____ Alzheimer’s Disease and Other Dementias: Symptoms, Stages, and Communication Strategies Expanded
Healthcare Consideration: It is important that members of the care team collaborate to explore new technological options that can improve aspects of the AD situation. Assistive tech- nologies can limit wandering and help with communication, various therapies, medication reminders, socialization, and education. They can also support a sense of independence (Palmdorf et al., 2021). DELIVER A RESPONSE WITH WARMTH AND REASSURANCE Focus on the feelings the AD patient expresses, as opposed to their actual words. Respond with verbal and physical expres- sions of comfort, warmth, and reassurance. If the patient is comfortable with touch, offer your hand as a gesture of safety and kindness. Respect boundaries, go slowly, and let the patient know that you are a loving presence. REMINISCE AND MAINTAIN A SENSE OF HUMOR Let the patient share stories, as patients will have an easier time remembering their personal history and things from the past. Encourage the person to share photos and personal images, and if they are open to questions, then ask them to share more. EMBRACE THE PATIENT, NOT THE BEHAVIOR People with AD and other dementias may experience a change in personality. Compassion will serve the caregiver well when addressing needs and behaviors. For example, if the person wants to sleep on the floor instead of the bed, ensure safety and let them. As a patient senses a loss of control over their life, they may act out. Permit safe choices that may be nontraditional. MEDICATION REVIEW Medication should be evaluated by a professional regularly as the disease progresses. Patients must take medications as prescribed. However, their medication regimen should be monitored and evaluated periodically. Medication manage- ment will identify any potential reactions and changes that are pharmacologically induced. Remember, the person may not have the ability to express how they are feeling, so the medication regimen must be overseen by a caregiver. Self-Assessment Quiz Question
HELPING WITH DAILY LIVING
ACTIVITIES OF DAILY LIVING (ADL) AND INSTRUMENTAL ACTIVITIES OF DAILY LIVING (IADL) Activities of daily living (ADL) are functions of everyday living learned throughout life and encoded in unconscious thought. Implicit memory, which is acquired in early life and brain development, may not be impaired for some AD patients, leaving them with the ability to perform ADLs. FIf this is the case, the patient will be able to maintain aspects of health and independence for a longer period. Table 6 lists the basic activities of daily living.
BASIC ACTIVITIES OF DAILY LIVING
Eating Bathing Dressing Personal hygiene: Grooming and toileting Sit and stand Continence Walking/mobility Adapted from Lourenco et al., 2019
Table 6 Instrumental activities of daily living (IADL) are activities that are not implicit but require executive function and reasoning skill. While IADL vary, they are intrinsic to everyday life and include: • Grocery shopping and meal preparation • Laundry • Housekeeping chores • Personal finance management • Safety and emergency response capability • Medication management • Transportation and mobility As AD progresses, additional support for both ADL and IADL may be needed. The person may respond with frustration, anxiety, and anger—all of which create stressful situations. Feelings of loss, an overall sense of fear, confusion, and a lack of control can also impair IADL.
12. As an AD patient experiences advanced symptoms, it is important to remember: A) To embrace the patient, not the behavior.
B) That the patient’s behavior can be controlled with affirmation. C) That the patient will not try to control their environment. D) To always ask the patient lots of questions.
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