Recognizing Changes in the Consumer that Need to be Addressed

Cognitive Impairment A temporary or permanent change within the brain which affects a person’s ability to think, reason, and learn. Temporary causes may include stress, medication, depression, vitamin deficiency, thyroid disease, alcohol, and head trauma. Permanent causes include severe head trauma, illness, brain disease and brain damage at birth

Disorders that Cause Cognitive Impairment: Depression- emotional sadness, and withdrawal Anxiety- persistent feelings of fear and nervousness Suspiciousness- distrust of others Delusion- false belief not supported by reality Paranoia- irrational feeling of being persecuted, suspiciousness, and hostility Schizophrenia- suspiciousness, paranoia, and delusion resulting in inappropriate behavior Mental retardation- process which slows or stops a child’s brain from maturing Dementia- progressive mental deterioration due to organic brain disease which causes structural changes within the brain (ex. Alzheimer’s)

Reducing Effects of Advanced Dementia Reality Orientation Helps resident remain aware of their environment, of time, and of themselves Validation Therapy Helps resident improve dignity and self-worth by having their feelings and memories acknowledged Reminiscing Allows resident to talk about past experiences, especially pleasant ones.

Responses to Difficult Behavior Difficult behavior may result from too much stimulation, change in routine or environment, physical pain or discomfort, reactions to medications, and fatigue. Remain calm, speak slowly and clearly Avoid approaching the resident from side or back Try to calm the resident by holding hands, patting and singing (if appropriate) Try to distract resident’s attention and redirect behavior Allow resident to express feelings (if talking reduces agitation)

Dementia Clients Need Assistance with: Safety Monitor movement, watch for inappropriate use of objects, check that clothing is worn properly Nutrition Assist client to dining area when food is served, have food ready, allow resident extra time to chew and swallow, serve only one food at a time, monitor food intake Hydration Offer fluids more often and in smaller amounts, listen for spoken cues that resident may be thirsty, watch for nonverbal signs (dry mouth, smacking lips) Dressing Choosing appropriate clothing, offer choice of two outfits, assist to dress properly, simplify dressing according to needs Bathing Prepare bathing area before bringing resident into room, explain procedure, check temperature, assist resident in bathing Elimination Take resident to bathroom frequently, provide perineal care as needed