---- Original Message ---- From: "Ron Carson" <[email protected]> To: <[email protected]> Sent: Saturday, December 13, 2008 2:05 AM Subject: [OTlist] Help with Treatment Plan???
> Evaled a new patient who was just transferred to an > Alzheimer's ALF. Is she diagnosed with Alzheimer's? Fronto/temporal lobe dementia might need to be ruled out. (Much different approach, and most often different setting needed.) My work experience is mostly with the FT clients, and those with Alzheimer's who have the most "difficult" behavior, thus often ending up in same placements. Being in a new placement - this is a time where I've seen a lot of struggling. At least when staff or other residents interfere - do this, don't do that. Two things: 1: Build connection, exchange smiles, kind words and gestures, cooperate. If she starts moving furniture, help her! If dangerous moves, distract. Silently offer involvement in whatever household tasks are happening - even a minute of shared folding of clothes is often worth a lot. 2: Find out what works - there may come a time where she's willing to go to bed - if that is fully dressed, so be it. It may take weeks to get to a somewhat acceptable hygienic standard - this is normal. But staff might need to be educated about this, or they might appear all physically combative and non-cooperative to the patient:-) The patient spoke primarily in Spanish > but also in some English. The language first learned will be the last to go. If at all possible, find her a contact person that can relate to her in Spanish - at least during this transition. Songs and tunes from her childhood/youth - sing or hum them while e.g. walking her to the bathroom - keep up the detective work til you find the right one. She was very non-cooperative > and was physically combative with ALF staff and myself. > > The staff says she is dependent for all ADL's except > eating and that she ambulates with CGA - Min A. > > What can I do with this patient? Make contact, observe, make some guesses to start the detective work, educate staff. Listen to staff and let them know they hold valuable information. And, what Chris said. Usually, in Denmark, a "dementia coordinator" (which might be an OT, or not) would do this kind of visiting consultancy. While an OT might simply be part of the nursing staff - I was. Without special background I'd hesitate to do consultancy about behavior issues. warmly susanne, denmark -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
