
When We Started
Hilda was 79 years old with a long career as an au pair and a love of traveling and nature. She was divorced and had not been in touch with her own children for many years. Her long-time friends were her only support, and she was declining. When we met Hilda, she was living alone with part-time caregivers. She needed to sell her home due to financial limitations and move to an assisted living community, but was unlikely to be accepted based on the following:
- Negative behaviors such as yelling, aggression, and agitation toward neighbors and friends
- Exit-seeking behaviors resulting in wandering
- Not eating regularly, with little attention to nutrition
- Napping for long periods in the middle of the day, with an unknown nighttime sleep routine
Interventions We Performed
- Expanded the caregiving team to include nighttime supervision
- Established a daily routine with regular exercise, walks outdoors, and improved nutrition
- Implemented medication changes and monitored behaviors
- Coached Hilda's friends and caregivers in ways to interact and redirect undesirable behaviors
- Implemented reminders and a toileting routine to reduce incidents of incontinence
Outcome
- Renewed interest in mealtimes and nutrition
- Engaged in her new routine, with decreased exit-seeking
- Pleasant and charming, with improved behaviors
- Decreased daytime napping and improved sleep at night
- Successful move, where Hilda quickly became a much-loved and active community member
The Results, By the Numbers
Incidents of Difficult Behaviors That Improved
- Month 1
- Month 2
- Month 3
To protect privacy, names and images have been changed.
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