Person-Centered Care in Residents with Dementia

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Q. Can you talk a little bit about your experience, specifically with dementia patients?
I’ve worked in long-term care for 35 years. I began my career as nurse aid and then attended college to become a social worker. Next, I became an Administrator. From there I became a Regional Vice President, where I oversaw multiple skilled nursing organizations. I then became a Certified Dementia Practitioner.

It was clear to me early in my career that I was drawn to the behavioral aspect of resident care. I found myself extremely interested in residents that acted out. It became my personal mission to uncover why these residents were acting out so I could help solve the problem to improve behavior. This led me to an interest in dementia and residents with dementia.

When I helped open a new CCRC in Georgia, I was determined to create and implement a new person-centered care program for our specialized dementia unit. I drew on my decades of experience, research, and education to create a thorough person-centered care program that was specific to residents with dementia.

We really started at the beginning to create this new program. We started with the hiring process. I was able to take my time and hand-select the right staff. From there, we successfully launched the program with great results. We had dementia residents that came to us bed-bound. Because we restored their usual routines the residents improved and became more independent.

As a result, we saw satisfaction rate soar with both residents and families. I was able to replicate this dementia program across multiple buildings when I re-entered a regional role later in my career. I loved working with nurses to educate them on how to identify behaviors and connect them to communication challenges. From there, it was easy to help nurses understand how to overcome these barriers.

My work with person-centered care for residents with dementia has been one of the most rewarding aspect of my career in healthcare.

Q. Let’s talk about dementia. Are there different kinds? What are some of the early symptoms?
Most people lump all dementia together, but there are many different kinds and stages.

The types of dementia are:

• Alzheimer’s disease
• Vascular dementia
• Dementia with Lewy bodies (DLB)
• Mixed dementia
• Parkinson’s disease
• Frontotemporal dementia
• Creutzfeldt-Jakob disease
• Normal pressure hydrocephalus
• Huntington’s disease
• Wernicke-Korsakoff Syndrome

Source: here

The stages are:

Source: here

Q. In dealing with residents with dementia, how are their communication needs different?
Residents with dementia that have reached the middle stages are in a world they don’t know anymore. The staff are complete strangers to them. Even modern technology can be frightening to them. Dementia patients first begin to lose their short-term memory and it deteriorates back to childhood. So, they find themselves in a time where computers and phones didn’t exist.

Even beyond a lack of recognition for technology, dementia patients eventually forget their families. The forget their spouse, their children. Many times this lack of recognition of their surroundings manifests as extreme fear or anger. Staff need to be extremely sympathetic to this.

The good news is that with training, staff can begin to understand and help residents with dementia. A few ways staff can communicate better with residents with dementia are:

1. Always approach a resident from the front. Don’t come from behind or the side of the resident. Give them visual cues you are coming to ensure they know you are approaching them and know they aren’t frightened by your advancement.
2. Call them by their first name. They are most likely to remember their first name.
3. Speak slowly. Residents with dementia have a hard time comprehending fast sentences and thoughts.
4. State the purpose of why you are speaking to them. Also, make sure they can hear you.
5. Eliminate distracting noises. Typically, with more noise there is more distraction and the more they will act out.
6. Give them one task to do at a time. If you want them to put their shoes on and stand up, ask them to put their shoes on. Once their shoes are on, then ask them to stand up.

Denise Ogden, Director of Corporate Development of COMS Interactive