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Non-pharmacological Approach to Behaviour that Challenges Jennifer - - PowerPoint PPT Presentation
Non-pharmacological Approach to Behaviour that Challenges Jennifer - - PowerPoint PPT Presentation
Non-pharmacological Approach to Behaviour that Challenges Jennifer Casson Advanced Dementia Support Team Jennifer Casson Advanced Dementia Support Team % ? Dementia is the biggest health problem facing older people today 52 %
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- Dementia is the biggest health problem facing
- lder people today 52 %
- ‘Dementia affects physical aspects of a
person’s health’ 74 %
- ‘Dementia affects mental aspects of a person’s
health’ 93 %
(Alzheimer’s Research UK)
% ?
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- Apathy: 50–70%
- Agitation: 20–60%
- Depression or anxiety:
40%
- Psychotic symptoms 25%
Ballard C, Howard R (2006)
Associated with
- caregiver burden
- Institutionalisation
- worse prognosis
- rapid rate of illness
progression
- high direct and indirect
costs of care
Lawlor, B. (2002) BJ Psych
2/3 -> 4/5
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defined as any behaviour that is unpredictable, frequent, of long duration and is distressing to the individual or a nuisance to others
(Tarbuck and Thompson, 1995)
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Agitated behaviour as ‘socially inappropriate’
- abusive or aggressive toward self or other
- appropriate but with inappropriate frequency
- socially inappropriate
(Cohen-Mansfield, Marx, and Rosenthal, 1989)
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UCLA Gary Small
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The limbic system
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Brain atrophy = brain failure
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Erik Erikson & Naomi Feil
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Unresolved conflict
Eight Stages Validation Theory unresolved life issues
- Mal-orientation
- Time confusion
- Repetitive motion
- Vegetation
Hope: Trust v Mistrust Will: Autonomy v Shame Purpose: Initiative v Guilt Competence: Industry v Inferiority Fidelity: Identity v Role Confusion Love: Intimacy v Isolation
Care: Generativity v Stagnation Wisdom: Ego Integrity v Despair
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‘Tom Kitwood’
Malignant social psychology An ‘enriched’ model Person-centred dementia care
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Unmet needs… Which is it?
Comfort? Inclusion? Identity? Attachment? Occupation?
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Cohen-Mansfield & James
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Life History Personality Social environment Physical health Medication Triggers to unwanted behaviour Intervention ideas 1,2,3 Other needs
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Teepa Snow N.V.C P.A.C
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peak intense behaviour calm TRIGGER! emotions accelerate agitation rises recovery de-escalation here
- 1. Remove the threat
- 2. Create space
- 3. Be on her side
- 4. Get at on or below eye level
- 5. Use hand-under-hand
- 6. Breathe in sync
- 7. Calm voice
- 8. Relax the body
- 9. Attend to need
10.Be willing
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Final thoughts
- Take a step back if you can
- Be person-centred
- Use your full tool-kit
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Would you like to get in touch?
- jenny.casson@eolp.org.uk
- www.eolp.co.uk/
- www.cheshire-epaige.nhs.uk/