5 CRITICAL AREAS OF DEMENTIA CARE

Dementia care involves first and foremost, providing for the safety of the person with dementia. One of the major symptoms of dementia, is the loss of safety awareness. Hand in hand with that, is the loss of the ability to reason, or think your way out of a situation. A real problem, if the situation is dangerous.

Added to providing for safety, is having good dementia communication, knowing what a happy environment looks like for someone with dementia, providing for social and spiritual needs as well as addressing everything physical.

5 Critical Areas of Dementia Care:

  1. Safety – walking alone across a busy highway, putting something on a hot burner and walking away forgetting about it, going outside in sub-zero temperatures without a coat, and more. Protecting the confused elder without having him feel he is being controlled, is good dementia care.
  2. Communication – just having the most beautiful home, with the best security system, won’t lead to great dementia care. Especially if the caregiver doesn’t know how to effectively communicate with a confused person. Good communication involves the speaker and the listener. When the confused elder is no longer able to communicate well, the burden is on the caregiver. The caregiver must know how to communicate through touch, gestures, smiles, patience and kindness.
  3. Environment – the environment needs constant review, and may change over time. Thinking of the environment as a way to make the elder with dementia know where they are and what is expected, is great dementia care. Clutter needs to be eliminated as it contributes to confusion. A kitchen needs to be used for preparing and eating meals. Having a TV running at all times in a kitchen reduces the environmental cues, that are telling the confused person, where he is. Creating a happy environment involves using music, activities, creating enjoyable smells, like the smell of cookies baking.
  4. Social and spiritual needs – whether this means continuing in church attendance, or participating in social groups, these connections remain important.  When the elder can no longer play that card game they won at for years, continuing the activity, while changing the level of the game is what is important. Getting together with familiar people, playing a game, laughing together, watching a movie together, these are important parts of dementia care.
  5. Physical – involves really knowing the person physically. What are the physical problems the person is challenged with other than dementia? Does this person have a vision or hearing deficit? Also good dementia care means knowing when the confused person has had a physical change in condition, when they cannot tell you. Physical also literally means engaging in physical activity to keep the body strong.

Many of these areas crossover to other areas. The person with a hearing deficit, will have an added burden of communication, increasing their confusion. The person who may be diabetic, will no longer be able to understand, how unsafe it is to not follow their diet restrictions.

To provide over all wellness, only 5 areas of dementia care turns, into a very big job.

Virginia Garberding RN

Certified in Gerontology and Restorative Nursing

Dementia 101 – The First Case of Alzheimer’s Disease

Auguste Deter was born in 1850, and met Dr. Alzheimer in 1901 at the Institute for the Mentally Ill, Frankfurt, Germany. Dr Alzheimer was a psychiatrist and neuropathologist at the institute. This is Auguste’s story.

Auguste was married to Karl Deter, and was a housewife.  At the time Karl sought help at the institute, Auguste; had no sense of time/or place, and she wasn’t sleeping at night. During the day she was dragging sheets all over the house, she was very paranoid and was constantly accusing Karl of having affairs. She was having trouble with language and writing, as well as having signs of anxiety, mistrust and withdrawal, and oh yes, Auguste would also scream for hours.

Auguste was a danger to herself, especially in the kitchen using knives. She was recorded as saying repeatedly “I have lost myself.” Even though the institute was a scary place, known to the locals as the “Castle of the Insane,” her husband had no choice but to bring her there.  Karl was a middle aged man who had to work and no one else was able to care for her.

For thousands of years when the elderly had symptoms of memory loss doctors thought this was just normal aging.  Auguste Deter on the other hand wasn’t elderly, she was only 51 when she first met Dr. Alzheimer. He worked with her documenting her behaviors, memory problems, lose of her words, anger issues and constant paranoia. And later when he left the institute he requested that on her death Auguste’s brain be sent to him.

Auguste died at the age of 55, and her brain was sent to Dr. Alzheimer. Dr. Alzheimer had a very famous friend at that time, Carl Zeiss who had just invented the first distortion free microscope. Dr. Alzheimer took Auguste’s brain tissue, froze it and then sliced and stained the tissue. Putting it under the microscope, magnified 100’s of times he saw for the first time the plaques and tangles later to be known as Alzheimer’s disease.

Virginia Garberding RN

Certified in Restorative Nursing and Gerontology