CNA Care Of Cognitively Impaired Residents 4
The end of the day can bring a common behavior for residents with dementia, called
Caregivers can notice a big change in late afternoon or evening with clients who have dementia. Fading daylight seems to trigger confusion and agitation. It is also connected to hunger, poor vision, and less natural light. Take time to recognize the response of each resident who displays different behaviors. Does the twilight seem to cause confusion? Are lamps or other lights on? Could the residents be hungry? Does poor vision make it difficult to see?
When a resident is confused, you should
When a resident is perplexed, start by providing fundamental facts. "Good day, Mr. Jones. Your nurse's assistant, Sarah, here. Do you still recall me?" Then suggest various strategies to aid him in regaining his sense of space and time. "It is August 26 on a Tuesday. You watched the movie and had chicken for lunch." It can be beneficial to take the resident back to his room so he can see familiar items and pictures. Always be polite and calm.
Mr. Russell keeps getting up from his wheelchair. Instead of using a restraint, you should ask him if _________.
It is never appropriate to use a restraint for punishment or staff convenience. Also, never threaten a resident with restraints. Restraints can only be applied with a doctor's order for specific reasons. Try to find out what the resident needs. Often they require toileting, are thirsty or hungry, or have a reason they want to get up.
Some patients may exhibit some "false beliefs" not supported by facts or reality. This is known as
Delusions are false beliefs that involve a misinterpretation of experiences. A person may believe that they are being followed, tricked, or spied on. They may also be convinced that songs or books contain special information meant for them. Attempts to show the person that their belief is wrong or irrational are not accepted by the person.
Mrs. Johnson, a resident with dementia, loves to wear her favorite blue plaid shirt with her favorite green striped pants. What should you do?
Respecting each resident includes allowing them to make as many choices as possible. There is no harm in mis-matching clothing. There is probably a reason that Mrs. Johnson likes these clothes and feels good in them. Ask her to tell you, if she can. Allow her to select her outfits as often as possible.
Incontinence might become a problem as dementia worsens. How can the nurse's assistant help?
The resident can experience incontinence episodes as their dementia worsens. Adult diaper use shouldn't start right away. Set up a regular restroom visitation schedule and take the resident there. Waiting for them to inform you is unnecessary. Start keeping an eye out for symptoms of the urge to use the restroom. Is the inhabitant agitated? bending over? pulling at your clothes? Take them now rather than waiting until the next time that is scheduled. Bring a change of clothes when you go out, and keep an eye out for bathrooms. Remain upbeat if an accident occurs to lessen the resident's shame.
When the train will arrive, a resident holding a bag who is standing in the hallway asks the nurse assistant. The assistant should inform her.
Play along if a client seems perplexed, but don't. The client's perplexity and frustration are only exacerbated by this. Gently direct the client back to her room after letting her know where she is. Use her name, tell her where she is, and stay with her until she begins to feel secure.
In a reality orientation program you would do all of the following EXCEPT
Reality orientation is a formal program that involves repeating information to help residents understand their surrounding. To keep a residents oriented, their name is used frequently. Information such as date and time are reinforced with calendars and clocks. Show residents the weather, and ask them to identify smells and tastes.
Your facility is receiving a patient with dementia. Which of the following is true?
The process for moving into a long-term care facility is different for those with dementia or Alzheimer's disease. The procedure is quick and is completed in large part before the person arrives. The family leaves so that the staff can start assisting the person in meeting others with comparable situations and adjusting to their new routine. This helps them to adjust. The family may wait until the staff determines the patient is ready for a brief visit before returning.
A client with dementia has developed a fear of taking a shower. What can a nurse aide do?
A shower or bath can become a frightening experience for a client with dementia. Be patient and plan ahead. Gather everything needed and make sure the room is warm. In a gentle voice, tell the client what is going to happen throughout the process. Encourage the client to do as much as possible. Don't rush and never leave the client alone. If the client refuses to shower, give a bed bath and try a shower another day.
A dementia patient has wandered off to another building. When the nurse's assistant locates the resident, what should she say?
In 6 out of 10 dementia patients, wandering occurs. A resident may experience brief confusion even in the early stages. They can be fidgety or attempting old behaviors, like leaving for work or "going home."
A resident with dementia has wandered to another unit. What should the nurse aide say after finding the resident?
6 out of 10 patients with dementia will wander. Even in the early stages, a resident can become confused for a short time. They may be restless or trying to do former activities, such as going to work or "go home."
You would complete everything of the following, EXCEPT, in a reality orientation program.
A systematic program called reality orientation repeats information to assist individuals comprehend their surroundings. A resident's name is frequently utilized to keep them on track. Calendars and clocks serve as reinforcement for information like date and time. Ask residents to name flavors and odors while you display the weather.
How should you act when you approach a dementia resident?
Patients who have dementia are able to recognize moods and attitudes and behave similarly. The resident will get afraid if they sense that you are not interested, are not present, or are otherwise occupied. They can try to take advantage of you if you are weak. With a positive outlook, they will react appropriately since they can sense your comfortable, nonjudgmental nature.
What crucial step may be taken to make the person feel at ease in a long-term facility?
It is crucial to keep familiar objects close by during any change or transition. Important special items are little furniture pieces, blankets, pictures, or keepsakes. Even personal goods like soap and shampoo can improve comfort in an unfamiliar setting. Encourage the resident's family to pay a visit if they have any so that the resident won't feel alone.
Which one of these behaviors is NOT a signal of possible combativeness?
Non-verbal signs can tell you more about a person's mood than their words. Non-verbal cues oten come from instinct. Observe the signals that tell you a person is angry and ready to strike. If words and behavior do not match, always believe the behaviors or actions.
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