How to Work With Patients With Dementia
Nearly seven million people in the United States suffer from dementia, a collection of symptoms caused by changes to the brain cells, according to the U.S. Congress Office of Technology Assessment. Dementia affects memory and reasoning, language skills, behavior, emotional control and psychosocial functioning. Dementia is a chronic, progressive condition that can be slowed with treatment, but not cured. Patients require increasing amounts of care through the end of life.
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Instructions
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Ensure physiological needs are met. The patient's need for assistance with daily activities increases as the condition progresses. This may include providing help with dressing, eating, toileting, bathing, and taking medication. Changes in personality, ability and behavior should be reported to the appropriate healthcare provider so that treatment protocols can be adjusted as necessary.
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Provide for the patient's safety. Diminished reasoning capacity, loss of memory, and increased aggressive tendencies can make the patient a threat to his own well-being and that of those around him. Keep hazardous objects out of reach. Install safety rails in the bathroom and on the patient's bed. Install locks and alarms on doors to prevent the patient from wandering, and make sure he wears identification as a back-up measure. Supervision should be provided at all times.
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Monitor the environment. Over-stimulation worsens dementia symptoms. The patient's environment should remain uncluttered, quiet and calm. Limit visitors, simplify decorations in the home, and maintain a slow-paced schedule for the patient. Routine and predictability will help the patient function more effectively and promote cooperation and emotional well-being.
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Encourage independence. Kathleen Fletcher, clinical assistant professor of nursing at the University of Virgina School of Nursing, recommends maximizing the patient's functional capability. Exercise will promote continued mobility. A structured schedule will allow the patient to provide self-care for a longer period of time. Encourage the patient to use his strengths, even as he receives assistance to compensate for his failing abilities.
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Promote cognitive and leisure activities. The National Institutes of Health report that intellectual stimulation may slow the progression of dementia. Similarly, multiple studies, according to NIH, show that engagement in leisure activities, exercise and social interaction improve patients' mood and quality of life. Ensure that activities are safe and appropriate to the patient's level of ability.
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Communicate clearly. Dementia diminishes language skills. Patients may forget the meaning of particular words, repeat themselves, or require more time to process verbal information. Mayo Clinic recommends talking slowly, using short sentences and simple words. Provide cues such as pointing at the object about which you are speaking. Listen patiently and show interest while the patient is talking. Avoid criticizing or arguing.
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Tips & Warnings
Encourage family members to receive caregiver education and support. The patient will benefit from their increased understanding and skill. The family will benefit from the interpersonal support that groups can provide.
Be aware that dementia patients sometimes exhibit uncharacteristic aggression or other violent behavior. Don't take it personally. Dementia affects emotional control. The frustration the patient experiences as his capabilities decrease sometimes leads to aggressive outbursts. Address the behavior in a calm and non-judgmental way. Moderate to severe dementia patients require constant supervision. Never leave a patient unattended, even for a short period of time.
