DEMENTIA 101
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example.
DEMENTIA IS A DECLINE IN COGNITIVE ABILITY CAUSED BY ...... SOMETHING
WHAT IS A BEHAVIOR?
A SIGN OF AN UNMET NEED
OR
AN EMOTIONAL RESPONSE TO EXTERNAL OR INTERNAL STIMULI
Caregivers of people with Alzheimer's and other dementias may also have difficulty maintaining healthy behaviors.
TRUE. Only 3% reported using physical activity as a way of getting relief from their caregiving responsibilities. High body mass index (BMI), also associated with chronic illnesses, was noted in approximately 66% of family caregivers, who were either overweight or obese.
ACTIVE LISTENING
THE TIMING AND SETTING OF COMMUNICATION
EFFECTIVE SELF EXPRESSION
WHAT STEPS DO YOU TAKE?
DISCUSS REFUSAL OF CARE VS PERSONAL PREFERENCE
All people who are older will eventually develop severe memory loss and confusion.
FALSE Memory loss and confusion are symptoms of dementia and are NOT a normal part of getting older
WHILE AGING IS THE NUMBER 1 RISK FACTOR, THIS DOES NOT MEAN THAT IT IS NORMAL TO HAVE COGNITIVE DECLINE THAT AFFECTS DAILY LIVING
NAME 5 OF THE MOST COMMON "BEHAVIORS" THAT ELDERS WITH DEMENTIA EXHIBIT
•Wandering
•Resistance to daily care
•Physical aggression
•Sexually inappropriate behavior
•Repetitious questioning
•Sleep disturbance
•Rummaging/hoarding
•Social Withdrawal
•Disruptive Vocalizations
•Sundowning
•Demanding behavior/verbal aggression
•Urinating/defecating in places other than the bathroom
FALSE!!!!
VALIDATION THERAPY.
ALWAYS, ALWAYS, ALWAYS, VALIDATE EMOTIONS
YOU SET THE TONE.
NAME THREE INTERVENTIONS TO HELP ENSURE A POSITIVE APPROACH
1. YOUR BODY LANGUAGE- facial expressions, body tension and overall mood
2. USE A CALM, GENTLE APPROACH- you set the tone for the interaction. model a relaxed manner.
3. DON'T BE DEMANDING- allow them choice
4. TRY USING TOUCH TO CONVEY YOUR MESSAGE- touch can show that you care and provide physical comfort; provides reassurance
5. BEGIN YOUR CONVERSATION SOCIALLY AND NOT TASK SPECIFIC
THE ANSWER IS WHATEVER IS IMPORTANT TO THAT SPECIFIC ELDER
ACTIVITES NEED TO BE SUCCESS ORIENTED, FAILURE FREE, AND PURPOSEFULL.
A resident who suddenly shows signs of dementia may simply be dehydrated.
TRUE It can also be a UTI, or they may be depressed, or have had a recent medication change.
DELERIUM, DEMENTIA AND DEPRESSION
WHAT ARE THREE WAYS THAT STAFF CAN INCREASE "BEHAVIORS" OR EMOTIONAL RESPONSES IN OUR ELDERS WITH DEMENTIA
RUSHING THROUGH A TASK
POOR COMMUNICATION SKILLS
POOR BODY LANGUAGE AND NON-VERBAL CUES
ELDER TALK
OVER-STIMULATING ENVIRONMENTS
HOW LONG SHOULD YOU GIVE AN ELDER WITH DEMENTIA TIME TO RESPOND TO A QUESTION?
90 SECONDS
NAME 5 QUESTIONS WE SHOULD BE ASKING AT ADMIT
WHAT DID YOUR DAYS LOOK LIKE?
WHAT IS SOMETHING THAT YOU CANNOT LIVE WITHOUT?
WHAT UPSETS YOU?
WHAT BRINGS YOU JOY AND COMFORT?
WHAT ARE YOUR FAVORITE FOODS?
DO YOU HAVE ANY CURRENT FEARS?
HOW CAN WE HELP YOU LIVE THE LIFE YOU WANT TO LIVE?
Dementia is caused by various diseases and conditions that result in damaged brain cells or connections between brain cells. Which of the following diseases does NOT cause dementia? a) Alzheimer's disease b) Parkinson's disease c) The flu d) Lewy bodies e) Alcoholism
(c) The flu
AS STATED PREVIOUSLY, THERE ARE OVER 100 DIFFERENT TYPES OF DEMENTIA
NAME THREE REASONS THAT AN ELDER MAY EXHIBIT INCREASED AGITATION AND AGGRESSION
•Pain or discomfort
•Medical/Physical Illness
•Fatigue/Lack of adequate sleep
•Fear or a general loss of sense of control
•Hunger or thirst
•Impulsivity/Disinhibition
•Medication side effects
•Restlessness/Overstimulation
•Low stress threshold
•Responding to caregiver affect
•Overextending abilities
•Severity of dementia
WHAT ACTUALLY HAPPENED.
WHAT HAPPENED JUST BEFORE THE INCIDENT
WHAT HAPPENED IMMEDIATELY AFTER THE INCIDENT
DID YOU FOLLOW-UP THE CARE PLAN?
What if a resident accuses you of taking something of theirs. Is it best to apologize and accept blame, even if you're innocent?
YES. Do not engage in a arguing match with a resident suffering from dementia. Enlist the help of other staff to find the missing item of the resident.
AND THEN PLAN AHEAD...
RELIGION AND SPIRITUALITY ARE NOT AN IMPORTANT PART OF A DEMENTIA ELDERS DAILY LIFE
FALSE-
THIS INFORMATION WILL HELP GUIDE YOU TO ESTALISH PERSON CENTERED INTERVENTIONS
WE CAN NOT HOLISTICALLY CARE FOR OUR ELDERS IF WE DO NOT REALLY KNOW THEM
All of the following are symptoms of dementia, except: a) challenges in planning and problem solving b) forgetfulness c) desire to watch television d) problems understanding directions e) confusion with time and place
(c) the desire to watch television
NAME 5 TACTICS TO HELP REDUCE BEHAVIORS
•Safety FIRST- ASK FOR HELP
•Redirect or remove from situation
•Remove possible triggers
•Assess and treat pain and/or medical conditions
•Model calm behavior
–Respond to their feelings, not the behavior
•Be non-threatening
•Provide constant reassurance
•Provide safe choices and alternatives
•Model calmness
–Low toned, calm voice
–Positive body language
•Simplify tasks
•Establish regular routines
•Avoid memory based questions
•Monitor for signs of overload
–Provide frequent breaks
–Limit visitors if overstimulated; educate family
Most residents with dementia don't notice loud voices or sudden loud sounds because they're so confused.
FALSE. They also notice when you're talking about them too!
A resident is agitated and yelling at other residents and staff around the nurses station. What might you do to help in this situation?
a) leave her alone, someone else will deal with her b) go over to her, unlock the brakes on her wheelchair and take her to her room c) go up to her, bend down, catch he eye and ask her if she needs your help d) contact her doctor and ask for a medication to address her behavior
CAN YOU NAME THE TYPE OF DEMENTIA THAT CAUSES EARLY ONSET HALLUNCINATIONS AND DELUSIONS?
PARKINSONS
LEWYBODY
ALZHEIMERS DISEASE DOESN'T PRESENT WITH HALLUCINATIONS OR DELUSIONS IN THE EARLY STAGES