Dementia: Communication, hard-to-manage behaviours and safety

A much needed re-framing of Dementia from Alberta Health Services clinical nurse specialists, Jennette Coats and Loralee Fox, who embrace care and caring for those with ‘broken brains’. I sat in on their extremely practical and sensitive strategy session for supervisors of Home-Care Workers organized by Revera Health Care.Whose patient population increasingly has one or more Dementia: Alzheimer’s, Lewy Body, Fronto-Temporal Lobe, Vascular

Revera

Attendees included nurses, occupational therapists, social workers, personal support workers and physiotherapists who shared some of their own coping stories, dealing with their own parents with Dementia:

“I could tell my mom all the awful stuff about my divorce. She’d forget as soon as I told her – so I got to ‘dump’ without guilt.”

As the broken brain description implies, it’s more than just memory loss that caregivers cope with. It’s the responsive b behaviors – aggression, anxiety, agitation, wandering – that drains emotionally and physically. One of the strongest messages acknowledged the issue of time:

Caring for someone with violent behaviours of dementia can take 50% more time

Staying safe takes time: trying to be efficient can be self-defeating

“Rushing through can cause emotional distress and increase anxiety, agitation, and aggression.”

From the Gerio Psychiatric Education program in Victoria British Columbia, the acronym, ABCDE

ABCDE

Apologies: One of the most powerful the calming strategies

  • I’m sorry – I didn’t mean to upset you.
  • I’m sorry – you’re right.
  • I’m sorry I made you feel (angry, hurt, dismissed..)
  • I’m sorry – I know you’re trying so hard.
  • I’m sorry – this must be so hard for you.

One of the most ineffective calming strategies (hint: even without dementia it doesn’t work well)

“You need to calm down!”

A collective rolling of the eyes was the response when attendees were asked: “How does that make you feel, being told to just ‘calm down’.”

As apublic member on the Board of the College of Occupational Therapists, I see Time as Enemy facing so many who are in the business of caring for us.

Absorbing this excellent education and hands-on training, I’m encouraged that these supervisors will have tools to support their home care teams of nurses, personal support workers, social workers, Occupational therapists.

Being increasingly involved in the end-of-life space, I have so much more respect and admiration for health care professionals caring for our elders. The title of my presentation: Dignity, Power and Patients and the songs we sing. My message: we all want to be treated with dignity and respect – patients, families and healthcare professionals.

If you liked this post, you may also be interested in tips from a Long Term Care Association Summitt, featuring Commander Chris Hadfield