behavioral interventions in patients with dementia

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So here's the deal. I am an RN supervisor in a skilled nursing facility. We take a lot of rehabilitation stuff but we also have a good chunk of long term patients with dementia. We have had some issues with nurses just giving PRN's withoug trying other interventions first. This doesnt look good when the state comes in, the patient falls, or the family see's them all snowed. The DON has asked me to do an inservice for the nurses on behavioral interventions and proper documentation prior to med administration. Any suggestions?

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I am also a supervisor and this is such a dilemma but I just have my cna do toileting,change them walk them for 10 mns, offer fluids first if that doesn't work, prn is in order. Working beautifully so far! Good luck

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Im looking for more than just the obvious I guess. Things other than basic needs stuff.

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Specializes in Emergency.

I don't know if this is what you are looking for but we will occasionally give a big bag of facecloths to a person with dementia and ask them to help out by folding them. It works a treat for a lot of people, they feel useful, it keeps them busy and is very low time commitment from the nurse. When they are done take the towels away and bring them back as a new batch. Granted I work ER so only have these people for short times but it has worked for me in a pinch.

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Try the Alzheimer's Association website for ideas. When it comes down to it though, behaviors in the dementia population are usually driven by the basics.

Cold, thirsty, pain, hunger, toileting needs, boredom, lonely. Pain will be the biggest trigger. Are your resident's pain being adequately evaluated and treated?

Are they being stimulated too much, or not enough? Get your activity department to do more with them.

Also research validation techniques and distraction techniques. They really do work.

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Involving the activities department more is not an option. Basic needs stuff is already on my list. Pain control isnt really an issue. Like I said my nurses tend to give a lot of prns lol. Pretty much every behavioral patient of ours has been scheduled pain meds with prns for breakthrough. The wahcloth thing is kinda what im looking cor more of. Ive used that one before with a lot of success

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A quiet room where they can watch old classic movies, especially Westerns.

Books of fabric samples for them to sort through.

Photo books with LARGE bright pictures of pets and children, then ask them to tell you about the people in the photos.

A plastic tool box with a Little Tykes/Playskool tool set, especially the large screws and fake boards with the screw holes.

A large print book of word searches- they won't complete them accurately, but still like to do them.

Sets of dummy keys and wallets with blank ID cards, and purses with wallets for the women- a lot of times they are agitated because they don't have these things on/near them, and they are used to always carrying them. Also-wristwatches.

Baby dolls and/ or weighted stuffed dogs and cats to hold in their laps.

Blankets with long fringes or fabric muffs with buttons and tassels sewn on- something for them to fidget with.

Music. Varying kinds, especially old time favorites with simple melodies that are easy to sing along to.

And of course, toileting, toileting, toileting. Even if they've just gone- especially the women. They are not great at completely emptying their bladders.

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I'm an aide working in ltc. Everyone(nursing, dietary, housekeeping, maitenance) working in ltc in our health region has to take the gentle persuasive approach inservice, well its a class. I found it very helpful. https://uwaterloo.ca/murray-alzheimer-research-and-education-program/research/projects/gentle-persuasive-approaches-gpa-dementia-care-project

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