Ron, Just went to a course on Dementia.? Possible goals 1) Decrease agitation while showering and dressing?2) Decrease agitation during transition of the nursing staff. 3) Decrease agitation throughout the day by 25%.
I would then make a log, in which Joan mentioned, called a behavioral mapping log.? This identifies during the day and night when these agitations occur and what was going on in the enviroment.?Staff will have to be trained on how to fill it out. ?Some possible triggers from my experience?are a)showering at night time when they are used to showering in the morning b) too much TV c)hates to get dressed d) when the daytime shift nurses go home and the evening nursed come in (nursing transition). Some practical evidence based behavioral treatment ideas for the above: a) Play some soft music that was once the patient's favorite, if the family is involved prior to and during showering.? Try a routine that matches the patient's preference (morning versus night).? Allow calming scents prior to the shower to calm the patient.? Reward the patient with her favorite type of candy during and after the shower (usually chocolate kisses work). b)Many times watching Jerry Springer and the other daytime trashy shows can cause an episode of agitation.? I would elminate the shows and replace it with more meaninful activities a) Memory lane activities b) Trunk full of junk from their generation era, so they can safely fidget with different things. c) Play soft music and reward with chocolate or something they enjoy.? Simple guiding tecniques in which you initiate part of the dressing can help. d) To decrease agitation during staff transition, I tend to train the staff to complete this transition as secretely as possible.? Do not say your goodbyes to patients or staff members, because they often think they get to leave as well and then flip out when they don't get to leave.? This is a perfect time to have an activity for the most agitated so a distraction can occur.? I am also big on walking clubs.? This is where everyone gets to go for a walk sometime during the day.? All the staff members get to participate in this one (even the lunch lady).?Just be sure to match the skilled therapists with the pateint's that cannot walk well and the non therapy staff with the patient's who can walk well. This has been shown to decrease agitation as well. Chris Nahrwold MS, OTR -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
