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Flashcards in Dementia - Management Deck (18):
1

Primary goal for nursing care of dementia? (3)

Promote
– maximum function
– dignity
– QOL
for the person with dementia.

2

Key aspects in providing care. (4) PUPS

Patience
Understanding
Provide approp. info.
Support independence + self-directed care

3

6 Care Environments AAAHHL

Adult day programs
Advanced directives
Assisted living
Home health care*
Hospice care
LTC facilities
* "Really important. Part of the Canada Health Act. People can self-refer."

4

4 frameworks for interventions
~ Piaget, get OUT of here already.

• Progressively Lowered Stress Threshold Model
• Need-driven Dementia-compromised Behavior Model
• Cognitive Behavioural Approach
• Neurodevelopmental Sequencing Model

5

Progressively Lowered Stress Threshold Model
– Framework's raison d'être

Ability to tolerate stress (internal/external) declines with disease progression.

6

Progressively Lowered Stress Threshold Model
– Goals (summary slide - 2 points)

• Identify + eliminate/reduce stress-inducing stimuli
• Maintain max. function through supportive environment

7

Progressively Lowered Stress Threshold Model
– Mantra/Interventions

Adapt processes to reduce stress!
Routine, rest, memory cues, simple choices, a place for everything and everything in its place

8

Need-driven Dementia-compromised Behavior Model
– Framework's raison d'être

Person cannot communicate verbally and does so behaviorally. Reframe disruptive behaviour as an expression of unmet needs.

9

Need-driven Dementia-compromised Behavior Model
– Goals (summary slide - 3 points)

Assess / organize
personal / environmental factors
to
• identify / understand unmet needs
• provide individualized care
• reduce dysfunctional behaviour

10

Cognitive Behavioural Approach
– Framework's raison d'être

Cognitive skills + functional abilities seen as lost
in reverse order from which originally learned.

11

Cognitive Behavioural Approach
– Goals (summary slide – Oh, Jean.)

Reverse order of Piaget’s developmental levels is
used to individualize assessment and intervention. (cognitive and functional)

12

Neurodevelopmental Sequencing Model
– Framework's raison d'être

Choosing interventions to match the functional skills of person with dementia.

13

Neurodevelopmental Sequencing Model
– Goals (On considering 3 levels of functional ability)

1) ambulatory – active sports, games, cognitive stimulation
2) wheelchair-bound – exercise and sensory stimulation
3) non-ambulatory – ROM exercises, massage, sensory integration activity

14

Interventions can be directed toward what 3 uhh, things?

Person, Environment, Caregiver

15

5 interventions directed toward the person
Be the fuck creative.

• Group activities – reduce agitation
• Creative individualized activities – babies, pets
• Art therapy – sense of control/self, sensory stimulation
• Comp/Alt therapy – therapeutic touch, music
• Pharmacological – limited time then cause more problems than benefits, in addition to...

16

3 interventions directed toward the environment

• Modification - safety, remove/modify stimuli, pleasant, things in familiar places – supports habits/routines
• Home – maintain comfort, remove busyness, use contrast
• Music – calming and individualized…to stimulate memories

17

3 interventions directed toward the caregiver
Fun Fact! 70% of PWD are cared for by spouses or family members!

• Make sure make sure respite is really respite
• Referral to support groups
• Care home placement - ST respite, LTC

18

The New Role for Family in PCH – check in regularly to see?
(List of Fran-isms. Take what you need.)

How to make them feel welcome?
Facilitate their visits?
Form partnership?
Ideas to assist with activities, stimulation?
Advice they have for you?
Education they need from you?
Referrals can you make depending on their needs.
Help them help you. Consider them a client too.