Week 6 - Nursing Models that guide PWLD

Question 1

How do nursing models guide the care of PLWD and explain why PWLD display responsive behaviours? (4)

Answer 1

• recognizing that the major impairment hat PLWD is communication
• recognizing that the PWLD have difficulty conveying needs
• decreased ability to manage environmental and physical stressors
• guiding the implementation of strategies to reduce stress and foster communication

Question 2

What are 4 nursing models that guide caring for PWLD?

Answer 2

• Progressively lowered stress threshold
• Need driven dementia-compromised model
• abilities approach
• related well

Question 3

Why do PWLD experience a progressively lowered stress threshold? (2)

Answer 3

• progressive loss of ability to cope with demands and stimuli in the environment
• stressed out more easily

Question 4

What is the need driven dementia-compromised model?

Answer 4

• the person’s needs are not adequately addressed, considering their unique individual and environmental factors

Question 5

What is the abilities approach? (2)

Answer 5

• the social and physical environment does not optimize the person’s opportunities to use their continued abilities
• so you should optimize person’s function in your approach

Question 5

Applying models of care to a case study

Answer 5

Question 5

What is relating well?

Answer 5

• the person’s social environment is not fostering opportunity for therapeutic interactions

Question 6

How should you apply CJMM to PLWD who display responsive behaviour? (4)

Answer 6

• What is the meaning of this behaviour
• always rule out medical problems
• framework for assessment (collecting and analyzing cues)
• ie. 5Ws and what now

Question 7

What are gentle persuasion approaches for responsive behaviors? (3)

Answer 7

• based on the need-driven dementia compromised behaviour model
• Relabel behaviours as self-protective and an attempt to exert control in frightening situations
• studies show that LTC facilities that have staff trained in this approach have reduced responsive behaviours

Question 8

What are some nonpharmacological approaches to responsive behaviours? (12)

Answer 8

• exercise
• individualized activity
• music therapy
• sensory intervention
• reminiscence
• simplifying tasks
• enhancing communication
• group activities
• homelike environment
• changes in meal time
• bathing environments
• consistent staffing