other planet, maybe.” My own personal mantra can remind me that it isn’t going to make sense.  As a course of last resort, I’ve found the best thing to do is turn on the radio to a station that Joe enjoys.  He’ll settle right into the news of the day as though it’s the first time it’s been heard.

Adjust creatively and laugh

Watching a television program I enjoy can be a challenge to my patience when Joe insists on grilling me about random things in a sarcastic and provoking manner.  He used to joke with me pre-FTD about saying “shut up, shut up, shut up,” when someone is being annoying.   I know it may sound odd, but if I do say it, he often laughs and then is quiet–at least for a few minutes!  It also helps me because it used to be a little joke between the two of us, and I can see that it still has some meaning to him.

Refusal to put on clean clothes or wash his face and shave easily becomes a tug of war that has the potential for ruining the day. I have yet to figure out the best thing to do other than gently instruct him to “wash his face,” or “brush his teeth.”  If I can do this while I’m doing it, I get little resistance.  If it entails him going into the bathroom from another room, I may as well forget it.  I keep hand wipes in the car and soap in the kitchen, so at least I can keep his hands clean without too much fuss.  The clothing situation is a bit easier because I can simply take the clothes and put them in the dirty laundry pile.  He’ll then just reach for something new not remembering the old, dirty ones.  Oddly, he does change his underwear on his own at least 5 times a day.

Supportive friends are the key

I think the thing that is the most overwhelming is the unpredictability of Joe’s responses.  Things that flow easily one day are met with resistance the next.  I feel the need to be perpetually prepared for anything.  I sometimes take a deep breath and count to ten.  Sharing these experiences with friends and getting their support is probably the remedy for just about anything that goes on with Joe.  Their listening without judging, their empathy without pity, make dealing with the behaviors all the more manageable.

 

Written by Lynn Field, PhD, caregiver for her husband.

May 2009