Alzheimer’s Disease and Dementia can be very challenging for a CNA.
With this article we want to inform and prepare you for your work with Dementia or patients with Alzheimer’s Disease.
Brain with Alzheimer’s disease
More and more people are diagnosed with Alzheimer’s Disease since we are living longer and also as a result of the baby boomer years.
Alzheimer’s disease is regarded as the most frequent reason of dementia, affecting an estimated 5.3 million Americans. As a result the government is setting priority in the research of Alzheimer’s Disease and Dementia in 2012 and 2013.
Alzheimer’s disease is really a accelerating, degenerative disease, attacking the brain and resulting in impaired memory, thinking and behavior.
Symptoms of Alzheimer’s Disease contain a gradual memory loss, decreased capability to do daily tasks, loss of time and space, change in personality, learn difficulties, and loss of language and communication skills.
The symptoms are different from person to person depending in what part of the brain the loss started and how progressed the disease is.
From the start of the symptoms, a patient with Alzheimer’s disease may live somehow between 3-20 years with this disease.
At current time, there are 4 drugs prescribed to treat the symptoms of Alzheimer’s disease.
In some cases, the treatments are improving daily life though increasing memory and cognitive capabilities.
The following are tips how to deal with people having Alzheimer’s disease or Dementia.
Positive Approaches as a CNA with People who have Alzheimer’s Disease.
1. Set the Stage
- Environment: People with Alzheimer’s disease are very sensitive to noise, lightening, distractions and comfort level.
- YOURSELF: Before approaching a person with Alzheimer’s disease: take a deep breath to calm yourself down. Do not go to a person in a hurry and stay focused. Reach out to the person in a friendly way.
- Know the person: It is important to get a history from the family including health condition and restrictions, values, likes, dislikes, accomplishments, remaining strengths, motivations and triggers( very important to know), how does the person to be called, past activities and approaches that worked well…etc.
- Back-up plan: This might be just to back up from the situation and try it back later. Another option is to ask someone else to handle the situation.
- Be respectful – ALWAYS!
2. Physical Approach to a person with Alzheimer’s disease
- Approach in a friendly, relaxed manner from the front
- Introduce yourself – if appropriate
- Get the person’s attention by using the preferred name before you move into their personal space
- Go slow
- Offer your hand
- Move at least slightly to the person’s side to be less threatening
- Sit, squat, or kneel at person’s side, if seated, to seem less bossy and confrontational
- Use the hand-under-hand technique – if appropriate
- Wait for response before taking any action or moving the conversation forward
- Maintain eye-contact – if culturally appropriate
- Pay attention to your body language – look interested, non-threatening, non-provocative
- Pay attention to the person’s body language
- Use touch, but carefully to make sure the person seems to accept it!
- Friendly and respectful, not bossy or critical and avoid baby-talk
- Slow and easy Lower pitch is more readily and better understood
- Use words the person uses now Use simple, short phrases and sentences
- Be specific and avoid pronouns. “George, your water glass is on the table.” not, “It’s over there.”
- Stay positive and sincere
- Provide positive feedback, appreciation, thanks and praise Laugh with the person, not at Apply humor
- Do not argue or go into long explanations
- Give simple choices about options. “Would you like the red or the blue sweater?”
- Avoid asking yes or no questions, if no is not a good option.
Literature about Alzheimer’s Disease we recommend:
Alzheimer’s Disease: Dealing with Agitation and Aggression as a CNA
1. Possible causes or contributors to Alzheimer’s disease
- Infection or medical illness
- Over-stimulation or under-stimulation
- Discomfort due to pain, hunger, thirst, tight closing, itchiness, need to use the toilet….
- Fear, fatigue, frustration, confusion, especially when trying to make sense out of a confusing and senseless world
- Side effects of drugs
- Changes in the environment or routine like moving to a new residence
- Uncorrected visual or hearing loss
- (Miss)perceived threats
- Unwelcome assistance with personal care like bathing, toileting, cloth changes
- Compelling need to meet past responsibilities such as: get to work, catch a bus or find someone or something…(living or past)
- Compelling need to go “Home”
- Feeling disrespected, unable to exert control and maintaining independence
- Poor approach by caregiver( too rapid, rushed, confusing, confrontational, demeaning)
2. Strategies that might help you dealing with Alzheimer’s Disease
- Be aware of warning signs (e.g., becoming tense, red in face, clenched fists, rapid searching with eyes, hand waving, muttering, raised voice, restless)
- Stay calm. Don’t raise your voice, take offense, or show alarm. (This is the most challenging skill for a CNA – remember you are dealing with Alzheimer’s disease)
- Back off and ask permission.
- Look for the underlying cause – and try to alleviate it.
- Remove the person from environment or remove whatever is triggering the agitation.
- Make the environment calm (e.g., dim lights, decrease noise)
- Use your good communication skills.
- Do not argue or try to reason. (Remember that reasoning doesn’t work with dementia)
- Reassure the person. Use calming phrases and let the person know you care and are there to help. Validate the person’s feelings and demonstrate that you understand.
- Redirect. (Use what you know about the person’s interests and life story. Some ideas: ask the person for help, offer a snack or treat, ask the person to come with you, talk about something the person enjoys)
- Find outlets for energy. (For example, walking or assisting with a simple chore)
- Keep things simple & relaxed. Don’t ask the person to do anything complex or stressful until he or she has a chance to calm down.
- Involve the person in soothing activities. (art, music, therapeutic touch, a snack, watching birds, nature walk or viewing, reading familiar passages out loud, petting a dog)
- Have a code to call for extra staff assistance if necessary.
- Remove dangerous items from the environment.
- Slow down as the aggressive person speeds up. Don’t make sudden movements.
- Never surround or gang up on an aggressive person. This may prompt a flight-or-fight response if the person feels cornered or overwhelmed. Don’t use restraints or force. This may cause more aggressive behavior and possible injury.
- Have a medical consult. (Behavior could be due to a change in medical condition or a response to medications)
Possible Things to Say: (first greet the person by name)
“You seem upset.” “I’m glad you told me.”
“What’s wrong?” “You’re safe here.”
“I’m so sorry.” “Everything is under control.”
“I’m sorry that you’re upset.” “I’m on your side.”
“I’d be upset, too – if I thought…” “I will stay until you feel better.”
“How can I help?” “I could really use your help.”
“May I help you?” “Would you help me please?”
“What do you want?” “Let’s get out of here.”
“I know it’s hard.” “Let’s take a walk.”
- U.S. Drafts Plan to Fight Alzheimer’s Disease (healthland.time.com)
- Alzheimer’s Disease “Jumps” Across Brain Cells to Spread (pdresources.wordpress.com)