Dementia and Alzheimer’s are prevalent in all levels of care when taking care of the elderly. One of the main reasons we have such facilities as nursing homes is to help those who are no longer capable of taking care of themselves due to these mental illnesses.

PSW’s are the ones who are on the front lines working hand in hand, directly with individuals who have this illness.

Under no circumstance is it easy, but there are steps we can take to make it so. Our number one priority is always our resident, however our safety is something we cannot ignore.

Often time’s people with dementia tend to be verbally and sometimes physically aggressive.

Tying someone down or yelling at them isn’t an option – in fact, it’ll get you fired. Remember – it is the illness doing all these things, not the individual.

SAFETY FIRST

Unfortunately, Alzheimer’s and Dementia is a disease that progresses. What was once easy to handle is now extremely difficult, which is why it is important to implement safety tactics as soon as possible.

Following are some of the strategies that you can use when working with such clients:

• Their sense of judgment, place & time, behavior and physical abilities are changing. Their concept of things is no longer on par with us. With this in mind, a person with dementia should not be handling anything that has a possibility to hurt them or others. Examples being scissors and stove top.
• Watch out for any toxic substances. Someone with dementia doesn’t know the difference between a glass of water and bleach.
• Important documents should also be on hand for emergencies when working with someone with dementia. There’s a good chance that they couldn’t tell you the current date, never mind their doctor’s phone number.
• People with dementia tend to wander and the probability of them getting lost is great if they aren’t supervised adequately. To avoid this, make sure they are getting enough exercise, go on walks with them or involve them in daily tasks that are easy for them to manage such as folding laundry.

THE PSYCOLOGICAL PERSPECTIVE

You’re going to get called names. You’re going to get yelled at. It’s part for the course when dealing with dementia.

DO NOT take it personally, as difficult as this may be, but it will be the only way you’ll survive. Remember it is the illness talking and NOT the person it has rudely inflicted.

Just say yes: Sometimes, it’s easier to agree. If your resident tells you that she is going to call her mother, who probably died years ago, tell her “That’s great! Say hi for me!”

Making an attempt to tell her otherwise will upset her as she believes that what she is telling you is the honest to God truth.

Stay calm: Talking to someone with dementia or without in a calm and gentle manner will yield far better results than if you were to yell and be rude.

They are still people with feelings just as valid as your own, treat them as such!

Be a friend: When a resident with dementia is rude to you, it is often because they are frustrated and unsure of everything around them.

Maybe they are new to the facility. Maybe they are not aware of the changes taking place and aren’t sure how to deal with them. Be a friend, not an employee.

Therapeutic Lying:  Otherwise, telling little white lies to help calm your resident down. It may not seem right, but depending on the circumstances the truth may be more painful and cause more harm than good for your resident.

As an example, if someone who is not allowed to leave the building unsupervised asks to do just that, tell them the elevator is broken therefore they cannot go down.

The phone is broken too.

We’re going to have lunch soon.

I’ll go with you, but give me ten minutes.

There’s a good chance this will distract them and they will forget all about their outing.

Re-orienting: Is re-orienting a resident such a good idea?

Not necessarily!

As mentioned before, there is no harm what so ever in letting someone believe something other than what it really is.

A lot of people with dementia or Alzheimer’s tend to go back in time. The reasons for this are unclear, but often times you’ll come across someone who thinks it 50 years earlier.

Is there anything wrong in this?

Not at all.

If your resident is happy in whatever state of mind they are in, let them be happy. At this stage in the game they are not aware that they have dementia.

To them this is real. Let it be.

Little white lies: This goes back to telling white lies. Sometimes this also needs to be done in order to get an aggressive resident into a shower or the bathroom.

Tell them their friend is in there waiting for them. Tell them it’s fun.

You know your residents better than anyone else. Play on your knowledge of their likes and dislikes in order to get care done for them in the safest way possible. Remember, it’s not just their safety on the line, it’s yours as well!

Ask for help: Never forget this: ASK FOR HELP!

Sometimes we can’t deal with the psychological setbacks of dementia ourselves. A fresh face with fresh ideas may be able to help you with your resident.

I’ve had to pretend I was a police officer to help a co-worker’s resident take their medication. Sometimes the silliest ideas are the ones that work best.

TEST OF YOUR PATIENCE
Dementia and Alzheimer’s are one of the most painful illnesses you’ll ever have to deal with in LTC. When someone has this, there is unfortunately no hope of them getting better.

It is a degenerative illness which only gets worse the longer you have it.

Aside from all the aforementioned tips, it takes a special person to work alongside these individuals. Not only is the safety of your resident important, but yours is as well. Without your well-being being taken care of, you’re of no use to anyone else.

Always have patience and talk in a calm manner when dealing with the aggressiveness the disease tends to have.

REMEMBER: It is the illness talking, not your resident. You cannot deal logically with an illogical illness, so sometimes little white lies are necessary.

Most importantly, LOVE what it is you’re doing, in ALL aspects of PSW work.

Without your compassion and want to take care of these individuals, all the tips in the world won’t help you. The passion in a PSW is essential in this line of work. It is the only way we can survive day after day of work, Month after month and year after year.

Who knows, one day we ourselves may have this horrid disease. Wouldn’t we want the best care for ourselves?

I sure do!