Experiencing or caring for a loved one with dementia can be very challenging. Cognitive impairments can disrupt communication and cause confusion. Attending to the needs of individuals with dementia and adequately treating pain, as well as other symptoms, requires a special approach. Additionally, studies estimate that 50%-90% of individuals with moderate and severe dementia exhibit challenging behavior over the course of their illness. This in turn has adverse effects on their personal and professional caregivers. Caregivers can suffer from significant stress and often experience depression, psychological morbidity, anxiety, social isolation, or other mood disorders. Having the skills to alleviate different situations, as well as the knowledge to implement therapeutic routines, is integral to helping a client on a long-term basis. Caretakers, as well as patients, who have a better understanding of how to cope with dementia significantly improve their quality of life.
Dementia refers to chronic and persistent symptoms attributed to cognitive impairment and loss of cognitive functions. The symptoms may be mild, moderate, or severe. The extent and presence of dementia is usually clinically diagnosed. The life expectancy of elderly people with dementia is estimated to be 5 years from the first sign of symptoms, and 3.5 years from clinical diagnosis. Patients with Alzheimer’s, as a rule, belong to the category of cognitively impaired. Cognitive impairment can also occur from birth, from physical damage to the brain, from substance abuse, or other neurological conditions. Some of the symptoms that patients with dementia may experience include:
- Loss of memory
- Loss of adequate judgement
- Loss of ability to reason and rationalize
- Loss of orientation
- Loss of ability to use language and inability to communicate
- Lack of focus and low attention span
- Involuntary Urination, etc
In nursing homes, 40%-80% of seniors experience pain. Pain and other under-treated symptoms lead to further cognitive and physical impairment. Caregivers have to be equipped with special skills and tools, which they can use to properly assess pain levels of older adults with severe dementia. This is necessary in order to provide adequate care. Self-reporting pain and communicating its intensity may be a difficult task for patients with dementia. Numerous non-verbal tools have been developed in order to assess pain. These include observations of alteration in behaviour (i.e. sleep patterns), and observations of physiological factors (i.e. blood pressure), or a combination of both. There are many tools available to measure the extent of pain. These tools involve assessment of patients’ responses to certain situations, as well as specific verbal signals and facial expressions. Some of the tools require extended observation of sleeping and eating patterns. And some are designed specifically for caregivers who have known patients for long periods of time. Pain Assessment is a skill that nurses develop with experience and with the help of tools available to them.
Patients with dementia need integration of special routines into their long-term care. There are things like Cognitive and Behavioural Therapy, which involves in-depth, one-on-one work with a professional. However, good nurses and caregivers understand these needs and implement them into clients’ routines. Some of these techniques include the following:
- Positive Thinking. Dementia is commonly perceived as a disability. Changing the framework to focus on ‘ability’ instead is paramount not only to society, but to how the patient interacts with the world, the caregiver, and how he/she views oneself. The focus should be on what the patient is able to do, and what he/she is good at. Self-identification is not as detrimental when the individual sees his/her mistakes as challenges, and not symptoms of permanent disability. Stress that comes with the environment and the individual viewing oneself in a negative light leads to further emotional and psychological decline.
- Cognitive Stimulation. There are varying techniques used in Cognitive Therapy that can be integrated into everyday activities. Activities like reading, solving puzzles, and reciting poetry all stimulate brain and prolong its healthy functioning. Methods from reminiscence therapy could easily be used in any setting. These may include listening to the individual’s favorite classical recordings and sharing pleasant memories associated with them.
- Physical Activity. Exercise is necessary for individuals to maintain their motor skills, and thus everyday functions. Physical activity may help prevent other diseases such as Parkinson’s and vascular-related disease. It may aid in regulating sleeping and eating patterns. Research has established that physical activity improves mood, behavioural patterns, and cognitive functions in patients with dementia.
Numerous studies have proven that interventions, such as above, significantly improve quality of life, reduce symptoms of dementia, and slow the progression. Healthy lifestyle behaviors may also help prevent other diseases, challenging behaviour, and further decline in physical and psychological functioning. Particularly, focusing on ‘abilities’ as opposed to ‘disabilities’ improves the mental and physical well-being of affected individuals, their loved ones and caregivers.
Does your loved one have dementia? NurseRegistry can help. Our nurses are experienced in a variety of specialties. Visit NurseRegistry.com/private-care to learn more about how a private duty nurse can help individuals with dementia.
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