ACT on Alzheimer ’ s Disease Curriculum

1. ACT on Alzheimer’sDisease Curriculum Module IV: Effective Interactions

2. Effective Interactions • These slides are based on the Module IV: Effective Interactions text • Please refer to the text for all citations, references and acknowledgments

3. Module IV: Learning Objectives Upon completion of this module the student should: • Understand the principle of person-centered care and the importance of recognizing each person as a unique individual. • Articulate verbal and non-verbal communication that people with cognitive impairment may display. • Reframe what is traditionally labeled difficult behaviors to expressions of needs, desires, and distress and understand how those expressions are manifested in specific behaviors.

4. Dementia Care Overview

5. Suggestions for Dementia Care • The patient is a person, respect that individual’s humanity • The changes in this person are a result of a brain disease over which the person has no control • Different or challenging behaviors may be the only way for this patient to communicate

6. Three Keys to Quality Interactions • Affirm the person’s feelings, show empathy • Solve the problem whenever possible • Distract and/or relocate

7. Person-Centered Care • Patient care should be personalized, so a caregiver needs to understand: • What makes this person unique • His or her personality • What core qualities define this person • Caregivers can use these core personal qualities to develop suitable, personal care

8. Effective Communication

9. Communication Overview • A dementia patient’s communication patterns will change over time and a caregiver’s communication techniques need to change as well • The best way to support a person with dementia (and to communicate effectively) is to build a relationship with that person

10. Communication Challenges • Word-finding difficulty • Repetition • Loss of reading and writing ability • Revert to native language • Loss of ability to speak in clear sentences • Loss of ability to understand • Inability to use words

11. Communication Tips • Talk to the person in a place free of distraction • Begin conversation with orienting information • Look directly at the person • Make sure you have the person’s attention • Be at eye level with the person • Speak slowly and clearly

12. Communication Tips • Use short, simple sentences • Ask simple yes/no questions • Use concrete terms and familiar words • Talk in an easy-going, pleasant manner • Allow sufficient time for the person to respond • Break up tasks into smaller steps

13. Having Trouble Being Understood? • Be sure that you are allowing enough time for the person to process and respond • Demonstrate visually what you are saying • Think about the complexity of what you are saying • Try a hug and change the subject

14. Having Trouble Understanding? • Listen actively and carefully • Try to focus on a word or phrase that makes sense • Respond to the emotional tone of the statement • Stay calm and be patient • Ask family members about possible meanings

15. Things Not To Do • Do not: • Argue with the person • Order the person around • Tell people what they can not do • Be condescending • Ask questions that rely on good memory • Talk about people in front of them

16. When Verbal Communication Fails • Try distracting the person • Ignore a verbal outburst if you can not think of a positive response • Try other forms of communication • Learn your own body language • Learn the other person’s body language

17. Physical Interaction

18. Making a Positive Physical Approach • Come from the front • Go slow • Get to the side • Get low • Offer your hand (palm up) • Use the person’s preferred name • Wait for a response

19. Assessing Behaviors

20. Walking about Exiting or trying to leave Wanting to go home Showing fatigue as the day progresses Sleep disturbances Looking or searching for things Gathering Shopping Expressing discomfort Having hallucinations or delusions Being suspicious or paranoid Repetitive actions Loud verbalizations that may not be coherent Common Behaviors

21. Why Challenging Behaviors Occur • Change in environment • A caregiver’s approach to communication • Past history and behaviors • Internal needs of the person • The task that the person is doing • Inability of the person to express needs or desires

22. A Different Way to View Behaviors Wandering Demonstrating mobility Sundowning Tired at end of day Rummaging Gathering / Exploring Hoarding Shopping Resistance to care Feeling uncomfortable

23. When Is Behavior a Problem? • It violates the rights of others • It poses a threat to someone’s health and safety (including one’s own)