Dementia - Management Flashcards
Primary goal for nursing care of dementia? (3)
Promote – maximum function – dignity – QOL for the person with dementia.
Key aspects in providing care. (4) PUPS
Patience
Understanding
Provide approp. info.
Support independence + self-directed care
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 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
Progressively Lowered Stress Threshold Model
– Framework’s raison d’être
Ability to tolerate stress (internal/external) declines with disease progression.
Progressively Lowered Stress Threshold Model
– Goals (summary slide - 2 points)
- Identify + eliminate/reduce stress-inducing stimuli
* Maintain max. function through supportive environment
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
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.
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
Cognitive Behavioural Approach
– Framework’s raison d’être
Cognitive skills + functional abilities seen as lost
in reverse order from which originally learned.
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)
Neurodevelopmental Sequencing Model
– Framework’s raison d’être
Choosing interventions to match the functional skills of person with dementia.
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
Interventions can be directed toward what 3 uhh, things?
Person, Environment, Caregiver
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…
