How To Deal With Patients Suffering From Dementia
As a certified nursing assistant , the chances are high that you frequently care for patients who suffer from dementia or Alzheimers disease. With special strategies to keep patients safe and less confused, you can manage a smoother workday and provide an environment that supports patients who experience memory loss, periods of agitation and challenging behavior.
Never Dispute a Patients Reality
Patients with dementia in the nursing home or hospital often get lost in time and dont remember that their mother is deceased or that they are not residing at home. Attempting to remind them that their mother is no longer living may only force them to experience the grief all over again and result in increased agitation and uncontrollable anxiety.
Never argue with a person who suffers from memory disorientation and always respond to their reality with assurance and kindness. Tips for CNAs to help with memory care and promote orientation may include:
- Hanging a picture of their family on the door to their room
- Introducing yourself to the patient frequently during the day
- Maintaining a daily routine so the patient knows what to expect
- Not taking rude comments or remarks personally
Aggressive Behaviors on Bathing and Dressing
Sleepless Patients on the Night Shift
- Folding towels or other simple tasks for distraction
- Lighting an area of the room to prevent falls and injuries
- Playing soothing music to encourage rest or sleep
- Maintaining safety if a wandering event occurs
Which Job Is Best For You
When deciding between memory care and assisted living, it helps to assess your personal preferences. If providing constant, structured care interests you, then you should look into memory care training. If you dont think you are ready to take on the extra tasks of memory care at this time, then its best to choose to work in assisted living.
Getting the training needed for memory care can also help further your career. Any type of training can be a stepping stone to moving up in your nursing career, so if you are looking to move up in the future, it could be in your best interest to pursue a job in memory care.
Going Through An Agency
- Youâll have a large number of caregivers to choose from. If one doesnât work out, you can try a different one.
- If your caregiver is sick or has an emergency, the agency will send a backup.
- Agencies often take care of the caregiverâs taxes and liability insurance.
- Agency caregivers are bonded and insured.
- Agency caregivers are often trained in things like CPR and first aid.
- Agencies often have a nurse to supervise the caregivers and check in on the client from time to time.
- If you have an issue with your caregiver, the agency can help resolve it.
- Agencies are often more expensive than if you hire someone privately.
- You may have less of a say about whoâs assigned to your family.
Questions to Ask
The Three Stages Of Dementia
After dementia is diagnosed, it usually follows a three-stage, downward trajectory.
In mild dementia, people may have difficulty remembering words and names, learning and remembering new information, and planning and managing complicated activities such as driving. They may also be experiencing sadness, anxiety, loss of interest in once pleasurable activities, and other symptoms of major depression.
In moderate dementia, judgment, physical function, and sensory processing are typically affected. This can cause problems with personal hygiene, inappropriate language, and wandering. This stage — when your loved one is able to get around but has poor judgment — is physically and emotionally challenging for the caregiver.
“My dad went from being Mr. Nice Guy to Mr. Obsessed. And things were always worse at night. He was energized and I was physically exhausted,” says Robert Matsuda, a Los Angeles musician who worked full-time and cared for his father with Alzheimer’s Disease for three years before recently placing him in a nursing home.
As a patient moves from mild to moderate dementia, some home modifications that may include removal of throw rugs, installation of locks and safety latches, and the addition of a commode in the bedroom often need to be made.
This is also the time when the palliative care team should be brought in to support the caregiver and help manage behaviors.
Help Them Keep Their Animal Companion
There are many benefits to having a pet for older people. Cats, dogs, and other animals can provide continuing love and companionship for someone with Alzheimers. For those in the early stages, taking care of a pet can help them keep active.
If it becomes more difficult for the person to care for their pet, people can consider ways to keep them together. This may mean asking a neighbor or community member to take a dog for walks or ensure a cat receives its food on time.
Some organizations, such as Meals on Wheels America, may also be able to deliver pet food. Look for local charities that provide dog walking, cat sitting, and temporary fostering services for older adults with health conditions.
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Cna Perspectives On Caring For Residents With Dementia
Alzheimer disease and other dementias are common diagnoses in long-term care . In this setting, certified nurse aides provide the majority of care for residents with dementia. The responsibility can be challenging, however, as evidenced by frequent CNA staff turnover. Read about the findings of four focus groups made up of 20 CNAs to understand the unique barriers impacting their ability to care for these patients in a study reported by Managed Health Care Connect:
What Causes Alzheimers Disease
Remember that the brain is made of billions and billions of nerve cells called neurons. These neurons are responsible for thoughts and actions of the body. These neurons create the movement of typing or writing a paper or driving a car. When these neurons become damaged, physical actions and thoughts are affected.
