Understanding the T.E.L.L.S. Method™: A Roadmap for Responding to Challenging Behaviors with Empathy and Insight
Challenging behaviors can feel like they come out of nowhere but they rarely do. For caregivers supporting someone with dementia or cognitive impairment, understanding behavior as a patterned response, not a personal attack, is key to protecting both your loved one’s dignity and your own peace of mind.
At KSH Aging Solutions, we use the T.E.L.L.S. Method as a compassionate, trauma-informed way to observe and respond to behavior. It teaches caregivers to look beyond the moment and identify what led up to it and what can help de-escalate it.
T.E.L.L.S. Method™ = Trigger → Early Signs → Level of Escalation → Loss of Control → Settle/Shutdown
T – Trigger
Start by asking: what happened 10 minutes ago?
The trigger is often subtle and easy to miss, especially when you're busy managing a million things. But it holds the key to preventing future outbursts.
Ask yourself:
What were they doing right before the behavior started?
What time of day is it?
Did they leave their usual environment?
Are they spending time with someone less familiar with their routine?
Has there been a change in medications or sleep?
Has this happened before—same time, same place?
Even your own mood could be a trigger. Are you feeling rushed, irritable, or anxious today? Our loved ones often mirror our emotional energy.
Finding the trigger can help you understand what early signs to look out for in the future.
E – Early Signs
This is the moment where intervention can change everything.
Early signs are small signals that something is off. They often show up in body language or a change in rhythm:
Pacing
Trouble focusing on routine tasks
Repeating questions
Seeming “off” or easily frustrated
Caregivers are often more in tune with their loved ones than they realize. You might not be able to explain it but you know when something’s shifting. Trust that instinct. This is the time to validate, connect, and gently redirect.
L – Level of Escalation
This is the breaking point. Your response matters here.
The behavior is now more pronounced. You may see:
Raised voices
Arguing
Refusal to cooperate
Accusations or mistrust
This is a crucial moment. How you respond can shape the rest of the day:
A calm voice and body language can help diffuse the moment.
Redirecting to a familiar person, place, or even a comforting scent can sometimes bring the person back to center.
Avoid logic or correction, go for connection instead.
If this doesn't work, the next phase may arrive quickly.
L – Loss of Control
This is not your fault. It’s not their fault either.
When someone loses control, their body is in full fight-flight-freeze mode. This is a neurological response to stress not a personal attack.
You may witness:
Yelling, crying, or screaming
Physical gestures like hitting, kicking, or shoving
Refusal to be touched or approached
Important reminder:
Your loved one is not “being difficult.” Their brain is trying to protect them. Stay focused on safety, yours and theirs. Avoid restraint unless absolutely necessary, and don’t take anything personally.
This moment will pass.
S – Settle/Shutdown
Emotions can drop just as quickly as they escalated.
Once the nervous system starts to come down, the person may seem:
Tired or withdrawn
Confused about what happened
Back to “baseline” as if nothing occurred
Avoid rehashing the incident. Don’t ask, “Do you remember what you just did?” It won’t help and may trigger shame or another escalation.
Instead:
Offer comfort and a sense of safety
Reintroduce calm through a soft voice, a warm drink, or simply being present
Take care of yourself, this moment may leave you emotionally drained
The T.E.L.L.S. Method™ doesn’t just help you manage behaviors, it gives you a way to make sense of them. And when you can understand what’s happening, you can show up with less fear and more compassion.
At KSH Aging Solutions, we offer tools, training, and one-on-one support to help you feel confident through the hardest caregiving days. Because your loved one isn’t the only one who deserves care, you do too.
📞 Call: 614-259-8789
🌐 Visit: www.kshagingsolutions.com
📧 Email: katie@kshagingsolutions.com
