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A long term care facility with 24 dementia residents in a secure unit wanted help to develop a plan to give the residents with dementia the best care possible. They had already taken some steps towards improving the level of care by
recognizing the importance of providing dementia education for their staff and providing the appropriate level of training for all involved staff
ensuring consistent staffing in the secure unit including assigning a full-time recreation worker to the unit
These changes had a positive impact, but they soon realized that there was still room for improvement.
To increase the likelihood of a given activity or program for people with dementia being successful, many factors have to be taken into account. Of obvious importance is that the chosen activity be meaningful to the participant(s) and appropriate for them, but also important is the time of day that the activity is presented.
Brain function is affected by the circadian rhythm (natural alterations in alertness that happen during the course of 24 hours), and some activities are more appropriate than others at a given time of day. For example, energy levels and capacity to do physical activity are greatest early in the day, whereas cognitive alertness occurs a little later.
Does depression cause dementia? While no direct causal relationship has been proven, studies show that depression does in fact contribute to the onset of dementia.
Many people suffer from various degrees of depression and as we age, depression becomes more and more prevalent. Our ability to do things that we used to take for granted diminishes, our memory naturally declines as we age and our physical abilities also decline through aging. These factors often take their toll on our self-esteem and contribute to a state of depression.
When you look at the cartoon, what is your first thought? Do you think
It makes sense
I know someone who does that
He can’t do that!
It's a funny cartoon, but if we think about what it depicts, we can learn from it. One of the most important lessons we teach in our training is to observe the person and try to determine why a particular behavior is occurring and what we can do to prevent or modify it. To do that, we have to answer questions about the behavior.
In my visits to long term care homes, I usually have the pleasure of receiving a tour of the facility. Invariably, as we tour around, the conversation turns to “Montessori Carts” and my thoughts on how to best put one together or improve the one they already have.
I’m going to go against the grain and say that personally I don’t really understand the benefit of having a Montessori cart at all. Let’s look at why.
Where does the concept of a Montessori cart come from?
If you are like me and are interested in Montessori for dementia, you probably scour the internet for all things Montessori trying to learn everything you can about Montessori for children in order to gain a better understanding of the philosophy so that you can apply it effectively.
When we offer an activity to someone with dementia, we should do everything we can to ensure their success. We generally focus on the person's abilities when deciding if an activity is appropriate, but other factors are also important. Vision is one such factor.
Even without any underlying problems, our vision deteriorates as we age. Disorders such as age-related macular degeneration or cataracts can make matters far worse. Before choosing an activity, it is important to ensure that the person's vision will not hinder them in being successful.
Have you ever been in a store or public place and people around you are speaking in a language you don't understand? Maybe they're even glancing your way and gesturing. Do you wonder if they might be talking about you? Imagine what that would be like for someone with dementia. People with dementia often experience feelings of paranoia and caregivers speaking a language that they don't understand can make it worse.
Unfortunately, we see this all too often in care facilities. As in most workplaces, staff in facilities come from a diverse background and many have a first language other than English. It is natural that they talk to their coworkers in that language. The problem arises when they do it in the presence of the residents. While the conversation may have nothing to do with the resident, it can still cause the person to become upset.
Are you too warm? Too cold? Do you feel better when the temperature is just right?
For most people, when the temperature is too warm or too cold, their mood is affected. An ongoing study shows that for people with dementia, the effect can be significant. Frederico Tartarini, a PhD student in Australia is in the middle of studying the effects and, while his final results will be released in his PhD dissertation next year, he has released some preliminary findings.
If a person that you are caring for asks "Where's Henry?", referring to their spouse who passed away several years ago, how do you respond? Do you tell them that Henry passed away three years ago? Do you ignore the question and start talking about something else? Or do you lie and say that Henry is away for a while?
Telling them the simple truth is quick and easy (at least in the short term), but may not be the best approach. It may result in the person having bad feelings, perhaps even becoming distraught, and it could happen over and over again.