Anyone work with dementia patients?

LaterAlligator · Aug 11, 2011

I do, I work in a secure dementia facility. My tips on bathing are: have the room very, very warm. Use a bath blanket so you're only uncovering the parts you're washing. Don't tell them ahead of time that you're going to bathe them. Say "wash up" or "get cleaned up". If they're elderly, try singing some songs that they may remember from their day to calm them down and distract them, and see if they'll sing along (even really simple ones like You Are My Sunshine). Use a soft voice, tell them how well they're doing, and try to distract them as much as possible. Talk about things they might like hearing about, like children (cute stories about kids in your family, or whatever).

Mine usually tolerate an automated wrist cuff better for vitals, and I say something like "Hi Mrs. X, this bracelet is going to help me count your heartbeat. Let's put it on and then you put your arm here like you're saying the Pledge of Allegiance." and sometimes they literally say the pledge, which is so cute. If they're more advanced in their disease, I usually just hug them or hold them while the cuff is going to encourage them to be still and quiet. And we use a temporal thermometer (that goes across their forehead). I count respirations when they're sleeping or just sitting quietly.

For eating and drinking, try to have few distractions in the room, start with something you know they like (hot cocoa or coffee, likely) and a few sips to get them warmed up on intake. It might help to have them rest their hand over yours as you bring the spoon up to their mouth so they know it's coming. Tell them you made it for them and are excited for them to try it. Ask them how it is. Be enthusiastic and positive. Call them by their name like "Hi Henry! I'm so glad to see you. I made you some supper, and I brought it here for you. These potatoes smell really good. Let's try a bite of these."

Also, if you're in a hospital, isn't it fairly easy to get orders for sedatives for them? I know you don't want them completely asleep and knocked out, but premedicating before a shower or other activity that you know they're likely to hate is usually a good idea. If they're refusing to take meds PO, you can get ativan gel or haldol lotion that just gets rubbed onto their skin. It's less dramatically effective but can make a dent in the agitation.

Good luck!

KatieShoe · Aug 11, 2011

LaterAlligator is exactly right. I am new to it but I've noticed a few tricks that may help. It sounds evil but manipulation is key. Instead of you expecting them to adjust to you it's easier if you adjust to them. Make everything you do seem like it's their idea. Dementia patients are often violent because they feel as if they're losing control. (Which they are but they don't need to be as aware of it ) For example, for baths I tell the patient we're going on a really fun walk. And usually they argue so I say okay well I'll see if someone else wants to go. Then for some reason they end up following me. Once we're in the bathroom (I make an excuse saying I have to wash my hands) I say man that looks so nice and warm I wish I could take a bath! They usually respond with "me too". Because, after all they want to be included. So then I say oh well you can I'm just not allowed. So after that it's usually smooth sailing. It doesn't always work but usually it at least makes it a little easier. It's like playing make believe. I know it sounds weird but that's what works for me! It's just very important to remember that you should always be adjusting to them not vice versa. And instead of explaining the ins and outs of vitals try and make a game out of it. Once you get the hang of it, it's actually fun! I think so anyways :)

JDZ344 · Aug 12, 2011

Thank you! I'll try these tips next time I'm at work.

fuzzywuzzy, CNA · Aug 12, 2011

A lot of times I end up walking away and doing something for somebody who actually wants the attention. Then when I come back, sometimes the person has calmed down.

And sometimes you can just leave the supplies with them as an alternative. I gave a bath today to someone who seemed kind of agitated. She normally loves the tub though, so I figured it would calm her down. She kept swatting at me until she got in the water, then she calmed down for a few minutes and started to get agitated again. So I put a washcloth on the side of the tub and pretended to leave, but I was really standing behind her. She ended up washing herself because she thought no one was around. She did a half-assed job but it was better than nothing, lol. I've done the same thing with people that did not want to be fed.