auntieannie

Really detailed and compassionate overview, written for the layperson/care partner.5 tenets of habilitation1. Make the physical environment work. 2. Know that communication remains possible.3. Focus on remaining skills.4. Live in the patient's world: behavioral changes.5. Enrich the patient's life. Alzheimer's Assocation Safe Return program. $40 annual fee and ID jewelry.Make the physical environment work. -- Lighting. Mimic daylight. Avoid fluorescents. Use dimmer switches and turn the lights up in the late afternoon, evening to minimize "sundowning" which usually occurs between 3 and 8. -- Color schemes. Use unique color schemes to help identify spaces. Use vivid colors to identify, and use other schemes to hide or obscure (doors that shouldn't be opened, etc.)Lighter shades blend together. Stick to a palette of strong, simple colors.-- Flooring. Avoid shiny surfaces. Avoid area or scatter rugs. Simulated hardwood floor is a good choice. -- Interior pathways. Establish clear interior pathways. -- Furniture and hangings. Remove furniture that is difficult to get into or out of. Use sturdy chairs with arms and short depth from front to back. Keep wall hangings simple. Avoid mirrors. Faux windows of a scene like a lighthouse or a coastline are helpful and often used in facilities to brighten up a wall. Fish tanks are a good source of entertainment, but leave the feeding to someone else. -- Use images to replace words -- a picture of a toilet on a wall. -- Home areas. Allow for conversational places like a table for 2, or chairs at angles for conversation. Also allow for solitude, some time and space to be alone. -- Noise is problematic. Do what you can to sound-proof, but also use sound as a warning, with opening doors for wanderers, etc. Difficulties with communication-- Difficulties making and expressing choices. Will often choose the 2d of 2 choices. Will defer making choices. Approach the person in a calm, gentle way, always from the front. Set the stage for discourse with a tone that reflects respect. Speak slowly, in a low tone, using simple sentences. Hearing is not the problem. Do not raise your voice. Be patient; the person with progressive dementia takes extra time to process information.Avoid asking open-ended questions. Statements are better than questions -- let's have a cup of coffee, rather than would you like a cup of coffee?Use humor and music where possible. Listen to the emotion behind the communication. Focus on remaining skills.Never attempt to reason with someone who has lost her reason. Simplify dressing. Choose clothing for ease, comfort, recognizability, familiarity, colors that the patient likes, touch. Use textured clothing when you can. Eating. Difficulty recognizing food and using utensils. Recognize that large portions can easily overwhelm the patient, even if big servings pleased him in the past. Add sugar, brown sugar, softened chocolate chips, etc to help increase calorie intake. Use visual cues -- a simple table set for two. One course at a time. No distractions. Toileting. Sleeping. Live in the patient's world -- behavioral changes.Forgetting appointments. Losing track of time. Repetitiveness. Not recognizing people. Word-finding difficulties. Difficulties making choices. Diminished concentration. Accusatory behavior. Difficulty separating fact from fiction. Changes in judgment. Diminishing ability to sequence tasks. Difficulty writing and understanding written language. Getting lost in memories. Impaired concentration abilities. Changes in reaction time. Not recognizing objects. Lack of social appropriateness. Frequent emotional changes. Problems with holidays. -- distract the person with another task, situation, etc. rather than dwelling on the problem. -- follow the patient's logic or thought pattern, then gently guide her back to your world. -- don't hesitate to use white lies to keep the situation manageable. -- physically remove items that may cause problems. Keep a behavior log to help recognize patterns and suggest solutions to problem behavior. Enrich the patient's life. Patients spend much of their time in apparent idleness. But in fact, while he may appear to be doing nothing, he is trying to think through his situation; because he is not being productive, he feels unworthy, valueless, undeserving. Try to involve the person where you can, and engage them in enrichment activities. Keep a regular schedule as much as you can. Offer repetitive tasks, such as raking, planting, weeding or vacuuming in the morning, when a patient's energy tends to be at its peak. Don't complain, just thank. Caring for the care partner -- getting support, help, respite. Moving the person into a care facility. Make sure the new room is set up with personal effects. Familiar items should be waiting. Make sure the room has a familiar scent -- shaving cream, soap, etc.