In Alzheimers disease, researchers believe that the neurons and the spaces between the neurons fill with a protein deposit called beta amyloid . The protein creates what is referred to a plaques and tangles. Although this process is part of the normal aging process, those with Alzheimers seem to develop more. The plaques and tangles prevent the neurons from working properly. The messages sent between neurons to have a thought or move an arm is not sent because of the increased amount sticky plaque and tangles that have developed. The neurons become clogged with the abnormal amount of tangles and plaques and die off. The only positive way to determine if plaques and tangles are in the brain is to view the tissue . Doctors usually do this in an autopsy.
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Articles On Health Care Systems With Dementia And Alzheimer’s
If your loved one lives at home, you may want to hire someone to help you care for them. There are two main types of in-home care services: home health care and general in-home care.
Home health care is for people who need a nurse or other health care professional. They might need after-hospital care, help with their medicines, or physical therapy. These services may be covered by Medicare, Medicaid, or private insurance, at least in part.
In-home care is for people who need help to do things like take a bath, dress, make their meals, and help keep them safe. They also might do household chores or shopping. In general, these services arenât provided by nurses and arenât covered by insurance.
In-home care can be provided by a certified nursing assistant , home health aide , or personal companion. Although they often do many of the same roles, their level of training and experience could be very different.
CNAs must have more education, so under the supervision of a nurse, they can often do things like give medicines or change a wound dressing. In some states, home health aides are also trained to do these kinds of tasks.
Caring For Patients With Dementia Or Alzheimers Disease
Caring for someone with Alzheimers Disease or dementia can be one of the most challenging tasks a CNA faces during his or her career. In addition to taking care of the patients physical ailments, there are constant challenges that come with mental impairment. Often confused, patients may lash out when they do not understand what is happening. Helping to ease their minds by staying calm is one of the most important techniques, though there are other things that can greatly help when dealing with these patients.
It is common for Alzheimers or dementia patients to wander and become lost or take the wrong actions when they are confused. However, there are some small actions that can be taken to decrease their risk.
- Use locks or child gates to block stairs, doors, and windows.
- Provide an ID bracelet/necklace with a phone number.
- Keep medications, sharp objects, poisonous materials, and other potentially harmful materials locked up.
- When possible, activate controls for stoves and electronics.
- Do not speak loudly, restrain the patient, or make sudden moves.
Communication and Memory
When communicating with confused patients, there are several strategies that tend to help them understand better.
Caregiver Tips For Alzheimers In Home Care
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As a family member or caregiver, caring for someone with dementia or Alzheimers making them feel loved and wanted through long-term care is vital. This is a very difficult and complicated condition that can progress over time without cure or clear understanding of how long and how the disease progresses.
Family members or caregivers who are offering Alzheimers in-home care should ensure their patients are protected and taken care of with dignity. Following are a few sensible tips to help people feel confident about their lives and more likely to receive the care and help they desire.
Establish A Routine With A Daily Care Plan
The importance of routines and familiarity for dementia and Alzheimer’s patients cannot be underestimated. Creating a nursing care plan helps to reduce restlessness, anxiety, and other challenging behaviors.
Before making a structured daily plan, nurses need to get to know their patients, taking into account their abilities, likes, and dislikes. They should consider what times of day the patient functions best and when they need breaks or distractions.
While most care plans include regular times for waking up and going to bed, meals, and bathing, they should be flexible enough to allow nurses to adjust and experiment with activities that provide enjoyment and meaning. The best care plans include activities that help patients stay connected to their pre-dementia lives, such as watching a favorite TV show or movie. As the disease progresses, nurses should make sure the activities fit their patients’ ability levels.
Nurses should also include their own self-care needs when creating a daily plan, by incorporating activities that reduce their patients’ stress and their own, such as listening to music or taking a walk.
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Take Courses Or Read Guides
People can attend courses in person or do ones online that cover topics ranging from the early signs of Alzheimers to behavioral changes and financial planning.
People can find more information about caregiving by visiting the Alzheimers Association webpage or by reading this for caregivers from the National Institute on Aging .
These more comprehensive guides include step-by-step tips on how to help someone bathe, eat, and more.
Establish A Safe Space
One part of Alzheimers in-home care that makes it advantageous is that it all takes place in an environment that a patient is familiar with. It is easy for a person with Alzheimers to enjoy life and be cooperative with others if that person is in an environment that one is regularly found in.
But over time it can be easy for ones home to be dangerous. Over time, the lack of judgment and mental control on the part of an Alzheimers patient might be a real threat to ones life. Even ones home might make it a challenge for a person to feel confident about aging as it becomes harder to move around and enjoy life inside it.
Even ones home might make it a challenge for a person to feel confident about aging as it becomes harder to move around and enjoy life inside it.
