Catastrophic Reactions

Catastrophic Reactions, or CRs for short, are often described as “super anxiety attacks.” They are emotional outbursts, sometimes accompanied by physical aggression, that seem out-of-proportion to the situation. CRs occur when the person is unable to cope with or communicate during an actual or imagined stressful situation. 

WHO IS AT RISK?

The behaviors associated with catastrophic reactions happen because there is damage to the parts of the brain that help people communicate and make sense of the world around them. The people who are most at risk of having catastrophic reactions are those with:

• Dementia
• Alzheimer’s disease
• Traumatic brain injury
• PTSD
• Certain types of strokes

WHAT ARE SOME TRIGGERS?

• Too many steps in a single task.
• A rushed or upset caregiver.
• A new or unfamiliar place.
• An underlying illness.
• A change in routine.
• Fatigue.
• Pain.
• Hunger.
• Paranoia or delusions.
• Confusing sensory input.

THE A-B-C-D APPROACH TO CATASTROPHIC REACTIONS

ACTIVATING EVENT (the “trigger”). Every catastrophic reaction requires the healthcare team to do a thorough investigation and establish the trigger.

BEHAVIORS (the catastrophic reaction). People who have brain damage associated with dementia, Alzheimer’s Disease, stroke and some traumatic brain injuries have trouble making sense of the world around them—combined with difficulty communicating their feelings. 

COMMUNICATION (the caregiver’s response). No one can derail every catastrophic reaction., but everyone can learn a few communication techniques that may bridge the gaps between confusion and understanding for clients who are at risk.

DEVELOP A PLAN (the prevention strategy). It’s always better to prevent a problem than it is to react to one in the moment. That’s why it’s so important to come up with a plan to help your clients avoid catastrophic reactions.