1. ACT on Alzheimer’s Disease Curriculum Module IV: Effective Interactions

2. Competencies 4. Explain how different diseases can influence the functioning, behaviors, and attitudes of individuals including dementia/Alzheimer’s Disease. 5. Describe selected client service strategies, including customer service, their impact on quality client care and the importance of client participation in group/family activities. 8. Using a problem solving process applied to healthcare situations, describe how healthcare workers can be aware and sensitive to their clients’ needs/behaviors.

3. Dementia Care Overview

4. Suggestions for Dementia Care The patient is a person, respect that individual’s humanity The changes in this person are a result of a brain disease over which the person has no control Different or challenging behaviors may be the only way for this patient to communicate

5. Three Keys to Quality Interactions Affirm the person’s feelings, show empathy Solve the problem whenever possible Distract and/or relocate

6. Person-Centered Care Patient care should be personalized, so a caregiver needs to understand: – What makes this person unique – His or her personality – What core qualities define this person Caregivers can use these core personal qualities to develop suitable, personal care

7. Effective Communication

8. Communication Overview A dementia patient’s communication patterns will change over time and a caregiver’s communication techniques need to change as well The best way to support a person with dementia (and to communicate effectively) is to build a relationship with that person

9. Communication Challenges Word-finding difficulty Repetition Loss of reading and writing ability Revert to native language Loss of ability to speak in clear sentences Loss of ability to understand Inability to use words

10. Communication Tips Talk to the person in a place free of distraction Begin conversation with orienting information Look directly at the person Make sure you have the person’s attention Be at eye level with the person Speak slowly and clearly

11. Communication Tips Use short, simple sentences Ask simple yes/no questions Use concrete terms and familiar words Talk in an easy-going, pleasant manner Allow sufficient time for the person to respond Break up tasks into smaller steps

12. Having Trouble Being Understood? Be sure that you are allowing enough time for the person to process and respond Demonstrate visually what you are saying Think about the complexity of what you are saying Try a hug and change the subject

13. Having Trouble Understanding? Listen actively and carefully Try to focus on a word or phrase that makes sense Respond to the emotional tone of the statement Stay calm and be patient Ask family members about possible meanings

14. Things Not To Do Do not: – Argue with the person – Order the person around – Tell people what they can not do – Be condescending – Ask questions that rely on good memory – Talk about people in front of them

15. When Verbal Communication Fails Try distracting the person Ignore a verbal outburst if you can not think of a positive response Try other forms of communication Learn your own body language Learn the other person’s body language

16. Physical Interaction

17. Making a Positive Physical Approach Come from the front Go slow Get to the side Get low Offer your hand (palm up) Use the person’s preferred name Wait for a response

18. Assessing Behaviors

19. Common Behaviors Walking about Exiting or trying to leave Wanting to go home Showing fatigue as the day progresses Sleep disturbances Looking or searching for things Gathering Shopping Expressing discomfort Having hallucinations or delusions Being suspicious or paranoid Repetitive actions Loud verbalizations that may not be coherent

20. Why Challenging Behaviors Occur Change in environment A caregiver’s approach to communication Past history and behaviors Internal needs of the person The task that the person is doing Inability of the person to express needs or desires

21. A Different Way to View Behaviors Wandering Demonstrating mobility SundowningTired at end of day RummagingGathering / Exploring HoardingShopping Resistance to careFeeling uncomfortable

22. When Is Behavior a Problem? It violates the rights of others It poses a threat to someone’s health and safety (including one’s own)