Responding Positively to Alzheimer’s Behaviors: Understanding the Dementia Clients View of Reality

When I first began my work in dementia care, the philosophy of care and approach centered on “Reality Orientation”.  Fortunately today, we not only have a better understanding of the disease process; but have become better acquainted with interpreting moods and behavioral interventions in order to respond better to our clients.

The philosophies of “Habilitation” and “Validation” therapies have done tremendous service for the dementia client, particularly in regard to the individual’s need to preserve “personhood”.  Family and professional caregivers continue to require understanding that the dementia client has little or no control over verbal and physical behaviors.

To assist care providers, we must provide skills to manage behaviors for those who are experiencing a different reality, related to their memory loss.  Key to good behavior management for the dementia client is for the care provider to, “get into their clients reality”, in order to redirect behaviors to a more positive response. This is achieved through observation of verbal and nonverbal clues to the individual’s behavior.

For instance, a client living within the home exhibits increased pacing, and is looking to go home.  Understanding the client’s view of reality would determine that in fact, the client was looking for his childhood home.  In order to determine successful redirection strategies, would include a good social history, understanding behavior triggers and appropriate environmental cues.

Recommended redirection approaches include:

1. Agreement: attempts to change the clients reality generally  result with increased frustration, anxiety and even aggression.

2. Redirection: due to the client’s short attention span, behaviors can be easily redirected to a new activity.

3. Environment: Having an understanding that our clients are sensitive to environmental stimulation such as noise, clutter and lighting.

4. Task completion: we can reduce behavioral episodes by simplifying tasks to complete, such as dressing and answering questions.

Caring Resources is committed to providing caregivers with the necessary skills and resources to enable them to provide exceptional care to their clients.  Our training and educational modules are geared to professionals working in both community-based and residential care settings.  For more information regarding our training modules contact a representative today.

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2 thoughts on “Responding Positively to Alzheimer’s Behaviors: Understanding the Dementia Clients View of Reality

  1. In our experience at Rose Lodge in Exmouth, UK, validation can be very effective in supporting people with dementia in the later stages. We call it “getting into their bubble” and is based on the understanding that the most basic need of all people is to be understood. Quite often just listening is enough to allow someone to move naturally from an agitated state into a state of wellbeing.

    Still, some people in the early stages are better supported by keeping them at least partially in touch with “our” reality, A couple of examples: One of our residents keeps an old-fashioned “calenday machine” with her, and every morning she sets it to the correct date, then keeps this with her for most of the day. Knowing the right date is in some sense comforting to her. Another residents really enjoys a life book which we put together with her. She often walks around with it, reads it, looks at he pictures and shares it with others. We sense it is very important to her at the moment to use the lifebook to retain her sense of identity and self.

    For us the key deciding factor when considering different approaches is the impact to people’s well-being. Put simply: it it makes them happy then it’s a good approach.

    Peter de Groot
    Dementia Care Devon

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