CAREGIVERS - THE PROFESSIONAL
Care plans, educational programs, products, and the delivery of health care services to individuals with dementia are built on the foundation of “person-centered care” – care that, in all of its aspects, considers, respects, and preserves the dignity of the whole person. A growing number of state legislatures are mandating professional caregiver training to ensure compliance with caregiving standards for quality and safety.
Nearly one quarter of all older hospitalized patients have some degree of dementia. And dementia occurs in more than half of persons residing in long-term care facilities, more than forty percent of residents in assisted living, and one-third of all Medicaid beneficiaries. The large, and growing, numbers of the elderly with dementia who are in some form of institutional care make it imperative that those providers develop programs of person-centered care that are understood and implemented by all staff.
Typically the diagnosis of dementia is superimposed on other chronic illnesses such as diabetes, hypertension, and obstructive pulmonary disease. Acute episodes or exacerbation a of these chronic conditions regularly occur in which a change in the health care setting is required and with care to be delivered by a new team of caregivers. These professionals have a responsibility to implement and manage a medical care plan always mindful of the level of debilitation due to dementia that defines the whole person.
Astrum Care has developed educational programs, products, and consulting services that support the professional in delivering state-of-the-art person-centered care. Several approaches are presented to support communication and the care planning process bearing in mind that there are no stereotypical behaviors or responses that are consistent among individuals with dementia and the approaches to care must be based upon an unbiased assessment of the individual.
When interacting with a person with dementia, it’s important to always:
- Introduce yourself, explain who you are, and describe what you will be doing;
- Address the patient directly, not from behind or to the side regardless of the individuals cognitive state”;
- Stand or sit at eye level with the patient to establish one-to-one personal contact and speak clearly, distinctly, and at a normal rate;
- Address the patient by the name the that they prefer and that all others routinely use;
- Allow the patient sufficient time to respond and assist if there appears to be a word that is “lost” in their response;
- Avoid negative words and approaches to conversation or questioning;
- Express affection with a smile, holding a hand, or giving a hug. Use a light touch and move slowly.
- Be supportive and reassuring throughout every encounter with a patient with dementia.
Other important rules of of the road for implementing person centered-care may include”:
- Ascertaining the care routine that includes activities of daily living (ADLs) and Maintain the same routine;
- Adapting an effective communication style by watching for cues in words or actions that can help maximize the patient’s performance of ADLs;
- Determining by documented history and/or interview the cognitive and functional status of the patient and adjust the care plan as needed;
- Supporting the family caregiving unit;
- Working with other professionals to create an interdisciplinary team approach to care;
- Advocating for the patient with dementia.
Most importantly, join the journey of the individual with dementia. Vital to delivering patient-centered care is understanding the patient’s mental place in time and memory so as to provide support and care that is meaningful, compassionate, medically correct, and respectful.