H I L L T O P DEMENTIA TRAINING MANUAL - Senior Daybreak

[Pages:226]HILLTOP

DEMENTIA TRAINING MANUAL

A CAREGIVING TOOL FOR FAMILIES & PROFESSIONALS

Revised January 2015

PREFACE

This Dementia Training Manual was created in the hopes of offering a comprehensive and practical training on understanding and caring for persons with dementia. This

material was compiled to educate as many people as possible, because we live in a world with an increasing number of people with dementia and we know that the more you

understand dementia, the better you can care for people with dementia, whether it is a family member, friend, or Hilltop resident.

This manual is not copywritten and can therefore be copied and shared with others. This manual is given for free to any individual or family who is caring for a person with

dementia. Donations to Senior Daybreak of Hilltop to offset the cost of printing are welcome. (approx. $10 each manual to print). This manual is also available as a free PDF

document for those interested in obtaining an electronic file at Senior Life Options Senior Daybreak Resources

"Dementia Training Manual"

ACKNOWLEDGMENTS

The information in this "Hilltop Dementia Training Manual" was compiled from various resources by Laurie Frasier, Joni Karp, and Rachel Brown, from their work at the Alzheimer's Association, their personal experience caring for a loved one with

Alzheimer's disease, various Alzheimer's websites and books, and by their experience caring for persons with dementia through their positions at Hilltop Community Resources with Senior Daybreak of Hilltop, The Commons Assisted Living, and

The Fountains Assisted Living. To the best of their ability they have given credit to all known resources from which the information was collected and adapted.

If you no longer need this manual, please pass it on to someone else who might benefit. Or, return to: Senior Daybreak of Hilltop 1620 Hermosa Ave., #64, Grand Junction, CO 81506 (970) 241-7798

We appreciate any comments or feedback you have on this manual. Please email or call: Laurie Frasier, Director, Senior Daybreak of Hilltop

laurief@ 970-241-7798

Donations to offset the cost of printing are welcome. These manuals cost approximately $10 each to print.

TABLE OF CONTENTS

Page CHAPTER 1: Overview of Dementia and Alzheimer's Disease.......................1

What is common forgetfulness and normal aging ........................................3 What is dementia..........................................................................................3 What is Alzheimer's disease ........................................................................4 History of Alzheimer's...................................................................................5 Famous people with Alzheimer's..................................................................5 What causes Alzheimer's .............................................................................5 What are the risk factors for Alzheimer's......................................................6 Other risk factors ..........................................................................................7 Different types of Alzheimer's.......................................................................7 How is Alzheimer's diagnosed .....................................................................8 How does Alzheimer's progress...................................................................9 Mysterious moments of clarity ......................................................................9 Does a person know they have dementia ................................................. 10 Do people die from Alzheimer's ................................................................ 10 How prevalent is Alzheimer's .................................................................... 11 Medications used to treat Alzheimer's ...................................................... 12 Research and Alzheimer's ........................................................................ 13 Early warning signs and symptoms ........................................................... 15 How does a person with dementia feel ..................................................... 17 HANDOUTS: To My Family and Friends ......................................................................... 18 Stages of Alzheimer's ? Alz Association ................................................... 21 Other Conditions Which Cause Dementia ................................................ 23

CHAPTER 2: Individualized Care, Communication, Environment............... 25 INDIVIDUALIZED CARE: ............................................................................. 27 Dementia affects each person differently .................................................. 27 Each individual is unique ........................................................................... 28 Emotional needs of a person with dementia ............................................. 28 COMMUNICATION & INTERACTION: ......................................................... 29 Best friend approach ................................................................................. 29 Affectionate care ....................................................................................... 29 Expect changes to occur with communication .......................................... 30 Tips for communicating ............................................................................. 32 2 interaction do nots .................................................................................. 32 Conversation is stimulating to the brain .................................................... 32 Conversation starters ................................................................................ 33 Keep a sense of humor ............................................................................. 34

ENVIRONMENT ............................................................................................. 35 People with dementia and the environment .............................................. 35 Familiar and comfortable environments .................................................... 36

HANDOUTS: 10 Things to Remember............................................................................ 37

