Printer-friendly version Introduction Caring for a loved one with dementia poses many challenges for families and caregivers. This fact sheet provides some practical strategies for dealing with the troubling behavior problems and communication difficulties often encountered when caring for a person with dementia. Improving your communication skills will help make caregiving less stressful and will likely improve the quality of your relationship with your loved one. Good communication skills will also enhance your ability to handle the difficult behavior you may encounter as you care for a person with a dementing illness.
Life does not stop with a diagnosis of dementia: As a result and combined with the time constraints and regulatory requirements that neurologists and all health care professionals face, this can create situations in which detailed disease management, rather than the healing potential within the provider-patient relationship, directs clinical encounters.
For conditions without effective treatment or cure, placing clinical interactions firmly within such a therapeutic relationship may be especially important. In addition to having no cures or consistently effective treatments to offer, neurologists also may lack the training or experience to field questions posed by caregivers, often on the theme of managing challenging behaviors.
Likewise, neurologists may not fully understand the plight of the caregiver and so may be unable to offer informed advice that could ease the burden of caregiving, which in turn can improve the quality of life for persons living with dementia.
First-person accounts that could educate neurologists on what it is like to live with dementia call to mind unconscious biases neurologists may harbor regarding patients with dementia, suggesting that targets for care and support are scarce in the medical literature on AD.
Numerous persons living with dementia have communicated with the authors of this article about the negative impact their interactions with neurologists have had on them, especially when receiving the diagnosis of dementia. In 2 recent national conferences Dementia Action Alliance in and American Academy of Neurology inthere have been panel discussions of persons living with early-onset dementia from various causes.
The interactions these individuals describe often are characterized as lacking empathy, compassion, or acknowledgement of fundamental personhood with poor eye contact and communication skills of the neurologist, ignorance or poor communication of available resources, and a perceived lack of effort or concern to help patients live well with their diagnosis.
First-person accounts like these can be informative, and the authors of this article advocate for using them to educate providers by including them in medical education from premedical training through medical school, residency, and continuing medical education.
Research, including accounts such as these, shows that persons living with AD feel unsure of themselves in an unfamiliar world and try to restore normalcy through maintaining a sense of continuity in their lives. Rather than responding about the personal or functional impact of dementia, participants focused on poor interactions with physicians during and after diagnosis, as well as how the stigma of dementia changed the way they were treated by others after diagnosis.
The stigma of being diagnosed and the immediate implications for control and autonomy in everyday decisions were of primary concern to town hall participants.
This paradigm emphasizes losses eg, ability, identity despite evidence that people living with dementia retain their selfhood,9 and may continue to be productive, often discovering previously unknown talents and abilities.
In contrast, transcending this disability-focused dementia paradigm may contribute to an understanding of dementia that is more aligned with respect, dignity, and social justice. This may in turn enhance the well-being of people living with cognitive impairment by helping to maintain their sense of selfhood and relationships.
Arrange for the participation of a primary caregiver during diagnosis discussion.
Provide adequate uninterrupted time and a proper office space. Make a specific diagnosis, unless cultural, educational, or other factors dictate otherwise.
Make the diagnosis a process that occurs over several office visits. Counter nihilism and despair by focusing on remaining abilities: When sharing the diagnosis, it is recommended that the physician position himself or herself as a partner of, and advocate for, the patient and caregivers.Many people with dementia may not remember what happened 45 minutes ago, but they can clearly recall their lives 45 years earlier.
Therefore, avoid asking questions that rely on short-term memory, such as asking the person what they had for lunch. Intermediate care does have a role in preventing admission in patients with dementia, but its role is best limited to patients with a defined single diagnosis suitable for home treatment and its cost effectiveness has been questioned.
A study was conducted to examine the impact of the physical environment on the behavior of residents with dementia in a special care unit in the Rocky Mountain region, and to determine which features support a better quality of life.
Discussing impact of dementia on patient and carer. Print Reference this Some communities supply respite facilities or adult day care centres that will take care for dementia patients for a period of time, giving the primary caregivers a break.
those who may be 'powerless' in many other aspects of their lives as well as in regards to. Sleep disturbance symptoms are common in persons living with Alzheimer disease (AD).
However little is known about the impact of sleep disturbance symptoms in patients living with AD on caregiver burden and quality of life (QOL).
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