A gentle approach to dementia...

nursemouse · Apr 25, 2003

Wow! Awesome responses, and many things I hadn't heard of before. Yes, I do work in an acute care facility. Gwenith, I hadn't heard of the scale you mentioned, but I'm going to the web to see if I can download a copy and include it. Please post or PM me if you have a link I truly appreciate the answers and anymore you can provide. I knew you would come through. Many thanks!!! :kiss :kiss Nursemouse

nursemouse · Apr 25, 2003

Wow! Awesome responses, and many things I hadn't heard of before. Yes, I do work in an acute care facility. Gwenith, I hadn't heard of the scale you mentioned, but I'm going to the web to see if I can download a copy and include it. Please post or PM me if you have a link I truly appreciate the answers and anymore you can provide. I knew you would come through. Many thanks!!! :kiss :kiss Nursemouse

oramar · Apr 25, 2003

Cargal talked abput and once posted about a seminar she took called Validation Therapy. Go to search and type in Validation Therapy and read her post. I for one hope to take a seminar like that someday.

oramar · Apr 25, 2003

Cargal talked abput and once posted about a seminar she took called Validation Therapy. Go to search and type in Validation Therapy and read her post. I for one hope to take a seminar like that someday.

betts · Apr 25, 2003

Mood and Emotional Behavior. Alzheimer's patients display abrupt mood swings and many become aggressive and angry. Some of this erratic behavior is caused by chemical changes in the brain. But certainly, it can also be attributed to the terrible and real experience of losing the knowledge and understanding of one's surroundings, causing fear and frustration that they can no longer express verbally.

The following recommendations for caregivers may help reduce agitation:

Keep environmental distractions and noise at a minimum if possible. (Even normal noises, such as people talking outside a room, may seem threatening and trigger agitation or aggression.)

Speak clearly. Most experts recommend speaking slowly to an Alzheimer's patient, but some caregivers report that Alzheimer's patients respond better to clear, quickly spoken, short sentences that they can more easily remember.

Limit choices (such as clothing selection).

Offer a diversion, such as a snack or car ride, if the patient starts shouting or exhibiting other disruptive behavior.

Simply touching and talking may also help.

Maintain as natural an attitude as possible. Alzheimer's patients can be highly sensitive to the caregiver's underlying emotions and react negatively to patronization or signals of anger and frustration.

Showing movies or videos of family members and events from the patient's past may be comforting.

Although much attention is given to the negative emotions of Alzheimer's patients, some become extremely gentle, retaining an ability to laugh at themselves or appreciate simple visual jokes even after their verbal abilities have disappeared. Some appear not unhappy, but to be in a drug-like or "mystical" state focusing on the present experience as their past and future slip away. Encouraging and even enjoying such states may bring some comfort to a caregiver.

There is no single Alzheimer's personality, just as there is no single human personality. All patients must be treated as the individuals they continue to be, even after the social selves have vanished.

Appearance and Cleanliness. For the caregiver, grooming the Alzheimer's patient may be an alienating experience. For one thing, many patients resist bathing or taking a shower. Some spouses find that showering with their afflicted mate can solve the problem for a while. Often the Alzheimer's patient loses the sense of color and design and will put on odd or mismatched clothing. This may be very frustrating to a loved one, particularly since (certainly in the beginning) embarrassment is a common and painful emotion experienced by the caregiver. It is important to maintain a sense of humor and perspective and to learn which battles are worth fighting and which ones are best abandoned.

betts · Apr 25, 2003

Mood and Emotional Behavior. Alzheimer's patients display abrupt mood swings and many become aggressive and angry. Some of this erratic behavior is caused by chemical changes in the brain. But certainly, it can also be attributed to the terrible and real experience of losing the knowledge and understanding of one's surroundings, causing fear and frustration that they can no longer express verbally.

