ADvancing Care is a newsletter for people who work in nursing homes and other residential care settings, and for the families and friends of those who live there.
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Pain and People with Dementia: Cultural Competence and Health Disparities
An African American Perspective As we know, people with dementia often receive poor pain management, particularly in the later stages, because of their difficulty in articulating their pain. However, oftentimes within the African American community this problem is compounded by other health disparities.
Treatment Approaches: Pharm & Non-Pharm
Non-pharmacological management strategies are the first line of choice and are often also used in combination with medications. Reactions play a powerful role in how anyone experiences pain, and this is true for people with dementia as well. Pain can lessen when we feel safe, relaxed, cared for, and connected with pleasurable or soothing experiences. Pain can intensify when we feel overstimulated, fearful, anxious, angry, or lonely.
Occupational Therapy: Treating Pain & Providing Comfort for People with Dementia
As we know, pain can be physical, emotional, psychological or even spiritual. This is true for people with dementia as well, and there are ways that occupational therapy can be helpful in all these areas. Occupational therapy addresses the physical, cognitive, psychosocial, sensory-perceptual, and other aspects of performance in order to support engagement in activities that affect physical and mental health, well-being, and quality of life. Thus, the most effective way to treat pain and bring comfort is by using a person-centered approach that takes into account someone’s values, needs, environment, routines, and supports.
Organizing to Treat Pain
What we know: At least half of the people living in nursing homes have some level of cognitive impairment, and for people with cognitive impairment, pain tends to be underrecognized, undertreated, and poorly managed.
Understanding the Impact of Pain on People with Dementia
Dictionary definitions of pain describe it as physical suffering or discomfort related to injury or illness, as well as mental or emotional suffering or torment. When someone is in the advanced stages of dementia (which can last years), pain most often presents as behavioral disturbance, such as withdrawal, apathy, sleep disturbance, screaming, moaning, resistance to care, or agitation. Pain is the most common cause of behavioral symptoms in dementia.
The Hard End of the Day: Shedding New Light on Sundowning
Sundowning is a term used to describe the agitation, pacing, irritability and disorientation that many people with Alzheimer’s experience during the late afternoon, evening or night. For those who work or live with older adults who have dementia, Sundown Syndrome or “sundowning” is one of the most challenging situations they encounter on a daily basis. Several years ago, staff at the nursing home on the Beatitudes Campus in Phoenix, Arizona determined they had a serious problem with sundowning and set about finding some solutions.
How Trauma Can Affect the Person with Dementia
Because people with dementia have both memory loss and trouble thinking, there is a tendency to think that past events are ‘lost’ to them, and have little or no impact on their lives in the present. However, although experiences or emotions from the past can sometimes be expressed in surprising or unfamiliar ways, and most memories do eventually disappear, the past can still remain very much a part of the lives of people with dementia.”
Living with Dementia in Residential Care: Care Planning for Comfort
Nursing homes use the MDS (Minimum Data Set) assessment form to assess care needs, as the basis for the care plan that is developed for each resident. As part of this assessment, staff are asked whether a resident (1) resists care; (2) has “verbal behavioral symptoms directed towards others;” (3) has “physical behavioral symptoms toward others;” or (4) has “other behavioral symptoms not directed toward others.” Staff bring these assessments to care plan meetings. Whenever any of these items are checked off as part of the assessment, it is a signal that the resident is experiencing distress, which means a focus of the care planning process should be a plan to uncover what is causing the person’s distress. The answer should never be: “It’s the dementia.”
Archives - Summer 2016
No matter our age, for most of us music plays a significant role in our lives. Just hearing a song we associate with a particular time, person or event can bring back a flood of powerful memories. We all often find ourselves singing along to long-forgotten lyrics. The good news is that this is also true for people with dementia.
With more than 30 years of experience developing and implementing innovative, creative and leading-edge caregiving initiatives, CaringKind provides an unprecedented platform of programs helping New York’s entire Alzheimer’s community to care with confidence.