gwendolyn de geest, rn, bsn, ma managing responsive behaviors in care
TRANSCRIPT
Gwendolyn de Geest, RN, BSN, MA
Managing Responsive
Behaviors In Care
Alterations in Cognition• Delirium
• Dementia
• Depression
Maria Martin, VCC BSN student, 2011
Delirium
• Acute
• Reversible
• Physiological, psychosocial, environmental factors
Dementia
• Chronic, progressive
• Symptoms- loss of memory- poor judgment- mood swings- disorientation
Alzheimer’s Disease
• Dr. Alois Alzheimer
• 1906 – Auguste D.
• Frankfurt, Germany
• Plaques and Tangles
Aaron Copland90 yrs
Rita Hayworth68 yrs
Aaron Copland90 yrs
Sugar Ray Robinson
67 yrs
Burgess Meredith89 yrs
Barry Goldwater89 yrs
E.B. White86 yrs
AlzheimerDisease
Normal Brain
TIME July 17, 2000
Language
Memory
Language
Memory
GREEN
RED
GREEN
BLUE
RED
BLUE
BLUE
RED
BLUE
GREEN
GREEN
RED
Attention / Frontal Lobe Skills
The ThiefofMemory
• The person remains
• The person’s humanity remains
• Communicates with feelings, not words
Impact on Communication
Depression
• Chronic
• Reversible
• Often mistaken for dementia
• Reason for every behavior
• Check out approach
• Apraxia, Agnosia, Aphasia
Responsive Behaviors
Maria Martin, VCC BSN student, 2011
Apraxia
Loss of ability to take purposeful action even when muscles, senses, and vocabulary seem intact.
Agnosia
Inability to recognize objects by use of the senses.
Aphasia
Inability to use or understand language (spoken or written).
1. expressive aphasia
2. receptive aphasia
Intervention Strategies (1)• Calm approach
• Explore cause of behavior
• Understanding
• Education and support for family
Intervention Strategies (2)• Apraxia
- loss of independence
• Agnosia- environment
• Aphasia- frustration
Communication Strategies• Reminiscence
• Simple repetition
• Appropriate touch
• Distraction- catastrophic reaction
Nursing Process Application• Situation
86yr-old woman exhibits disturbed attention and confusion
• Nursing diagnosis ineffective coping related to organic
memory loss
Nursing Process Application• Nursing goal
minimize factors that contribute to inattention
• Nursing approach supportive, calm
Nursing Process ApplicationNursing intervention• Direct eye contact
• Use of appropriate touch
• Clear, simple direction
• Repeat messages slowly
• Modify environmental stimuli
• Assist family to understand
Evaluation of Successful Outcomes
• Does not occur through words
• Behavior
• Co-operation
• Positive response
References
• Arnold & Boggs, Interpersonal Relationships
• De Geest, G., Living Dementia Case-Study Approach
• Potter & Perry, Canadian Fundamentals of Nursing