Re: Re-directing tips needed for Alzheimer's/behavior pts
I work in a facility with many alzheimer residents and like the other poster said, you need to do labs if this is a sudden or pretty gradual onset. We use behavioral intervenions first, before we medicate. If 3-4 interventions don't work, we medicate. I also deal with those who have mental/pysch disorders. We have a list of 10 rule outs we do.
I worked with a resident with alzheimer's who was a nurse. We put M&M's and med cups on her table and this woman sorted them all into these med cups for 'her patients'. (she wasn't a diabetic) She did this for hours! Find nurse related things. Even though she may not remember, her soul may still know.
I have a resident who continually wants to leave and we just give her bags. The woman has tons of clothes. She tires herself out when she realizes they are put up and she re-packs and tires herself out.
You just need to be creative. Family can help with projects. But their behaviors are usually worse when something is physically wrong.
If you do medicate, you need to use the least medication with the least possible side effects. Most facilities don't like to use some of the meds we use cause it is a charting nightmare.
Our facility accepts those with violent, aggressive, and unpredictable behaviors that are hard to manage. Not many places take them anymore. We have behavior sheets we have fill out on everyone when they first come in, and then periodically after that. To justify the use of the meds we give.
Sometimes its as easy as soft music, to giving them lotion they can rub in their hands, to making them feel useful, or special. I have one resident who doesn't like me for whatever reason, and I brought stuff like 'lotion, perfume, soaps, old gaudy necklaces' and when she takes her meds, she gets to pick one. Sometimes, it's sugar free candy. You can tailor to their needs.
If I can think of anything else, I'll contribute.
We began using it last evening and her anxiety level has dropped tremendously. She still voices concerns about being "lost", but they only last maybe 1-2 hrs tops and she's off to bed at a reasonable time. I did ask for a lab order, but the NP that works for the Dr.s didn't see cause for labs at this time. 
The NP is a whole different issue. She didn't order a tx for a man whose u/a came back with <100,000 something or other, but still present, and guess who developed a full blown UTI? Anyway, I'll keep trying. After awhile maybe she'll get sick of hearing from me and do it just to shut me up. I'm rather persistent like that. Anyway, keep the tips coming! I (and others) will be in this field for a long time, and anything I can learn to be a better nurse will only help my current and future residents that much more.
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