Behavior Problems in the Elderly

Last updated Thursday, August 09, 2012   |   comments
At Butterfly Effects, we believe that it is important to acknowledge that it is behavioral rather than medical problems that lead to the institutionalization of the elderly.

This is actually an encouraging piece of information, as we are beginning to understand that there is much more that we can do to help loved ones enjoy complete lives of engagement and enrichment. 
Up until recently, very few care professionals addressed behavior problems in seniors, and even fewer addressed them with behavior solutions. More typically, behaviors in seniors are ignored until they can no longer be tolerated or until they become dangerous, and then they are often addressed with medical solutions, usually pharmaceutical ones.

In many instances, rather than respond to problem behaviors with a measured and effective response, untrained caregivers often react with anger and frustration.
This can lead to the caregiver employing active or passive punitive measures, which -- even for one's own good --  are rarely if ever the right answer. While it may seem expedient to restrict or deny the elderly one in our care, the more restrictive we become the closer we edge towards emotional abuse, and the further removed we become from a solution that everyone can accept..

Elderly abuse at the hands of family caregivers does continue to be a significant concern. Most of that abuse is triggered by environmental and economic stress but unresolved behavioral issues are also a significant contributor.

When caregivers do not know how to appropriately respond to problem behaviors, it opens the door to potential abuse.
That abuse can be physical; it can also take other forms. humiliation, chastisement, the withdrawal of affection and attention, isolation, the removal of opportunities for socialization and enrichment. These can all become abusive actions when they are employed as punishment.  

Severely under-reported, many believe that more than a million cases every year in the United States; two million when we factor in self neglect.. Others put the number as high as six million. (Elder Assistance Daily, 2010)  We may think of nursing homes as the most common perpetrators. but the fact is that nearly two thirds of all elderly abuse not considered self neglect -- is perpetrated by family members. (AoA, 2011)

Because negative reinforcement can have an immediate impact, because it is all that some of us know, it is often used without regard of long-term consequences.
Several decades of behavioral research tells us that negative reinforcement rarely if ever appropriately answers the need expressed by the problem behavior. It can suppress problem behaviors, but without proper resolution, an unmet need will manifest in another, often worse, behavior or lead to depression and stress, which can trigger mental and physical health concerns.
Read about depression and the elderly

At Butterfly Effects, we believe that the use of constant encouragement and positive reinforcement is the best way to modify undesirable behaviors. This is as true for seniors as it is for anyone.

To help mediate behavior problems in the elderly requires a systematic approach, a better understanding of behavior, and the development of a behavioral management toolkit.

Common behavior problems in the elderly encountered by caregivers:
  • Anger and aggressiveness
  • Elopement - intentional as well as accidental wandering
  • Financial extremes - recklessness as well as excessive frugality
  • Food refusal or over-selectivity
  • Non compliance to medical advice  -- intentional as well as accidental
  • Refusal to work with outside caregivers
  • Inadequate hygiene and grooming
  • Failure to employ life skills such as housekeeping and cooking
  • Inappropriate language
  • Excessive vocalization
  • Failure to converse
  • Dangerous or excessive attention seeking actions
  • Hoarding
  • Obsessive behavior
  • Paranoia and delusional behavior
  • Lack of social exertion (getting out)
  • Sleeping irregularities - both excessive sleeping as well as sleeplessness and erratic sleep schedules
  • Vehicle operation - ignoring limitations or unsafe driving

While many of the behaviors listed above can seem to be spontaneous, none of them occurs in a vacuum.
In fact, no human behavior occurs outside the desire to satisfy a need or want. Yes, dementia and other conditions of aging can obscure the reasons behind those needs, but those reasons are very real and very identifiable, if we have the patience and skill required for close examination.

Want to discover those reasons why?
Read about Functional Behavior Assessments, the invaluable tool for uncovering the reasons behind a behavior.

At Butterfly Effects, we can help you meet behavior challenges presented by your loved ones.
We've built a national reputation on  our expertise in behavior management. We employ Board Certified Behavior Analysts in all parts of the country. Trained in the proven practices of  Applied Behavior Analysis, our behavior consultants will
  • Assess the problem and the individual in his or her natural environment and then set up and deliver a behavior plan
  • Provide family caregivers with recommendations, and/ or training in support of your own behavior intervention
  • Come into care facilities at your request to assess behavior concerns and support a loved one receiving institutional care

Functional Behavior Assessments for the Elderly

AoA, 2011. Who are the Abusers. Administration on Aging, National Center on Elder Abuse. Retrieved from

Elder Assistance Daily, 2010. Elder Abuse Data and Statistics. Elder Assistance Daily. Retrieved from

National Center on Elder Abuse, 1969. Types of Elder Abuse in Domestic Settings. Elder Abuse Information Series. Retrieved from

Questions about this service or any of the services provided by Butterfly Effects? Call us at (888) 880-9270, contact us - or - leave a comment for our Facebook community below.

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