Transcript PMA 2020 Alzheimer’s Disease Curricula

ACT on Alzheimer’s
Disease Curriculum
Module IV: Effective Interactions
Effective Interactions
• These slides are based on the Module IV:
Effective Interactions text
• Please refer to the text for all citations,
references and acknowledgments
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Module IV: Learning Objectives
Upon completion of this module the student should:
• Understand the principle of person-centered care and
the importance of recognizing each person as a unique
individual.
• Articulate verbal and non-verbal communication that
people with cognitive impairment may display.
• Reframe what is traditionally labeled difficult behaviors
to expressions of needs, desires, and distress and
understand how those expressions are manifested in
specific behaviors.
Dementia Care Overview
Suggestions for Dementia Care
• The patient is a person, respect that
individual’s humanity
• The changes in this person are a result of a
brain disease over which the person has no
control
• Different or challenging behaviors may be the
only way for this patient to communicate
Three Keys to Quality Interactions
• Affirm the person’s feelings, show empathy
• Solve the problem whenever possible
• Distract and/or relocate
Person-Centered Care
• Patient care should be personalized, so a
caregiver needs to understand:
– What makes this person unique
– His or her personality
– What core qualities define this person
• Caregivers can use these core personal
qualities to develop suitable, personal care
Effective Communication
Communication Overview
• A dementia patient’s communication patterns
will change over time and a caregiver’s
communication techniques need to change as
well
• The best way to support a person with
dementia (and to communicate effectively) is
to build a relationship with that person
Communication Challenges
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Word-finding difficulty
Repetition
Loss of reading and writing ability
Revert to native language
Loss of ability to speak in clear sentences
Loss of ability to understand
Inability to use words
Communication Tips
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Talk to the person in a place free of distraction
Begin conversation with orienting information
Look directly at the person
Make sure you have the person’s attention
Be at eye level with the person
Speak slowly and clearly
Communication Tips
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Use short, simple sentences
Ask simple yes/no questions
Use concrete terms and familiar words
Talk in an easy-going, pleasant manner
Allow sufficient time for the person to
respond
• Break up tasks into smaller steps
Having Trouble Being Understood?
• Be sure that you are allowing enough time for
the person to process and respond
• Demonstrate visually what you are saying
• Think about the complexity of what you are
saying
• Try a hug and change the subject
Having Trouble Understanding?
• Listen actively and carefully
• Try to focus on a word or phrase that makes
sense
• Respond to the emotional tone of the
statement
• Stay calm and be patient
• Ask family members about possible meanings
Things Not To Do
• Do not:
– Argue with the person
– Order the person around
– Tell people what they can not do
– Be condescending
– Ask questions that rely on good memory
– Talk about people in front of them
When Verbal Communication Fails
• Try distracting the person
• Ignore a verbal outburst if you can not think of
a positive response
• Try other forms of communication
• Learn your own body language
• Learn the other person’s body language
Physical Interaction
Making a Positive Physical Approach
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Come from the front
Go slow
Get to the side
Get low
Offer your hand (palm up)
Use the person’s preferred name
Wait for a response
Assessing Behaviors
Common Behaviors
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Walking about
Exiting or trying to leave
Wanting to go home
Showing fatigue as the
day progresses
• Sleep disturbances
• Looking or searching for
things
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Gathering
Shopping
Expressing discomfort
Having hallucinations or
delusions
• Being suspicious or
paranoid
• Repetitive actions
• Loud verbalizations that
may not be coherent
Why Challenging Behaviors Occur
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Change in environment
A caregiver’s approach to communication
Past history and behaviors
Internal needs of the person
The task that the person is doing
Inability of the person to express needs or
desires
A Different Way to View Behaviors
Wandering
Demonstrating mobility
Sundowning
Tired at end of day
Rummaging
Gathering / Exploring
Hoarding
Shopping
Resistance to care
Feeling uncomfortable
When Is Behavior a Problem?
• It violates the rights of others
• It poses a threat to someone’s health and
safety (including one’s own)