If you have HD, this damn disease will challenge you. In fact, you may need help from your family or other folks. It takes a team to fight HD with you. I am often awed at how well those with HD and their teams come up with clever ideas. Then they use them to manage or prevent problems by anticipating and avoiding them.
There are many different kinds of problems that you may face. The cognitive changes that HD brings can cause anger, a short temper, intolerance, repetitive insistence on things and a drive to have the same things in the same way at the same time. They may be very troubling to you. They may be irritating to those with whom you live. In some less common instances they may become disruptive to your family.
Have you ever found yourself saying:
“I just don’t know…”
I’ve tried everything!”
“I don’t know what I’m going to do about…”
“What else can I do?”
If you have, then using the 5 A's may be helpful in coming up with an approach to the problem. One thing is certain: there are no easy answers to many of the challenges that HD presents.!
“Just tell me what to do!”
“I’m at my wit’s end!”
“God, help us!”
"I can't do this."
The Five A's is an approach
It's not the Five Answers! For complicated problems with "misbehavior," it's an approach. When your overwhelmed it's a way to analyze your approach to the problems you're trying to address.
An ongoing experiment at home
Think of your using the 5 A's as an ongoing experiment as you try to figure out how to approach problems. It's an experiment in changing the things in your home that you can change!
Here are some things in your home that you can change
your own behavior.
the layout of your home.
the sensory environment: what one hears, sees, the temperature, comfort, etc.
the daily or weekly routine of your home or family.
the intensity of various things.
schedules.
You can't ask or expect your loved one with HD to change! He has his hands full already fighting the HD. The cognitive changes that HD brings to him make it difficult for him to make a realistic assessment of his own behavior. Other changes may make it even more difficult to muster the "motivation" or insight needed to change.
Here's one thing that you can't change or do
This notion of the 5 A's is based on an original idea by Rosemary Best
When you can use the 5 A's
The 5 A’s look like this
Allow
Accommodate
Adapt
Arrange
Anticipate
The 5 A's read as
If I can anticipate the problem behavior, then I can allow it, accommodate it, make adaptations or arrange things in a different way
Let's consider "Anticipate"
It's very interesting that so very many of all the problem behaviors that families face do not come as a surprise. Problems tend to build up over time and not to appear suddenly. As an expert in your loved one's behavior, you often learn to anticipate problems. You come to know what will "press his buttons." You get very accurate in predicting what things will turn into power struggles.
Almost all misbehavior has antecedents, or "setting events, that you come to recognize.
Seeing these conditions, you anticipate the problem. If you can anticipate a problem, you can take a few moments and come up with an approach...allowing it, accommodating it, adapting things for it or arranging things for it.
As HD progresses and brings on cognitive changes, folks may lack precision or accuracy in self-awareness. This may give you a better perspective on your family member's behavior than he has on himself. In a sense, you can think of all behavior as communication. Very often problem behavior, or "misbehavior," is another way for the person to say "No" or "Help" or "Something's wrong." Over the years, especially now, you have become an expert on his behavior.
