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Helping People with Dementia
This document discusses person-centered care for people with dementia. It outlines the principles of a person-centered approach, which focuses on viewing each person as a unique individual. As dementia progresses, individuals experience increased physical, social, and emotional impacts that affect their needs. Caregivers should meet these varied needs while respecting each person's dignity, preferences, and self-worth through effective communication, empathy, and validation. A range of support services can help address medical, social, and emotional needs for people with dementia and support their caregivers.
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Helping People with Dementia
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- 2. Person centered careseeks to view the person with dementia as a whole and study how the person is influenced. A person centered approach has following principles: • Uniqueness • Complexity • Enabling • Personhood • Value of others • Empowerment Using person centered approach
- 3. • Person centredcare is not a suitable method of care for a confused person because they cannot assess their own needs. • Some aspects of person centred care would include comforting the client by talking, a gentle touch, maintaining eye contact, providing attention, validating their feelings, understanding their individual needs and making them feel important. Using person centered approach
- 4. Individual needs As dementiaadvances, bodily functions are lost and mobility becomes difficult. The needs of the client increases and they become dependent. Some of the individual needs includes: • Mobility • Eating and drinking • Bathing • Hygiene • Dressing • Oral Health • Podiatry • Risk and safety • Encouragement • Acceptance • Validation
- 5. Individual needs As dementiaadvances, bodily functions are lost and mobility becomes difficult. The needs of the client increases and they become dependent. Some of the individual needs includes: • Mobility • Eating and drinking • Bathing • Hygiene • Dressing • Oral Health • Podiatry • Risk and safety • Encouragement • Acceptance • Validation
- 6. Work with awarenessof the physical, social and emotional impact of dementia on a person: 1. Physical impact 2. Social impact 3. Emotional impact Individual needs
- 7. 1. Physical impact •Gradual decline in the physical health. • Memory loss, confusion and disorientation. • Gradually, severe memory loss may be apparent. • They may need assistance in performing activities of daily living. Physical Impact
- 8. 2. Social Impact •Society rarely shows empathy towards people with dementia. • They are isolated because they are old and they forget things. • Lack of patience and understanding can lead to discrimination. Social Impact
- 9. 3. Emotional impact •Feel ignored and hurt very easily. • May also cause mood disturbances and depression. • May neglect aspect of their lives as they do not know how to deal with Emotional Impact
- 10. Dementia and other cultures •Dementia sufferers from different cultures may: o have different understandings of dementia o have different beliefs of the causes of dementia o feel stigma associated with dementia o present late for diagnosis o not know how to access appropriate services
- 11. Services provided tothe older people Adult day care Home health care In- home respite care Government programs
- 12. • Adult daycare: Provides supervision and social opportunities for people with dementia outside of the home for anywhere from a few hours to a whole day. Adult day care agencies normally do not offer overnight care. Many can provide personal care such as assistance with medication, toileting and eating. Meals are often included. Services provided to the older people
- 13. • In-Home respitecare: Provides caregivers with a break while providing supervision and social engagement to people with dementia. Some respite providers are not licensed to provide personal care, but can provide socialisation and light meal preparation. These types of respite care providers are appropriate during early stages of dementia. Services provided to the older people
- 14. • Home healthcare: Provides medical care services such as injections, frequent blood pressure checks. Services provided to the older people
- 15. • Government programs: Severalprograms may be available to help meet the needs of people with dementia. For example, Meals on Wheels. Services provided to the older people
- 16. Services and referralsfor clients with dementia The person’s doctor can put you in contact with: • Aged Care Assessment Team • Commonwealth Respite and Carelink Centres • Commonwealth Carer Resource Centres • Counselling
- 17. Tips for effective communicationskills • Talk to the client as an adult and maintain their dignity. • Do not use childlike language when speaking to them. • Speak clearly and try to use a gently tone. • Use person’s preferred name.
- 18. Tips for effective communicationskills • When greeting a client help them by reminding them who you are, like Hello Jean, its carol here. • Keep sentences short and simple. Never overload the client with too much information. • Use body language - gestures, facial expressions and visual demonstrations.
- 19. Tips for effective communicationskills • Use of touch to gain attention and convey feelings. • Avoid use of very modern words, it may frustrate the client. • Assess whether your client has special needs such as hearing or visual impairment that you should take into consideration.
