What “Behaviors” Are Really Trying to Tell Us.

When a person living with dementia begins pacing, calling out, refusing care or becoming agitated, it’s easy to focus on the “behavior” rather than on an “unmet need” that they may be having a difficult time communicating.

Someone who can no longer explain what they’re feeling may be trying to tell us they’re in pain. They’re frightened. They’re developing an infection. They didn’t sleep. They’re dehydrated. They’re lonely. They’re confused because a familiar routine changed. They just want to go outside and have their face in the sun.

The Challenge Is that Resident Intent is Not Always Obvious.

Care teams in senior living make hundreds, sometimes thousands, of decisions every day while caring for residents with increasingly complex medical and cognitive conditions. They are balancing safety, dignity, staffing shortages, family concerns and regulatory expectations, often all at once.

In this recent announcement, CMS is sending a clear message, that psychotropic medications should never be used simply because a resident is difficult to care for. Before these medications are initiated, or while residents remain on them, communities are expected to understand what is driving the behavior, attempt person-centered, non-pharmacological interventions whenever appropriate and continually evaluate whether medications remain necessary.

CMS also emphasizes that “acting out” may likely reflect underlying medical conditions such as pain, infection, dehydration, medication side effects or environmental stressors that should be addressed first. In other words: Treat the cause, not just the symptom.

This is easy to say if you’re not a care professional who is responsible for eight residents simultaneously, having to check doors every hour at night (sometimes unintentionally awakening the people in your care). It’s much harder to do when you only see snapshots of a resident’s day.

The Problem with Using Snapshots to Understand People.

Imagine trying to understand someone’s health by checking on them every few hours. You might see them sleeping. Then pacing. Then eating lunch. Then resting again. These observations are valuable but they’re isolated moments.

What happened between those moments? Did they get up 14 times overnight? Have they gradually stopped walking as much over the past week? Are they making more trips to the bathroom? Have they become increasingly restless every afternoon? Did their sleep change before anyone noticed confusion?

Patterns Tell the Real Story. Earlier Insight Leads to Better Decisions.

This is where continuous, passive health monitoring like Amba can make a meaningful difference. Amba quietly observes changes in daily routines, mobility, sleep and activity without cameras, wearables or disrupting residents’ privacy.

The goal is to provide care teams with additional context. Instead of reacting only after a behavior becomes severe, clinicians can begin asking different questions: “Has something changed?” “Could this resident be uncomfortable?” “Is this different from their normal routine?”

Those conversations often lead to more individualized care and sometimes to identifying medical issues before they become crises. For example, allowing night owls to sleep in late, to prevent them from being sleepy or grumpy during the day time. That simple act of observing can prevent a fall or an unnecessary medication.

Pain Doesn’t Always Look Like Pain.

One of the most difficult challenges in dementia care is recognizing pain.

A resident may not be able to say, “My hip hurts.” Instead, they may become withdrawn. They may resist bathing. They may pace. They may become increasingly agitated.

Today, the Amba platform helps clinicians assess facial expressions and other indicators that may suggest pain in individuals who cannot reliably self-report it. When caregivers have another source of clinical insight, they’re better equipped to investigate what a resident may be experiencing instead of simply responding to the outward behavior.

At communities using Amba, that approach has been associated with meaningful clinical improvements, including reductions of more than 50% in falls, hospitalizations and serious infections within the first month of implementation, alongside significant reductions in psychotropic medication use as part of broader efforts to provide more individualized, proactive care.

Those outcomes happen because caregivers have better visibility into what residents may be experiencing.

The Future of Dementia Care.

We know the future of memory care will use technology not to replace the care professional, but to enhance the work of the care professional. Instead of checking on people every hour, they can focus on helping those who need help and allow those who don’t need their help, to live their day (or night) out as they choose. All dementia care will eventually use technology to help us treat each other more humanely. We can listen better, recognize subtle changes sooner and understand what someone may be trying to tell us—even when they can no longer find the words.

Check Out Our Webinar Series.

We’re excited and honored to share the air waves with three of our partners at Certus Senior Living, Aravilla and Gulf Coast Memory Care coming up soon. In just 30 minutes, each Dementia Bytes session features a mini case study about quality communities using passive health monitoring and data informed care practices.

Sign up today by clicking here.