But by creating a safer environment that is a little easier to control, it will be easier for people to feel positive about the aging process. You can help by ensuring that all of the floors and surfaces in a home are organized well and that any rugs, cords or other obstructions are kept out of the way.
You can also add locks to different surfaces around a home to ensure a patient does not get into any cabinets or other spaces that might contain potentially dangerous items. Any fire safety materials in your home can also be analyzed and cleaned out too.
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Complete Continuing Education Courses In Alzheimers Disease And Gerontology
As the population ages and the number of patients with all types of dementia increases, healthcare providers will need to become familiar with new techniques and treatments. Kriebel-Gasparro suggests that nurses can provide the best possible care to their patients through professional development and continuing education that focus on dementia and Alzheimer’s. She also recommends that nurses pursue advanced practice nursing graduate degrees that offer adult-gerontology specialties in acute care and primary care.
Several professional organizations offer continuing education credits and certification that help nurses keep current with changes in treatment and care options:
- The Gerontological Advanced Practice Nurses Association administers a gerontological specialist certification. Nurses may also choose from several continuing education options that focus on the signs and symptoms of cognitive degeneration and impairment, behavior changes, diagnosis, treatment, and management of dementia.
- Portal of Geriatrics Online provides a free collection of toolkits, competency-based case modules, continuing education courses, and geriatric nursing education materials.
- Engage-IL, administered by the University of Illinois at Chicago, provides evidence-based training and geriatric continuing education modules. The site offers free mobile apps to help identify behavioral symptoms of dementia and links to activity tool kits and national support services.
How Can We Help You
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Live-In Home Health Aides Often times an unplanned health care setback can create a need for an immediate home care solutions. Live-in home health aides can play a key role in providing companionship and a safe home environment after a health set back. Accountable Home Care can provide an affordable short term or long term
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Week 6 Skill Scenario #: Caring For People With Dementia Alzheimers
Dementia is a general term that refers to a serious loss of mental abilities such as thinking, remembering, reasoning and communicating.
Symptoms of Alzheimers disease appear gradually. Alzheimers disease begins with memory loss. They eventually cause dementia. As the disease progresses, it causes greater and greater loss of health and abilities.
People with Alzheimers disease may get disoriented. They may be confused about time and place. Majority of the sufferers are eventually completely dependent on others.
Stages Of Alzheimers Disease
The hallmark of Alzheimers disease is that it progresses gradually over a period of years. Typically, there are three stages that can be seen . These are early, middle and late. Each stage can also be classified as mild, moderate or severe.
The first stage may be mild and not very noticeable. Usually, family or others close to the person notice the symptoms. The patient typically has an idea that something is not right and may try to cover up their symptoms with confabulation or making up stories unconsciously to maintain self-esteem . Symptoms in the first stage include difficulty learning new material, decline in recent memory, difficulty performing tasks, appearance deteriorates, decrease concentration and judgment, time disorientation, difficulty finding words or naming objects. In this stage, since the patient is usually aware of their forgetfulness, they may withdraw socially and feelings of shame, helplessness and frustration may be seen .
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Nursing Assistant Skill Scenario: Care For People With Alzheimers Disease
Our nursing assistant online class teacher gives us this scenario: Caring for People with Dementia Alzheimers.
Today he is in the dining room before breakfast and he picks each wooden chair up, places in on the table with the legs up. He wiggles each of the legs and then puts the chair back down. He is telling other residents to get up and dont sit in the chair until hes checked it.
As the day progresses, he does this with every wooden chair he comes across that is sitting by a table. Other residents are becoming angry or annoyed by this behavior.
1. In order to solve the puzzle of his behavior, what should you keep in mind as you observe Marvins behavior?2. What do you think his behavior represents, and how can you help prevent his behavior from upsetting the other residents?3. What phase of dementia do you think he is in?
What Is Alzheimers
The disease was first described by and named after Dr. Alois Alzheimer in 1907 . Alzheimers disease is a progressive and fatal illness that causes areas of the brain to shrink. Symptoms typically appear in stages starting with a gradual decline in memory, judgment and personality changes. In later stages, physical symptoms appear including loss over body functions . Currently, the actual cause of Alzheimers disease as well as the cure are unknown.
Alzheimers is a form of what is called a degenerative brain disease. It is rarely seen before the age of 50, but when it is seen in younger patients, the stages of symptoms progress much quicker. Since the disease is progressive, symptoms will present in stages . Progressive deterioration of mental capacities, such as memory and confusion, lead to other symptoms such as dysphagia. As the disease advances, neurological signs develop such as paralysis of limbs and weakness. The progression of the disease can vary depending on age of onset. It may be a few months to several years before complete loss of function is seen. Diagnosis is made based on symptoms alone. These are no tests to confirm the diagnosis. Diagnosis is confirmed after an autopsy is performed and the damage to the brain can be seen.
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