Partners in FTD Care, Spring 2020
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Resistant behaviors in FTD can seem unpredictable, but are usually the result of a person diagnosed responding to a trigger. Triggers can range from a confusing instruction or request, an unfamiliar environment or location, an encroachment on their personal space, pain or discomfort, and many more.

To prevent stressful and potentially dangerous situations, both in the home and in community settings, it is essential to employ best practices for individualized, person-centered FTD care while ensuring the safety of all parties. Following are several best-practice strategies to help ensure that the individual with FTD, their caregiver(s) and others are safe when encountering resistant behaviors:

Behavioral strategies
Assess the situation for possible triggers. Ask yourself, “What did I do to contribute to this reaction?”
Redirect behavior away from potential triggers.
Determine what the immediate need is, and work to satisfy it. If something has been proven to calm resistant behaviors, have that readily available.

 

Communication strategies
Do not argue, or be confrontational. Speak in a clear, calm, reassuring, positive voice.
Do not try to use logic.
Avoid saying “no.” Instead, frame responses in a “yes” format.
Engage in respectful adult-to-peer communication.

 

Environmental strategies
Remove firearms and care keys, and lock away sharp objects, dangerous appliances and other potential weapons.
Reduce noise, glare and background distractions.
Identify a safe space for all parties that is free of triggers.
Install monitoring devices in the home.

 
Remember to revise and adapt any non-pharmacological FTD care approaches and strategies as needed, and to communicate the plan to all care parties involved. If necessary, seek private duty staff to assist with activities that prompt resistant behaviors. Develop a care team—including a primary physician, FTD specialist, and social worker—to assist with behavioral management and to review necessary medical interventions. Prepare for emergency situations and develop a plan. Always remember to follow your gut; if you feel you are in any immediate danger and your loved one is a threat to themselves or anyone else, contact local authorities immediately. Be sure to explain to emergency personnel the individual’s diagnosis, potential behaviors, and needs.

See also:

• I’m Only Trying to Help: Approaches to Resistant Behavior in the Home
• Combatting COVID-19 When FTD Causes Hand-Washing Resistance
• Optimizing Medications for Difficult Behaviors in FTD
• The Importance of Recording Resistant Behaviors
• A Care Partner’s Perspective
• Additional In-Home and Community-Based Care Options
• What to Do About Managing Resistant Behaviors
• Download the full issue (pdf)