The elevator stops at oz


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Presentation by Dr. Sherri Bernier, Ed.D.

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The elevator stops at oz

  1. 1. The Elevator Stops At OZ:Entering The World ofDementia Dr. Sherri Bernier, Ed.D. Bernier, 2009
  2. 2. Abstract There’s no place like home… Harr and Kasayka (2000) state that “to create comfortable and secure environments and programs that foster human dignity and individuality, we must understand how the ‘the power of place’ influences the preservation of resident personhood” Bernier, 2009
  3. 3. Achieving a harmonious environmentand enhancing the “quality of life” inthose afflicted with dementia mustinclude opportunities for freedom ofchoice, sensory stimulation, andsocial interaction. Allen-Burge,Stevens, and Burgio (1998)contended that challenging behaviorsassociated with dementia includebehavioral deficits such as thefunctional domain of peer interaction.It is imperative that all healthcaredisciplines be educated and trained to Bernier, 2009
  4. 4. “enter the world of dementia” in thequest to cultivate pleasantrelationships and to decreaseagitation in those they serve. Thismethod supports innovatedtechniques and creative interventionsfor the helping professional in the fieldof dementia care. Bernier, 2009
  5. 5. Achieving a harmoniousenvironment means promoting: Autonomy: freedom of choice A sense of control Socialization Sensory stimulation Least restrictive surroundings Caregivers trained to meet both emotional and physical needs of the person afflicted with dementia Bernier, 2009
  6. 6. The Approach: Remember when interacting with someone who has dementia, you are entering “their world” Always approach from the front It is of the utmost importance to make eye contact so that the person remains focused Bernier, 2009
  7. 7. Dining Early afternoon dinners are recommended due to “sun-downing” Finger foods for those in mid-latter stages of the disease; i.e. chopped ham and pickle Pasta that can be eaten with a spoon; i.e. elbow macaroni Bernier, 2009
  8. 8. Environmental Safety: Well lit rooms Furniture should not clutter living space Lock away small items that could easily be put into pockets or mouth; i.e. silverware, keys, small easily swallowed or breakable items Be cautious of the noise level Bernier, 2009
  9. 9. Supporting Language Become familiar with the cognitive impaired person’s vocabulary: frequent used words When words are not used appropriately, do not correct the person Be attentive to the person’s body language Keep conversations simple and direct Encourage person to speak using gestures,cues, and supportive devices Bernier, 2009
  10. 10. Dealing with Poor Judgment andInsight Limit choices Encourage fidelity: trust and loyalty Do not use authoritarian or judgmental approaches Dismiss yourself at the first display of aggressive behavior Bernier, 2009
  11. 11. Behavior Interventional Studies Holmberg (1997) -Walking Program-71% reduction in agitation Buettner et al.(1996)-Recreational Therapy-30% decrease in staff incident reports of aggression Williams et al.(1994)-In-service Training-significant decrease in incident reports Gerdner (2000)-Music Therapy-65% decrease in observed agitation Hussian (1988)-Stimulus Enhancement-85% reduction in frequency of observed behaviors Cleary et al.(1988)-Special Care Units-53% decrease in agitation levelSnowden, Sato, & Roy-Bryne (2003) Bernier, 2009
  12. 12. Communicating in the “Time-Line”of the Dementia Resident By asking open-ended questions, find out where in ‘time’ the resident is at that present moment Enter into the resident’s moment; i.e. if the resident is crying about a person such as a parent, ask questions about the event that is going on By entering their world, we may decrease agitation and can become part of a pleasant interaction Bernier, 2009