How to Communicate Effectively with Dementia Patients Objectives Understand the behaviors associated with dementia and their causes Identify techniques to manage
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Slide1
Navigating the Divide:
How to Communicate Effectively
with Dementia PatientsSlide2
Objectives
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 diseaseSlide3
We came here for a reason
Nonna
Mel
GramsSlide4
The Divide
Gaps in cognition make it unable to communicate
Meaningful connections
Quality of life
BurnoutSlide5
Dementia
The Disorders of LossSlide6
Definition and Criterion
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 EditionSlide7
Common Causes of dementia
Over 70 types of dementia
Often comorbid or “mixed”
Alzheimer’s Disease
Vascular Dementia
Lewy
Body Dementia
Frontotemporal
Degeneration
HydrocephalusSlide8
Basics of Alzheimer’s
Understanding the disease
Progressive
Degenerative
Ultimately fatalSlide9
Barriers to Communication
As a Result of Dementia and Related DiseasesSlide10
Methods of Management
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
Reorientation
Joining Patient’s RealitySlide11
Mel Vs. AugusteSlide12
Dementia’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 resolvedSlide13
Recognizing Barriers to Communication
Identify underlying causes
Question
Overcome
Assess
Repeat if necessarySlide14
Behavior as a Barrier
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”Slide15
Behavior Barriers
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 SaladSlide16
Behavior Barriers
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 CleanlinessSlide17
Question 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 normalSlide18
Overcome the Behavior
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 endedSlide19
Engage 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 addressedSlide20
What 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 personSlide21
Reassess 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
EmotionalSlide22
Not One Size Fits All
There is no one universal answer
One solution may work, until it doesn’t any longer
Not every behavior will be resolved
Regain perspectiveSlide23
Ideas From Family
Memory people
Give time to answer
Listen
Be patient
Respect
patients as people
Still have intelligenceSlide24
Tremendous Opportunity
It all comes down to perspective
You are my sunshine