- 20. HONESTY Carers should aimto be honest with clients, explaining clearly what they are doing and why, and giving clients the opportunity to express views or feelings. Tips for effective communication skills
- 21. EMPOWERMENT Let the clienttake small responsibilities. Look for strengths and skills in each client and empower them by encouraging them to use their skills. This will boost their confidence and give them a feeling of independence. Tips for effective communication skills
- 22. ENCOURAGEMENT Always encourage theclient to do as much as possible for themselves. Never try to bully or intimidate them. Allow them to use their skills like cooking, games, sewing etc. But always encourage them in a safe and risk-free environment. Tips for effective communication skills
- 23. AVOID LABELS Try notto label people as problems. Consider how it may affect their personality. Labeling someone as aggressive may make other carers nervous of them. Likewise labeling someone as a wanderer may result in others being over restrictive towards them. Tips for effective communication skills
- 24. ACCEPTANCE Recognise all theskills the person with dementia still retains after focusing on the losses and accept them for the unique person they are. Tips for effective communication skills
- 25. PATIENCE Allow time forthe patient to perform their activities. Wait for replies when talking, do not hurry them when walking and allow plenty of time to finish eating. Tips for effective communication skills
- 26. VALIDATION Validation strategies involvethe acceptance and confirming of the client’s feelings and own experience of reality. Pay attention to your clients facial expressions. This often helps reduce anxiety, distress and agitation and promotes a sense of security. It is important to let clients go back to the past and to validate their memories. Tips for effective communication skills
- 27. INCLUSION Allow clients toparticipate as much as possible in the daily activities of the house. Folding clothes and linen, cooking and washing up may be arranged for those who enjoy household chores. Tips for effective communication skills
- 28. Empathy Acceptance of theperson's reality Acknowledgment Allowing expressions of distress Providing verbal and/or physical reassurance Use reminiscences frequently to connect with clients Tips for effective communication skills
- 29. IHNA offers qualificationsin aged care, disability and nursing. Go to http://www.ihna.edu.au to kick start your health career. Thank you for viewing this presentation!
Editor's Notes
- #2 Phases of dementia – Institute of Health and Nursing Australia
- #5 As dementia advances, bodily functions are lost and mobility becomes difficult. The needs of the client increases and they become dependent. Some of the individual needs includes: Mobility A lot of physical assistance would be required. Ensure clients get appropriate exercises to prevent loss of muscle power. Advice use of walking aids like sticks, walking frames etc. Ensuring chairs are high enough for clients to get in and out easily. Eating and drinking Some client may show signs of withdrawal from food. Organise a visit from the dietician if the client is loosing weight. Use colorful bowls and plates to serve the food. Try decorating the food before serving. Maintain a calm and pleasant environment in the dinning area. Test food for temperature. Present courses one at a time to avoid confusion. Serve food like salads, fruits, chicken etc. in bite sizes. Incontinence It is a major problem as dementia worsens. It is the loss of control over urinary bladder. Make sure the client toilet regularly. Gently redirect the client by labeling places like playing, TV watching., puzzle solving. This will redirect the mind to such activities. Review and change the drinking patterns. Use continence aids like urinals or bedpans. Bathing Clients with dementia may loose interest in bathing and hygiene. Try to break each task into small steps like undressing, washing and personal care. Allow time for the client and give encouragement. Maintain the same routine everyday at a fixed time. Check the water temperature. Make sure the bathroom is warm and well lit. Use gentle soap only. Hygiene Monitor the clients personal hygiene. Encourage independence by allowing them to do by themselves. Be aware of safety issues. Dressing Supervise clothing along with providing independence to the client. Make sure the client has clean clothes. Lay clothes in a order such that it can help client to dress easily. Allow plenty of time. Avoid stockings and tight tops. Oral Health Poor oral health can have a impact on the clients nutrition and general health. Help the client brush and rinse their mouth frequently. Use a soft toothbrush. Encourage intake of water. Rinse dentures after each meal. Podiatry Care of feet is very important. Make sure their nails are clipped and feet kept dry. Give suitable shoes and slippers which are easy to wear. Risk and safety Assess the risks of the client like fall risk(fall from bed/ chair), risk from environment(very hot water for bathing) etc. These risks should be eliminated by the carers. Encouragement It is very important to encourage the client in all the activities they perform. Acceptance Recognise all the skills of the person with dementia rather than focusing on the losses. Make the person feel important Validation Enter into the feelings and experiences of the person to try to understand them better.
