The most common cause for combative behavior in clients with dementia is confusion about their care. Because of memory loss, clients become confused when staff members try to help them. Clients may not recognize their caregivers, or may not want to do what the caregiver is telling them, such as getting up, eating, or taking a shower. The clients' automatic reaction will be to say "No" and push, hit, or kick. Always allow plenty of time when dealing with the clients. Speak softly and explain what is happening. Don't argue. Remain calm and be prepared to try again in a few minutes.
Reality orientation involves repeating information to help clients understand their surrounding. To keep a client oriented, their name is used frequently. Information such as date and time are reinforced with calendars and clocks.
It is beyond the scope of practice for a nurse aide to deal with some client situations, such as leaving against medical advice (AMA). Immediately inform the nurse or a supervisor. Stay with the client and reassure her that the nurse will help her. Try to redirect her focus or offer a new activity.
The GDS will become known to CNAs who work in a facility with residents who have dementia or Alzheimer's disease. Pre-dementia stages 1-3 are those with no or minimal evidence of decline. Inability to concentrate, work completion, and social retreat are symptoms of stage 4. Stage 5 includes some ADL assistance and the inability to remember recent facts, such as the present date or location. Stage 6 calls for significant assistance with ADL, incontinence, and loss of family recognition. Stage 7 calls for total care and the inability to walk or speak.
Play along if a client seems perplexed, but don't. If you encourage the confusion or hallucination, this only increases the client's fear. Reasonable justifications won't be of any use because the client fervently believes the fantasy. The best course of action is to calmly confront the issue head-on. Bring the client with you to the closet to reinforce reality. Remind the client of their surroundings as you stay by their side.
Memory prompts are ways to help clients stay oriented to place and time. A calendar and a clock in each client's room are useful. Bulletin boards and public areas can be decorated for seasons and holidays. Repeat information at regular intervals to reinforce where the client is and what is happening.
Knowing the signs of aggressive behavior can help you prevent a situation from escalating. An aggressive episode can develop unexpectedly. If the client has a clenched jaw or fist, or suddenly begins to pace or rock, act quickly. Assess the situation to find a possible cause. Is the client in pain? Tired or hungry? Overstimulated? Confused? Use a calm manner to deal with the client. Eliminate distractions and try to focus on a new activity.
Use a calm voice when conversing with a client who is confused or upset. Call the client by name and speak personally to them. Use brief sentences and give the client time to answer. Always be respectful and deal with clients like adults.
Never employ a restraint as a form of punishment or for staff comfort. Never use shackles to intimidate a resident, either. Only with a doctor's order and for specific purposes can restraints be used. Attempt to determine the resident's needs. They frequently need to use the restroom, are hungry or thirsty, or have a reason for wanting to get up.
Eating can become a challenge for a resident with dementia. Start by reducing distractions so that the resident can focus on the meal by making the dining area quiet and calm. Make it easy for the resident to eat by serving finger foods, using bowls instead of plates, and putting lids on cups. Small meals and snacks are appropriate for the limited attention span of these residents.
Knowing the signs of aggressive behavior can help you prevent a situation from escalating. An aggressive episode can develop unexpectedly. Act immediately if the client's jaw or fist is clenched, if they start pacing or rocking suddenly. Assess the situation to find a possible cause. Is the patient hurting? Tired or hungry? Overstimulated? Confused? When interacting with the client, remain composed. Cut out the noise and make an effort to concentrate on your new task.
Getting dressed can be a source of confusion for a client with dementia. Simplify the process by limiting choices of clothing. If the client has a favorite outfit, try to get several identical sets. Clothing should be comfortable and easy to get on or off. Help the client by placing clothes in the order they are put on.
Alzheimer's patients may find doll treatment beneficial. Dolls, according to studies, help relax and calm residents and reduce wandering. Additionally, a doll can help with communication and speaking. The loss is handled appropriately because the doll is viewed as "genuine" by the resident. A fresh doll can eventually be introduced to the resident. It's crucial to remember that men can also appreciate dolls.
Residents with late-stage dementia or Alzheimer's lose their ability to communicate with speech. They are still able to understand some verbal communication, so talking to them in simple sentences is useful. They can also express themselves with facial expressions, emotions, and body language.
Often the first symptom of Alzheimer's disease is a loss of short-term memory. The client can still recall events and information about the past until the disease progresses to complete loss of brain function. Depending on the stage of Alzheimer's, a client could certainly detect the smell of a fire.
A dementia resident may find it difficult to eat. Make the dining area calm and quiet to start removing distractions so the resident can concentrate on the meal. By presenting finger foods, using bowls in place of plates, and covering cups, you can make it simple for the resident to eat. Small meals and snacks are suitable for these residents because of their short attention spans.
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CNA Care Of Cognitively Impaired Residents #2
