Zcmiraflores,rn,mn

 1. Provide cognitive stimuli

to enhance memory and
orientation
 -needed for mental
stimulation
Ex. A. Reorienting client every now and
then
B. Place a clock and a calendar in
clients room
C. read newspapers
 2.
use reality orientation and
reality testing skills
 -Done by person who is in most
frequent contact with the client
(follow through whatever
information is given to the client)
 -orienting client back to reality
(basic facts should be given
repeatedly)
 Ex. 1. Reorient client
a. constant reminders
b. physical set up of the house

AVOID TOO MUCH INFORMATION

OVERLOAD DURING REAITY ORIENTATION
3. Provide regular
social interaction
 -socialization is needed for
mental stimulation
 Ex.
 A. family and friends is
encouraged to visit
 B. ask only one question at a
time avoid confusion
 C. frequent short visits is
important less tiring
 D. schedule visits does not
occur during rests periods
 E. client should be allowed to
reminisce found to be
good interventions for
older periods
 4.Maintain self-esteem
through involvement in
ADL skills
 encourage to do own
activities of daily living
but ALLOWED PLENTY OF
TIME to complete the
task
  breakdown task into
individual steps and allow
to do one step at a time
  giving CUES IS NECESSARY
due to simplest things can
be forgotten
 5.Maintain a structured
milieu or social
environment
 -avoid too much sensory
stimulation such big room with
many people ( provide
environment with decrease
stimuli is bests)
 -activities should be well
planned( avoid confusion)
 -may favor a certain location
or spot (set up a place design
for the client) to prevent
TRANSLOCATION SHOCK
 6. Pay attention to the use
of nonverbal communication
techniques as well as verbal
cues to maintain effective
communication patterns
 -when speaking make sure to talk
in a normal tone of voice
 Speak slowly and simply
 face while talking
 Maintain eye contact
 Minimize hand movements 
threatening
 7.use behavior
modification techniques
to modify negative

 -do not confront client if

she/ he is agitated
 Remove the agitated
stimuli so as not to harm
the client

Really need a lot of time ,

energy and patience
 8.
Conduct assessment
and evaluation of the
need for medication

 Ex.

 Psychotropicdrugs  drug
capable of affecting the mind,
emotions, and behavior

-watch for tardive dyskinesia

as an adverse effect
LIMITING AND
MANAGING
COMPLICATIONS
As a healthcare provider , should be
alerted of the extreme difficulties
encounter in the care of clients with
dementia ,these includes the
following:
 1. Difficulty in communicating with patient
especially during the advanced stages of
Alzheimer's disease
 REMEMBER: Continue talking to client though
you may not be understood

 BARTHOL (1979)  stressed that actions at these

times have more impact than words
2. Difficulty in managing the
patients behavior especially
when the environment is
misperceived and appears
threatening
 Irritation and anger are normal reactions
on caregivers par t  do not let the client
see all these
 Approach agitated client in a calm and
agitated manner
 Distracting clients attention during
agitated moments sometimes proves
beneficial
 CARING
FOR THE
CAREGIVERS
 “Resolve own ISSUES
INORDER TO CARRY ON
WITH THE TASK OF
CAREGIVING”
SEVERAL STAGES IN REACTION
TO ILLNESS (ELIOPOULOS)1990

 1. DENIAL
refused to recognized
the present of illness

  lead to poor
assessment and wrong
decision
 3. over-involvement
caregivers performance of
practically all self-care
activities for the client

 - result in unnecessary
dependency on the client
(not beneficial for the
client)
Caregiver should realize that
his/her actions are not helping
the client
3. ANGER  developed
as caregiver becomes
frustrated over caring role
reversal, embarrassed by
clients behavioral problems
and feeling abandoned

 caregivers given the

chance/opportunity to
ventilate anger
4. GUILT caregiver
might feel that she has not
done what ought to be done

 Avoided if: caregiver must

realize that it was never
his/her fault ease the
burden

 SUPPORT groups might cope

with feelings of guilt
 PERSONAL COUNSELLING is
also beneficial
 5. Acceptance
 Can only occur if the ff. have been
achieved:
 1. understanding the disease process
 2. finding sufficient resources within
yourself and the community like
finding other health professionals
and institutions involved in the
care of the client
 3. working through the responses of the
stages of reaction to illness
 4. recognizing that your loved one is no
longer the person you once knew..
sundowning behavior
 5. open communication exist among
family of those caring for he client
 No known cure for
alzhiemer’s until now

 Mgt. includes :
pharmacologic and non-
pharmacologic
interventions
 Management is geared
towards maintenance of
remaining physiologic
functions and limiting
and managing
complications
 Used to temporarily improve dementia
symptoms: Cholinesterase inhibitors

These medications includes:

Donepezil (Aricept)
Rivastigmine (Exelon)
Galantamine (Razadyne)

 work by boosting levels of a chemical

messenger involved in memory and
judgment