- #6 As dementia advances, bodily functions are lost and mobility becomes difficult. The needs of the client increases and they become dependent. Some of the individual needs includes: Mobility A lot of physical assistance would be required. Ensure clients get appropriate exercises to prevent loss of muscle power. Advice use of walking aids like sticks, walking frames etc. Ensuring chairs are high enough for clients to get in and out easily. Eating and drinking Some client may show signs of withdrawal from food. Organise a visit from the dietician if the client is loosing weight. Use colorful bowls and plates to serve the food. Try decorating the food before serving. Maintain a calm and pleasant environment in the dinning area. Test food for temperature. Present courses one at a time to avoid confusion. Serve food like salads, fruits, chicken etc. in bite sizes. Incontinence It is a major problem as dementia worsens. It is the loss of control over urinary bladder. Make sure the client toilet regularly. Gently redirect the client by labeling places like playing, TV watching., puzzle solving. This will redirect the mind to such activities. Review and change the drinking patterns. Use continence aids like urinals or bedpans. Bathing Clients with dementia may loose interest in bathing and hygiene. Try to break each task into small steps like undressing, washing and personal care. Allow time for the client and give encouragement. Maintain the same routine everyday at a fixed time. Check the water temperature. Make sure the bathroom is warm and well lit. Use gentle soap only. Hygiene Monitor the clients personal hygiene. Encourage independence by allowing them to do by themselves. Be aware of safety issues. Dressing Supervise clothing along with providing independence to the client. Make sure the client has clean clothes. Lay clothes in a order such that it can help client to dress easily. Allow plenty of time. Avoid stockings and tight tops. Oral Health Poor oral health can have a impact on the clients nutrition and general health. Help the client brush and rinse their mouth frequently. Use a soft toothbrush. Encourage intake of water. Rinse dentures after each meal. Podiatry Care of feet is very important. Make sure their nails are clipped and feet kept dry. Give suitable shoes and slippers which are easy to wear. Risk and safety Assess the risks of the client like fall risk(fall from bed/ chair), risk from environment(very hot water for bathing) etc. These risks should be eliminated by the carers. Encouragement It is very important to encourage the client in all the activities they perform. Acceptance Recognise all the skills of the person with dementia rather than focusing on the losses. Make the person feel important Validation Enter into the feelings and experiences of the person to try to understand them better.
- #7 Work with awareness of the impact of physical, social and emotional aspects of the environment on the person with dementia Physical impact: A person with dementia experiences gradual decline in the physical health. He may have memory loss , confusion and disorientation. He may also feel neglected and show signs of social withdrawal. As dementia progresses that may have severe memory loss. They would even need assistance in performing activities of daily living. Social impact : In very rare cases society shows empathy towards the people with dementia. There are situations when they are categorized as abnormal. They are separated because they are old and they forget things. These behaviour comes from the youngsters because of lack of patience. Due to such discrimination the older people feel neglected and not wanted in the society. Emotional impact: People with dementia are usually very weak at heart and feel ignored and hurt very easily. They would feel incapable of doing any work and hence ignore every details of their lives. The disease condition may also cause mood disturbances and depression. Hence, it is very important to make them feel wanted by giving attention and listening to them. A person centered care approach can also help build self confidence in them.
- #8 Physical impact: A person with dementia experiences gradual decline in the physical health. He may have memory loss , confusion and disorientation. He may also feel neglected and show signs of social withdrawal. As dementia progresses that may have severe memory loss. They would even need assistance in performing activities of daily living.
- #9 Social impact : In very rare cases society shows empathy towards the people with dementia. There are situations when they are categorized as abnormal. They are separated because they are old and they forget things. These behaviour comes from the youngsters because of lack of patience. Due to such discrimination the older people feel neglected and not wanted in the society.
- #12 The Australian healthcare system has a good network of active services for the ageing population. Some of them includes: Adult day care In home respite care Home healthcare Government programs
- #17 Servicers and referrals for clients with dementia Information might come from any of the following sources: Their local doctor may provide advice on support services, counselling and help to the client and families, particularly those who will be responsible for caring for clients. The doctor can put you in contact with an Aged Care Assessment Team. Aged Care Assessment Teams (ACAT) help older people and their carers work out what kind of care meets their needs when they can no longer manage without help. They have a range of health professionals to assess needs and suggest options. Information on ACATs is available from the Commonwealth Carelink Centres. Commonwealth Respite and Carelink Centres They provide information on aged care, community care services and programs and how to access them anywhere in Australia Commonwealth Carer Resource Centres They provide information and assistance on carer services and entitlements and advice for carers. They can put families in contact with Carer Associations in all states and territories. A copy of the Carer Information Kit can be obtained through them in each state/territory Counselling Which can be sought through the Carer Associations to assist with stress, loss, grief and coping skills Centrelink can provide information on pensions and financial support for carers. Alzheimer’s Australia provide extensive information, support and counselling – they produce useful information including simple fact sheets Aged Care Australia can provide information and booklets on aged and community care, and has a very good website.