Even under the best situations, giving peri-care can be awkward or embarrassing for a resident. For a resident with dementia, cleaning the genital area can cause various reactions. If the resident feels threatened or fearful, they may strike back. If they have a history of unwanted sexual actions, they may cry or complain of being assaulted. Always tell the resident what you are going to do and why. Describe each step before you do it. Speak in a calm manner.
When residents who are confused about the past, do not contradict them or try to convince them they have no such thing. Do not play along with their misunderstanding. Look for the meaning behind their words and behavior. You can say, "Tell me what your mother was like. What are your best memories?"
When a resident has a mistaken understanding of a situation, delusions can result. For instance, a tenant might overhear conversations in the dining area and suspect his food is being poisoned. Reassure, reply, and concentrate are the Three R's to keep in mind when dealing with delusions. Do not attempt to defend the resident's position. Accept the fear and deal with it from your point of view. You appear offended, but I don't know how someone could tainted your food. Give an answer, such "I can get your tray right from the kitchen." Keep in mind that the resident won't be able to distinguish between fact and fiction, therefore your assurances will help to reassure them.
An intellectual impairment (ID) is characterized by below-average intelligence and functional abilities. ID may result from an event that occurs prior to birth, such as drug or alcohol usage or pathogen exposure. Down syndrome is an illustration of a chromosomal abnormality. An hereditary disorder like Tay-Sachs disease or PKU can lead to ID. There are also birth-related issues, including as oxygen deprivation or early delivery. Even illnesses like meningitis and whooping cough can cause ID.
If you are hit by a resident while giving care, notify the nurse. You may be asked to complete an Incident Report. If you are injured, get treatment. Always remove yourself from harm by stepping out of the way of the resident's reach. Remain calm and explain that hitting is not acceptable.
Residents with dementia can have fearful thoughts, such as if anyone is going to help them or if they are going to starve. With a regular schedule, they know what is going to happen next: I wake up, I go to the toilet, I get dressed, I have breakfast, etc. Routines are predictable and reassuring, even if they are boring for the staff.
Clients can benefit from memory cues to help them stay on track with time and place. Each client should have a clock and a calendar in their room. Public spaces and bulletin boards can be adorned for the seasons and special occasions. In order to emphasize where the client is and what is happening, information should be repeated at regular intervals.
Patients with dementia can detect moods and attitudes, and act in a similar manner. If you are not involved, distant, or busy, the resident can detect this and react in a fearful way. If you are meek, they may try to take advantage of you. With a positive attitude, they can sense your nonjudgmental and relaxed demeanor and will respond accordingly.
Intellectual disability (ID) is a below-normal intelligence and ability to perform basic tasks. ID can be caused by something that happens before birth, such as exposure to alcohol or drugs, or an infection. An example of a chromosomal disorder is Down syndrome. ID can be caused by an inherited condition such as Tay-Sachs disease or PKU. Problems with the birth, such as oxygen deprivation or premature delivery are two more reasons. Even infections such as meningitis or Whooping cough can result in ID.
When residents who are confused think they still have a job, or are excited about a new job, do not contradict them or try to convince them they have no such thing. Do not play along with their misunderstanding. Simply ask them about the job and redirect them. You can say, "That sounds important. Let's have breakfast first, okay?" Give them a task, take a walk, or take them to another activity.
Confusion over their treatment is the most frequent reason for hostile behavior in people with dementia. When staff employees try to assist customers who have memory loss, the clients become perplexed. Clients might not recognize their caregivers or might not want to follow instructions from the caregiver to get up, eat, or take a shower. The consumers will automatically say "No," push, hit, or kick in response. When working with clients, always give yourself enough of time. Explain what's happening in a gentle voice. Avoid arguing. Keep your cool and get ready to attempt again in a short while.
Reality orientation involves repeating information to help clients understand their surroundings. To keep a client oriented, their name is used frequently. Information such as date and time are reinforced with calendars and clocks.
When a resident seems confused, start by offering basic information. "Hello, Mr. Roberts. I'm Sally, your nurse aide. Do you remember me?" From there, offer other ways to help him regain his sense of time and place. "It's Tuesday, August 26. You had chicken for lunch and watched the movie." Returning the resident to his room to look at familiar objects and photos can also be helpful. Always remain calm and friendly.
Don't argue with or try to dissuade residents who are unsure about the past if they are confused about it. Playing into their misconception is not acceptable. Look for the meaning underlying their actions and words. You may state, "Tell me about your mother, please. What memories come to mind?"
A client with dementia may experience confusion when getting dressed. Reduce the number of clothing options to make the process easier. Try to purchase multiple sets that are identical if the customer has a favorite outfit. Clothing should be convenient to put on and take off. Place garments in the order they are put on to assist the client.
A client may display any of the "Four A's" of agitation, anxiety, anger, or aggression as their dementia worsens. These actions are not deliberate; rather, they are symptoms of the illness. Throughout these episodes, remain soothing and composed. It's frequently a good idea to redirect the client to stop the behavior.
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CNA Care Of Cognitively Impaired Residents #3
