Challenging behavior is a catch-all term that, in the context of dementia, includes one or combinations of things like shouting, wandering, biting, throwing things, repetitive talking repetitive movements, destroying personal possessions and other objects without regard for whom it belongs, agitation and general anger, physical  or verbal attacks on others, waking others at night, making sexually inappropriate comments, disrobing inappropriately, and urinating or defecating in undesirable locations. This is not an all-inclusive list and I am sure you can think of many more examples that fit under the umbrella term of challenging behavior.

There is an urgent need to equip caregivers to better respond to and care for persons living with dementia.  Traditional training models have focused on the number of classroom hours an individual must spend in training, assuming that a person who completes the required training hours is ready to work successfully with people living with dementia.  The shift to competency-based training improves dementia care by focusing on mastery of tasks and tools that are learned.

What's it really like to live with dementia?  To cope with the anxiety, embarrassment, feelings of loss and hopeless that can so often accompany the progression of dementia.  There are far too many caregivers today who are struggling with truly understanding the depths of living with cognitive decline and sensory changes.  Instead caregivers try to cope with what's on the surface.  Transformation takes place when caregivers change how they think, feel and act!

Having just returned from Australia,  I'll be devoting several upcoming blogs to my research and fact finding with how Australia is advancing in aging and dementia care, as well as dementia and age friendly best practices.  I found their award wages for aged care workers to be one significant difference from the US and worthy of discussion.

The increasing diversity of the U.S. and other nations offers opportunities and challenges for senior care  care providers, health care systems, and policy makers to create and deliver services to culturally diverse patients and to train and increasingly culturally diverse workforce. Cultural competence refers to an ability to interact effectively with people of different cultures. Cultural competence comprises four components: (a) awareness of one's own cultural worldview, (b) attitude towards cultural differences, (c) knowledge of different cultural practices and worldviews, and (d) cross-cultural skills.   Developing cultural competence through training can result  in a better ability to understand, communicate with, and effectively interact with people across cultures and can lead to a 15% decrease in miscommunication.  In senior care, this communications training can significantly improve outcomes, especially in caring for those with dementias, chronic illness, pain and at end-of-life.

Families caring for aging adults have and will continue to reach unprecedented numbers affecting every corner of our society.   We MUST address the complex needs of this population who are the foundation of long-term care nationwide, exceeding Medicaid long-term care spending in all states (National Alliance for Caregiving and Overcare, March 2009).  Jo Horne, author of Caregiving:  Helping an Aging Love One created the Caregiver's Bill of Rights. These are powerful and impactful words of hope and guidance for each and every person caring for a family member or friend:

Lawrence Peter "Yogi" Berra was an American professional baseball catcher, manager, and coach who played 19 seasons in Major League Baseball.  One of his famous quotes "The Future Ain't What it Used to Be" couldn't be more appropriate as we look at the paradigm shifts taking place in our aging world.