alzheimer’s and dementia care: dealing with difficult behaviors

Why is this Important?

“When You know better you do better”Maya Angelou

How to keep their dignity and your sanity

Caregiving 101 or….911

Older adults may experience slower recall or forget only parts of an event.

Remains able to follow spoken and written instructions

Difficulty concentrating (requires fewer distractions, less noise, etc.)

Capacity to learn stays in tact, however, new info may take longer to absorb.

Dementia is the loss of mental functioning that causes deficits in memory, language, learning ability, judgment, and orientation.

Dementia is diagnosed when there are cognitive and behavioral symptoms that:

1) Interfere with the ability to function at work or usual activities,

2) Represent a decline from previous level of function

3) Are not explained by a delirium or other psychiatric disorder

D- drug reaction E- Emotional disorders (depression,

schizophrenia) M- Metabolic and endocrine E- Eyes and ears (sensory loss) N- Nutritional deficits T- Tumors or NPH I- Infection (UTI, Pneumonia) A- Arteriosclerosis

1) Alzheimer’s2) Lewy Body3) Vascular4) Parkinson’s5) Fronto-Temporal6) Chronic Traumatic Encephalopathy

More positively referred to as “actions or reactions”

Frontal Lobe Temporal lobe Hippocampus Occipital lobe Sensory Center

Usually first to go (Alzheimer’s) As disease progresses, age regresses Common behaviors seen Remember…those things that irritate

you today may be treasures tomorrow.

The single problem with communication is the illusion that it has taken place.” G.B. Shaw

When communication is impaired caregiving becomes a challenge

Validates feelings Creates reassurance and enhances

cooperation Enhances self esteem, reducing

depression Reduces isolation, loneliness Diffuses power struggles, prevents

catastrophic behaviors/abusive incidents

Stereotypic language “easier said than done,” “you got me”

Empty speech Violations of conversation rules Repeating stories Windows of lucidity

Verbal Nonverbal

Behind every behavior is an unmet need

Listen Observe what the patient is trying to

tell you Take time to figure out what they need Begin with basics toileting ,

temperature, hunger and thirst Develop trust by using good

communication

1. Greet before you Treat 2. Focus on a positive greeting 3. Give a compliment 4. Bring a positive visual cue

Validation is a method of communicating with and helping the disoriented.

Validation is built on an empathetic attitude and a holistic view of individuals. Naomi Feil

Can bring comfort Can cause agitation

1. Visual- Must start with visual 2. Verbal- has to match visual 3. Touch- last, only use if above two are

accomplished. 4. Smell 5. Taste.

1. Short simple information 2. Provide Choices (1 or 2) 3. Ask them for help (don’t command) 4. Eliminate distractions 5. Repeat same command and wait

Remember their Greatness Live their truth Provide structure Remove the word “No” Removing an object Identify favorites Be like a duck Be like the sun

Take Action Kick start Safe haven Let go of expectations

Start the morning off right Nap Do something they love

Problem solvers Validate before redirecting

If this is new problem the patient needs an evaluation.

Don’t try to fix it, but Acknowledge… Don’t use reality Connect with the patient’s emotion

regarding the situation Meet their need May need to change their environment Go with the Flow!!!!!!

When you have met one person with Alzheimer’s you have met one person with Alzheimer’s!

Listen to the words the staff/family use to describe the patient

Put the person first, not the characteristic

“People will forget what you said, people will forget what you did, but they will never forget how you made them feel.” Jolene Brackey

When we learn with pleasure we never forget, Alfred Mercier

Can be exhausting Feelings of grief/relief Ask for help Be aware of care giver burden and burnout! Resources are available: South Arkansas Center on Aging 870-881-8969 Local support groups

www.nia.nih.gov/alzheimers www.alz.org www.caregiving.org Teepasnow.com Jolene Brackey, “Creating moments

of Joy”