Concordia Home Care and Nursing Services LLC   Concordia Health Mobile Lab

Concordia Edvantage Training Academy                  Concordia Luxury Home

Mon-Fri: 9AM to 5PM

Dementia Care

Dementia Care

 

LEARNING OBJECTIVES

Participants will be able to:
• Know the definition and symptoms of dementia
• Know some good ways to respond to difficult behavior
• Know the importance of trying to understand what a patient with dementia is thinking and feeling
• Understand the difficulties faced by someone with dementia

Dementia is an organic mental disorder involving a general loss of intellectual abilities and changes in the personality. (Organic in this sense means the disorder is caused by physical changes in the brain.) Dementia is a general term for a decline in mental ability severe enough to interfere with daily life.

Symptoms

Symptoms can vary greatly, but at least two of the core mental functions below must be significantly impaired to be considered dementia:
• Memory
• Communication and language
• Ability to focus and pay attention
• Reasoning and judgment
• Visual perception

Many different things cause dementia. The most common, in order of occurrence, are:
1. Alzheimer’s disease
2. Strokes and other blood vessel diseases
3. Parkinson’s and other nervous system diseases
4. Miscellaneous causes, such as alcoholism, malnutrition, head injuries, drug reactions, thyroid disease, brain tumors, and infections

Important Things to Remember About Dementia

• Adult dementia sufferers deserve the respect and status they have earned. They often do not know their abilities have changed and do not understand why people treat them differently. They must be given as many opportunities as possible to make decisions and retain control over their lives.
• With the right environment and support, a patient’s ability to function can be strengthened and improved. If those supports are removed, the patient’s function will decline.
• The deficiencies caused by dementia affect all areas of a person’s life. Although the disability is invisible, it affects the patient’s ability to do even the smallest activities.
• The way a person with dementia behaves is not just the result of impaired brain functions. Behavior is often caused by efforts to meet needs while compensating for lost abilities.
• We can help people with dementia by trying to understand what they feel and think.

The Results of Dementia

• Memory loss:
–– Affects recent memories the most
–– Makes it difficult to learn anything new or to follow instructions
• Language loss (the meaning of words):
–– Makes it difficult to recognize words and understand complex sentences
–– Makes it difficult to express ideas
–– May use inappropriate words or curse words
Dementia is like looking at the world and being seen by others, through a funhouse mirror.
• Attention loss:
–– Unable to start or stop a task
–– Easily distracted
• Judgment loss:
–– Cannot accurately assess circumstances that may be dangerous
–– Unable to see consequences of actions
• Loss of perception or senses:
–– Unable to recognize things or people
–– Misinterpretation of what is seen, heard or felt
• Loss of muscle organization:
–– Unable to perform multiple-step tasks
–– Require prompts or cues for routine tasks

Communication Tips

• Be open, friendly, and gentle at all times.
• Always address the person by name to get his or her attention at the beginning of an interaction.
• Give your full attention to the conversation or task. This helps the patient stay focused.
• Briefly introduce yourself and offer some cues when you approach, stating your name and relationship and the purpose of your visit.
• Speak slowly, but do not speak down.
• Use gentle touching or hand-holding, but get permission first.
• Avoid arguing and attempts to reason with a person who is upset. Acknowledge the patient’s feelings and gently distract him or her with something calming, pleasant, and friendly.

Ways to Help a Patient Perform a Task

1. Explain each step in simple language, one thing at a time
2. Demonstrate each step, doing the task while he or she watches
3. Move the person through the steps of the task, placing arms and legs in the right positions
4. If the person becomes distracted, begin again at the beginning
5. Remember to be patient and unhurried

Case Studies: What Would You Do?

Mr. Blair

Mr. Blair is not normally incontinent. Recently, however, he has begun walking outside to relieve himself. Occasionally he wets himself. He has started to wander, and he often seems anxious and agitated.

What caregivers may assume: Mr. Blair has lost the ability to control his bladder and should be placed in adult incontinent briefs.

What is really happening: Mr. Blair cannot find the toilet. In his home, the white toilet blends in with the cream-colored tiles and walls, and his visual loss is causing him to be unable to see it. He spends much of the day looking for a place to urinate, but when he can’t find one he relieves himself outside, where there are more bright colors that are easy to see.

Try this: Place a brightly colored toilet seat or toilet cover on Mr. Blair’s commode to help him locate it. When you see Mr. Blair wandering anxiously in the halls or acting agitated, ask whether you can help him find the bathroom and then guide him to it.

 

Miss Mead

Miss Mead was a nurse for 40 years. She refuses to eat in the dining room but insists on having a tray brought to her room. She doesn’t eat the food you bring but places the dishes on her windowsills and cabinets “for the others.” She is losing weight rapidly but refuses to eat.

What caregivers may assume: Miss Mead will have to be placed in a hospital and fed with a stomach tube because of her refusal to eat.

What is really happening: Miss Mead is concerned for the “others” that she sees in her room. She believes that her reflections in the mirrors and windows are actually people that need her to care for them. She will not eat until she feeds them first.

Try this: Ask questions to determine what Miss Mead is trying to do. Once you understand the situation, remove the mirrors from Miss Mead’s room. Cover the windows with blinds or shades. You could provide two trays of food, one for Miss Mead and one for “the others.”