Teepa's Tips: The Value of Coaching

[@jordanshepetofsky2677]

Hey Teepa, tell me something: is it that all Alzheimer's patients are cranky to begin with, or do most of 'em get that way only when you make them agitated?

[@Missuskeefe]

not all Alzheimer's patients are cranky. They know they want something (and you have to remember that these people were independent adults who, for the most part, have raised kids, run a household, had jobs, etc.) They cannot communicate *what* it is they want and sometimes don't know what they want. Their brain isn't functioning like a healthy adult's brain. You have to ask questions to try and figure out what it is what they want. Narrow it down by giving them choices. I also find that it takes a bit of extra time for them to process what we are doing and asking. So you can't just start firing questions at them and you can't just rush in and feed them, wash them and care for them. It needs to be done at a pace they are comfortable with or they will react (often 'aggressively'). Just put yourself in their shoes. You can't verbalize something you want, it seems obvious to YOU but the person you are trying to communicate is speaking a different language. You also don't have the ability or patients to play charades. They have been successfully communicating with ppl for YEARS so it isn't *their* communication skills, it is yours. This is where a lot of agitation comes from (in my opinion). They just don't have the ability to communicate what they want, need or feel which would cause irritation and agitation to anyone. Keep talking to them, asking questions, look for facial and physical queues. Above all, go slow and use patients.

[@Missuskeefe]

I work in a hospital where I find the nurses are AMAZING but they have only so much time to do what needs to be done so things are always rushed (not the fault of the nurses, believe me). They need to feed, medicate, wash and assess the patient in X amount of time. This doesn't mix well with dementia patients because they need to go at their own pace. The patient is being handled (gently) but not at the pace of the patient so the patient feels attacked. What do most people do when they are attacked? They fight back. Please, please remember that you are asking them to do things they have been doing on their own for YEARS. In their mind, they may think they are 20 years old and can hop out of bed and go about their daily routine. In reality, they are much, much older. A fall risk on top of a whole other range of things including not making it to the bathroom on time. So, in your 'right' mind and health, how would YOU react to someone coming in and poking food in your mouth, stripping you down and touching your private parts (giving you a wash), telling you when to pee and not getting around to changing you as soon as you have an 'accident'? You'd be pretty pissed off and humiliated. This is only a small amount of what they are exposed to. This isn't the fault of anyone because you cannot reason with a brain injury.

[@jordanshepetofsky2677]

@@Missuskeefe Ok, I hear you.

[@jordanshepetofsky2677]

@@Missuskeefe I COMPLETELY agree with you that patience is key when it comes to caring for dementia patients. My only question then is, is there any way we can slow down the work day to match the pace of the dementia patient!!? Do we NEED to have a time limit? I mean, if you're telling me that we should slow down and have more patience with dementia patients, why can't we? Why can't we always just be there for them whenever they need? Why can't it just work that way!!??

[@jordanshepetofsky2677]

@@Missuskeefe And I'm sure that even a hospital is, unfortunately, a fast-paced workplace. But does it really have to be? Why?

[@jordanshepetofsky2677]

One question for you, Teepa: what if the person with dementia asks for the coffee at nighttime, or around supper time? How do you respond?

[@teepasnowvideos]

You might consider replacing caffeinated with decaffeinated...

[@jordanshepetofsky2677]

I'm hoping to work with patients like the one Olivia worked with, I.e., less cranky patients.

[@jordanshepetofsky2677]

Can you respond with negotiation?

[@teepasnowvideos]

If you are willing to negotiate, you certainly can try. What are the possible outcomes of the negotiation? Are you OK with those possibilities?

[@Flexmeister]

Usually you cannot give a person 2 choices, because they will often choose the second thing you say. Why do you ask a question every time they ask a question?

[@ivhmusicdept3084]

It's important to note, they were speaking specifically of Emerald stage. This of course is an example of a technique. It doesn't mean if you do exactly what they do it'll work every time. I think it's the concept of repeating what they said so they know you understood, and trying to jog their memory as to what they are asking for. Again, this is specific to the Emerald stage. Each stage requires it's own techniques. Great question.

[@teepasnowvideos]

That's OK if you give them two choices that YOU are OK with...