aging in place - a strategy for caring for people with intellectual disability and dementia leslie...
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Aging in Place - A Strategy for Caring for People with Intellectual Disability and Dementia
Leslie UdellProgram Co-ordinator
Winnserv Inc.
Partners in Care… Living in the Moment
March 6, 2007
Degree of Commitment to Supporting Individuals Educating Board of Directors Development of agency policies Recruitment and education of new
board members
Accessible/Dementia Friendly Housing Environmental considerations Evaluating current housing Considerations for people living in
apartments or on their own
Admission and Discharge Criteria Dealing with individual’s actions and
reactions to the symptoms of Alzheimer’s disease
The impact of significant health concerns Supporting people who have the need to
wander Supporting people who are living
independently Considerations for a death at home
End of Life Care Policies
Benefits and steps to planning ahead Planned death at home Advanced Care Directives, DNR orders Funeral planning Bereavement support
Assessment
Documentation of decline Gradual onset and continuing cognitive
decline Atypical actions and reactions Late onset seizure activity
Diagnosis and Misdiagnosis
Detailed medical history Thorough physical and neurological
exams Psychiatric examination Pharmacological review
Assessment Tools
Videotaping Vineland Adapative Behavior Scales Inventory for Client and Agency
Planning (ICAP) Scales of Independent Behavior Adaptive Behavior Scale – Residential
and Community
Specialized Dementia Scales Dementia Scale for Down Syndrome
(DSDS) -Gedye Dementia Questionnaire for Mentally
Retarded (DMR) – Evenhuis et al. Assessment for Adults with
Developmental Disabilities (A.A.D.S.) – McQuilliams, Kalsy, Oliver & Hall &
Generic Tools - Mini Mental
Change in Focus of Supports Provided Maintaining skills Stabilizing the environment Minimizing choices Giving reassurance Personal care Assessing and meetings medical needs Meaningful activities
Supporting Families
Provision of information Planning and directing care plans End of life decisions After the death
Staff Levels and Training Appropriate levels of staffing Dementia specific training Maintaining and preserving skills vs.
learning new skill Pain recognition and management Addressing concerns about reactions and
actions related to the disease End of life care, the dying process and
grieving for themselves and roommates
Provision of Personal Care
Body mechanics Use of equipment Assistance for eating and drinking Issues of incontinence
Support for Grieving and End of Life Care Support teams for staff and roommates Pastoral care for families, staff and
roommates Staff discussions around their beliefs and
concerns Families values and beliefs around death
and dying Utilizing hospice and palliative care Arrangements for final farewells
Disclosure of Diagnosis
Do you tell the person that they have dementia?
Consideration of policies on disclosure Do you tell roommates about the
diagnosis?
Understanding the Disease
How do you explain Alzheimer’s disease to the individual and their friends and roommates?
Fostering acceptance and addressing concerns