The following recommendations for caregivers may help reduce agitation:

Keep environmental distractions and noise at a minimum if possible. (Even normal noises, such as people talking outside a room, may seem threatening and trigger agitation or aggression.)

Speak clearly. Most experts recommend speaking slowly to an Alzheimer's patient, but some caregivers report that Alzheimer's patients respond better to clear, quickly spoken, short sentences that they can more easily remember.

Limit choices (such as clothing selection).

Offer a diversion, such as a snack or car ride, if the patient starts shouting or exhibiting other disruptive behavior.

Simply touching and talking may also help.

Maintain as natural an attitude as possible. Alzheimer's patients can be highly sensitive to the caregiver's underlying emotions and react negatively to patronization or signals of anger and frustration.

Showing movies or videos of family members and events from the patient's past may be comforting.

Although much attention is given to the negative emotions of Alzheimer's patients, some become extremely gentle, retaining an ability to laugh at themselves or appreciate simple visual jokes even after their verbal abilities have disappeared. Some appear not unhappy, but to be in a drug-like or "mystical" state focusing on the present experience as their past and future slip away. Encouraging and even enjoying such states may bring some comfort to a caregiver.

There is no single Alzheimer's personality, just as there is no single human personality. All patients must be treated as the individuals they continue to be, even after the social selves have vanished.

Appearance and Cleanliness. For the caregiver, grooming the Alzheimer's patient may be an alienating experience. For one thing, many patients resist bathing or taking a shower. Some spouses find that showering with their afflicted mate can solve the problem for a while. Often the Alzheimer's patient loses the sense of color and design and will put on odd or mismatched clothing. This may be very frustrating to a loved one, particularly since (certainly in the beginning) embarrassment is a common and painful emotion experienced by the caregiver. It is important to maintain a sense of humor and perspective and to learn which battles are worth fighting and which ones are best abandoned.

ktwlpn, LPN · Apr 27, 2003

Originally posted by nursemouse
Wow! Awesome responses, and many things I hadn't heard of before. Yes, I do work in an acute care facility.

I have often wondered why acute care facilities don't have "geriatric units" We have peds, etc, Geriatric pts have unique needs and should be treated by staff with understanding of same.....

ktwlpn, LPN · Apr 27, 2003

Originally posted by nursemouse
Wow! Awesome responses, and many things I hadn't heard of before. Yes, I do work in an acute care facility.

I have often wondered why acute care facilities don't have "geriatric units" We have peds, etc, Geriatric pts have unique needs and should be treated by staff with understanding of same.....

perfectbluebuildings, BSN, RN · Apr 27, 2003

I agree ktw. Also, I work with residents of a long term care facility as a coordinator of an adopted grandparent program, and I was wondering what you do when a resident thinks they know you and talks to you about people in their family as if you know them too, or other similar things. A lot of times with certain residents I will just go with the flow and pretend, maybe this is a bad idea? It always seems to keep them calm and we visit pleasantly, of course that is a different kind of interaction than nursing. So what do you all think?

perfectbluebuildings, BSN, RN · Apr 27, 2003

I agree ktw. Also, I work with residents of a long term care facility as a coordinator of an adopted grandparent program, and I was wondering what you do when a resident thinks they know you and talks to you about people in their family as if you know them too, or other similar things. A lot of times with certain residents I will just go with the flow and pretend, maybe this is a bad idea? It always seems to keep them calm and we visit pleasantly, of course that is a different kind of interaction than nursing. So what do you all think?

Helori · Apr 27, 2003

These are some great ideas!

I work acute care and my best advice to simply make sure that you always treat them with respect. You may think they are completely nuts but any patient with a fluctuating LOC or who is confused d/t an acute illness will remember how you treated them when they come out of it.

Helori · Apr 27, 2003

These are some great ideas!

I work acute care and my best advice to simply make sure that you always treat them with respect. You may think they are completely nuts but any patient with a fluctuating LOC or who is confused d/t an acute illness will remember how you treated them when they come out of it.