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N AVIGATING THE D IVIDE : How to Communicate Effectively with Dementia Patients.

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Presentation on theme: "N AVIGATING THE D IVIDE : How to Communicate Effectively with Dementia Patients."— Presentation transcript:

1 N AVIGATING THE D IVIDE : How to Communicate Effectively with Dementia Patients

2 O BJECTIVES Understand the behaviors associated with dementia and their causes Identify techniques to manage such behaviors Identify unspoken cues by dementia and Alzheimer’s disease patients Provide techniques to help engage patients suffering from dementia and Alzheimer’s disease

3 W E CAME HERE FOR A REASON Nonna Mel Grams

4 T HE D IVIDE Gaps in cognition make it unable to communicate Meaningful connections Quality of life Burnout

5 D EMENTIA The Disorders of Loss

6 D EFINITION AND C RITERION Dementia is characterized by loss Loss of ability to understand spoken or written language Loss of ability to identify or remember objects Loss of ability to perform motor activities Loss of ability to think abstractly These manifest as a loss of autonomy, control and oneself. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition

7 C OMMON C AUSES OF DEMENTIA Over 70 types of dementia Often comorbid or “mixed” Alzheimer’s Disease Vascular Dementia Lewy Body Dementia Frontotemporal Degeneration Hydrocephalus

8 B ASICS OF A LZHEIMER ’ S Understanding the disease Progressive Degenerative Ultimately fatal

9 B ARRIERS TO C OMMUNICATION As a Result of Dementia and Related Diseases

10 M ETHODS OF M ANAGEMENT Short term memory is effect them Honest with patients Relive painful trauma Death Patients physically cannot retain information Follow along with what the patient believes is true ReorientationJoining Patient’s Reality

11 M EL V S. A UGUSTE

12 D EMENTIA ’ S ROLE IN BEHAVIOR Keep in mind how far reaching the grasp of dementia can be What if our brains couldn’t complete the command or message What would happen if you couldn’t recognize what normal functions of the body feel like Urination Hunger Pain Imagine the anxiety and behavior you would exhibit if you didn’t know that these feelings could be resolved

13 R ECOGNIZING B ARRIERS TO C OMMUNICATION Identify underlying causes Question Overcome Assess Repeat if necessary

14 B EHAVIOR AS A B ARRIER As the ability to communicate wanes, behavior is the main way patients can communicate Problem Behavior Vs. Nuisance Behavior Must choose which behaviors are necessary to manage Some may not need management “Pick your battles”

15 B EHAVIOR B ARRIERS Nuisance behavior – Behaviors which do not put the patient or staff at risk; these may just be behaviors which are odd or socially unacceptable. Singing Repetitive speech “Babies” Word Salad

16 B EHAVIOR B ARRIERS Problem behaviors – Behaviors that could result in emotional or physical harm to the patient or staff. Delusions Hallucinations Wandering Sexual Inappropriateness Lack of Interest in Cleanliness

17 Q UESTION THE BEHAVIOR Discern if the behavior is in fact needing to be managed Singing may be a nuisance behavior at 3pm, but it may be a problem behavior at 3am If it needs managed, what could the behavior mean Consider what the client is not saying Are there non verbal cues Is this a common behavior Is the patient more disoriented than normal

18 O VERCOME THE B EHAVIOR Use cues from the client’s history to redirect to another activity Not wanting to bathe Overstimulation Modify the environment or remove items that could be causing an issue Notify other staff if you remove or replace something Simplify a task Questions Open ended Closed ended

19 E NGAGE THE PATIENT Assure the patient that they are safe Use a reassuring touch Which is commensurate with relationship Tell them what you plan to do Have confidence in your ability to manage the situation Use cues from your relationship with them to let them know you have had contact previously These will help to find the root cause of the problem, which may then be addressed

20 W HAT ARE THEY NOT SAYING Use nonverbal cues to read into what the patient is unable to tell you Pacing- worried, anticipating someone’s arrival Aggression- frustration at loss of control Wandering- confusion to place Sexual Inappropriateness- confusion to person

21 R EASSESS THE PATIENT After the root of the behavior is found and tended to, the patient needs to be reassessed Is the behavior still occurring? If it is, look for an additional meaning Physical Emotional

22 N OT O NE S IZE F ITS A LL There is no one universal answer One solution may work, until it doesn’t any longer Not every behavior will be resolved Regain perspective

23 I DEAS F ROM F AMILY Memory people Give time to answer Listen Be patient Respect patients as people Still have intelligence

24 T REMENDOUS O PPORTUNITY It all comes down to perspective You are my sunshine


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