CHAPTER 3: Behaviors and Intervention Strategies .................................... 39 Dementia Behaviors .................................................................................. 41 Possible/probable behaviors to expect in early stages ............................. 41 Responding to difficulties in early stages .................................................. 42 Transitioning and changing roles .............................................................. 42 Challenging behaviors to expect as dementia progresses........................ 43 Dealing with challenging behaviors ........................................................... 45 First step: decide if intervention necessary ............................................... 45 Second step: analyze the environment for triggers ................................... 46 Third step: try an intervention strategy ..................................................... 46 Distraction ................................................................................................. 47 Gentle guidance ........................................................................................ 47 Therapeutic fibbing .................................................................................... 48 Validation................................................................................................... 49 Reassurance ............................................................................................. 51 Best friend approach ................................................................................. 51 Prevention ................................................................................................. 52 Simplification ............................................................................................. 52 Walk away and try later ............................................................................. 52 Practice scenarios ..................................................................................... 53 Dealing with extreme anger or violence .................................................... 58 Using medications to help with behaviors ................................................. 58 Antipsychotics ................................................................................. 59 Anti-anxiety medications ................................................................. 60 Antidepressants............................................................................... 61 Pain management ........................................................................... 61 Sleeping medications ...................................................................... 62 Sexual behaviors and dementia ................................................................ 62 Communicating behavior solutions with others ......................................... 66

HANDOUTS: Sundown Syndrome .................................................................................. 67 An Affair to Remember .............................................................................. 68

CHAPTER 4: Safety Issues.............................................................................. 73 Home alone ............................................................................................... 75 Medications ............................................................................................... 75 Tripping, slipping, and falling..................................................................... 75

Operating tools and household machinery................................................ 76 Guns .......................................................................................................... 76 Alcohol consumption ................................................................................. 76 Environment proofing ................................................................................ 76 Getting lost ................................................................................................ 77 Driving ....................................................................................................... 77 Wandering ................................................................................................. 78 Living in a secure facility ........................................................................... 79

CHAPTER 5: Personal Care............................................................................. 81 Personal care general tips......................................................................... 83 Dressing .................................................................................................... 85 Bathing ...................................................................................................... 86 Brushing teeth ........................................................................................... 88 Hair, makeup and nails.............................................................................. 89 Shaving ..................................................................................................... 89 Toileting and incontinence......................................................................... 90 General toileting tips .......................................................................... 90 Changing and cleaning a person who is wet or soiled ...................... 91 Changing a person wearing pullups .................................................. 91 Changing a person wearing button or tabs........................................ 92 Changing a person who is bedridden ................................................ 92 Other toileting issues ......................................................................... 93

HANDOUTS: Bathing Troubleshooting Tips.................................................................... 94

CHAPTER 6: Nutrition, Hydration & Feeding ................................................ 97 Nutrition and dementia .............................................................................. 99 Supervising nutrition and hydration ......................................................... 100 Assisted living or nursing home setting ................................................... 101 Weight loss or weight gain ...................................................................... 102 Hydration ................................................................................................. 103 Feeding ................................................................................................... 105 Choking ................................................................................................... 106 Pacers and Eating ................................................................................... 107

CHAPTER 7: Medical Issues ......................................................................... 109 Dementia and medical issues ................................................................. 111 Finding and partnering with the right doctor ............................................ 111 Durable medical power of attorney.......................................................... 112 Doctor and dentist visits .......................................................................... 112 Hospital and emergency room visits ....................................................... 113 Monitoring medications ........................................................................... 113

Common medical issues of dementia patients........................................ 114 Depression....................................................................................... 114 Infections.......................................................................................... 114 Diabetes ........................................................................................... 115 Hypertension.................................................................................... 116 Coronary artery disease .................................................................. 116 COPD............................................................................................... 116 Arthritis ............................................................................................. 116 Osteoporosis .................................................................................... 117 TIAs.................................................................................................. 117 Weight loss ...................................................................................... 117 Chronic pain ..................................................................................... 118 Medical complications of antipsychotic medications ....................... 118 Falls ................................................................................................. 118 Incontinence..................................................................................... 119 Diarrhea ........................................................................................... 119 Constipation ..................................................................................... 119 End of life management ................................................................... 119

HANDOUTS: 8 Things Caregivers Should Know About Constipation & Dementia....... 121 Advance Directives.................................................................................. 122

CHAPTER 8: Activities................................................................................... 125 What kind of activities work best for people with dementia ..................... 127 Activities and ability level......................................................................... 128 Breaking activities into smaller tasks....................................................... 129 Trial and error and experimentation ........................................................ 129 An activity is successful........................................................................... 129 Jump starting the activity ......................................................................... 130 More activity basics ................................................................................. 130 Planning activities.................................................................................... 131 Adult day care centers............................................................................. 132 Care facilities and activities ..................................................................... 132 Activity idea categories............................................................................ 133 More activity ideas................................................................................... 134

HANDOUT: 101 Things to Do .................................................................................... 136

CHAPTER 9: Family Support......................................................................... 137 Family support ......................................................................................... 139 Ways to support families ......................................................................... 140 Tough decisions families face ................................................................. 140

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