Thanks Chris and Joan. Ron -- Ron Carson MHS, OT
----- Original Message ----- From: [email protected] <[email protected]> Sent: Sunday, December 14, 2008 To: [email protected] <[email protected]> Subj: [OTlist] Help with Treatment Plan??? cac> Ron, cac> Just went to a course on Dementia.? Possible goals 1) Decrease cac> agitation while showering and dressing?2) Decrease agitation cac> during transition of the nursing staff. 3) Decrease agitation throughout the day by 25%. cac> I would then make a log, in which Joan mentioned, called a cac> behavioral mapping log.? This identifies during the day and night cac> when these agitations occur and what was going on in the cac> enviroment.?Staff will have to be trained on how to fill it out. cac> ?Some possible triggers from my experience?are a)showering at cac> night time when they are used to showering in the morning b) too cac> much TV c)hates to get dressed d) when the daytime shift nurses cac> go home and the evening nursed come in (nursing transition). cac> Some practical evidence based behavioral treatment ideas for the above: cac> a) Play some soft music that was once the patient's favorite, if cac> the family is involved prior to and during showering.? Try a cac> routine that matches the patient's preference (morning versus cac> night).? Allow calming scents prior to the shower to calm the cac> patient.? Reward the patient with her favorite type of candy cac> during and after the shower (usually chocolate kisses work). cac> b)Many times watching Jerry Springer and the other daytime cac> trashy shows can cause an episode of agitation.? I would elminate cac> the shows and replace it with more meaninful activities a) Memory cac> lane activities b) Trunk full of junk from their generation era, cac> so they can safely fidget with different things. cac> c) Play soft music and reward with chocolate or something they cac> enjoy.? Simple guiding tecniques in which you initiate part of the dressing can help. cac> d) To decrease agitation during staff transition, I tend to cac> train the staff to complete this transition as secretely as cac> possible.? Do not say your goodbyes to patients or staff members, cac> because they often think they get to leave as well and then flip cac> out when they don't get to leave.? This is a perfect time to have cac> an activity for the most agitated so a distraction can occur.? I cac> am also big on walking clubs.? This is where everyone gets to go cac> for a walk sometime during the day.? All the staff members get to cac> participate in this one (even the lunch lady).?Just be sure to cac> match the skilled therapists with the pateint's that cannot walk cac> well and the non therapy staff with the patient's who can walk cac> well. This has been shown to decrease agitation as well. cac> Chris Nahrwold MS, OTR cac> -- cac> Options? cac> www.otnow.com/mailman/options/otlist_otnow.com cac> Archive? cac> www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
