Inform the nurse if you are struck while providing care by a resident. Someone might ask you to fill out an incident report. Take care of any injuries you may have. Always move out of the way of the resident's reach to keep yourself safe. Explain that hitting is unacceptable while remaining calm.
Residents who have Alzheimer's disease or late-stage dementia are unable to speak. Since they may still understand some verbal communication, using short sentences when speaking to them is helpful. They can also communicate their feelings through their body language, emotions, and facial expressions.
A loss of short-term memory is frequently the first sign of Alzheimer's disease. Before the condition proceeds to total loss of brain function, the patient can still recall past events and information. A client may undoubtedly smell a fire, depending on the stage of their Alzheimer's.
When speaking to a client who is confused or agitated, use a calm voice. Talk directly to the client, saying their name. Use short sentences and allow time for the client to respond. Be respectful and always treat the client like an adult.
Confusion and other symptoms can become exaggerated with fatigue. Causes of sleep problems for all residents can include the natural aging process, medication side effects, pain, and nightly urination. For residents with dementia, there is also a disrupted circadian rhythm, as well as fewer deep sleep cycles. Establishing a bedtime routine can reset the internal clock and make it easier for residents to fall asleep. Increasing physical activity during the day can improve the quality of sleep.
Late in the day or late at night, dementia patients' behavior can significantly change, according to caregivers. Confusion and agitation seem to be brought on by fading daylight. Additionally, it is related to lack of natural light, impaired vision, and hunger. Spend some time observing how each resident responds to varying behaviors. Is it possible that the dusk is confusing? Are there any lights or lamps on? Could the locals be starving? Does vision impairment make it challenging to see?
Because of their memory loss, it is common for clients with dementia to mix up names of others. They may even be aware that they are confused, but can't figure out why. When they refer to someone who is no longer living, they may have been thinking about the person. Help them remember by asking about the person. If there is a photo or memento of the person, show it to them and help them reminisce about happy memories.
If a client is confused, do not play along. This only adds to the client's fear if you support the confusion or hallucination. Sensible explanations will not be helpful, because the client absolutely believes the fantasy. The best approach is to calmly address the situation directly. Accompany the client to the closet, reinforcing reality. Remain with the client, reminding them of their surroundings.
As dementia progresses, a client can exhibit any of the "Four A's" of agitation, anxiety, anger, or aggression. These behaviors are not intentional, but signs of the disease. Remain calm and reassuring during these episodes. Redirecting the client is often a good way to end the behavior.
A client with dementia may find taking a bath or shower to be distressing. Keep calm and make a strategy. Make sure the room is warm and gather all of the necessary items. Inform the client of what will happen at each stage of the process in a kind manner. Encourage the customer to exert as much effort as they can. Never leave the client alone and don't rush. Give a bed bath if the client won't take a shower, and try again the next day.
Delusions happen when residents interpret a situation with a false understanding. For example, a resident may hear others talking in the dining room and decide there is a plot to poison his food. When dealing with delusions, remember the Three R's: reassure, respond, and refocus. Do not try to explain why the resident is wrong. Acknowledge the fear, and address it from your perspective. "I don't know how anyone could poison your meals, but you seem upset." Offer a solution, such as "I can get your tray directly from the kitchen." Remember that the resident will have a difficult time telling the difference between reality and fantasy, so your reassurance will have a calming effect.
More about a person's mood can be gleaned from their nonverbal cues than their words. Nonverbal clues frequently result from intuition. Keep an eye out for signs that someone is enraged and about to attack. Always trust the behaviors or acts if the words and actions do not match.
As dementia progresses, the resident may have episodes of incontinence. Do not immediately begin the use of adult diapers. Establish a toileting schedule and take the resident to the bathroom at regular times. Do not wait for them to let you know. Begin to watch for signs of need to go to the bathroom. Is the resident restless? Crossing legs? Pulling at clothing? Don't wait for the next scheduled time, and take them immediately. When going out, prepare by bringing a change of clothing and watching for restrooms. If an accident happens, stay positive to reduce the resident's embarrassment.
A nurse's assistant's ability to handle specific client scenarios, such departing against medical advice, goes outside the scope of their practice (AMA). Inform a supervisor or the nurse right away. Reassure the client that the nurse will assist her while you remain by her side. Try to refocus her attention or present a different activity.
If a client is confused, do not play along. This only adds to the client's confusion and frustration. Gently tell the client where she is and guide her back to her room. Use her name, remind her of her surroundings, and stay with her until she feels calm and reassured.
During any change or transition, it is important to have familiar objects nearby. Special possessions, such as small pieces of furniture, blankets, photos, or mementos are important. Even personal items like soaps and shampoo can make a new environment more comfortable. If the resident has family, encourage them to visit so that the resident does not feel abandoned.
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CNA Care Of Cognitively Impaired Residents #4
