The Professional Geriatric Care Manager’s Blog

Individualized Interventions

The most important thing we do as care managers is assessment, evaluation and care planning. While the process is the same for each Client, the care plan interventions are always specific and individualized to that Client’s strengths and needs.

Today I will discuss some of the interventions our care managers recommend to family caregivers who are providing care to an elderly loved-one who has been diagnosed with Alzheimer’s Disease. Each person who has Alzheimer’s Disease experience it’s symptoms and progression differently. Due to this fact it is important that your caregiving techniques vary accordingly.

In early stage Alzheimer’s Disease you will find that your loved one is still capable of performing their activities of daily living independently. As the disease progresses the ability to do things independently declines. With this decline your loved one will often experience frustration, agitation and aggression as these once easily performed tasks become difficult or impossible. Some interventions for dealing with these frustrations include:

• Scheduling wisely and allowing more time – You should determine the time of day when your loved one is most agreeable and calm. Once you have determined this you should schedule the most difficult tasks such as bathing and medical appointments. You should try to establish routines so your loved one’s day is more predictable leading to less frustration and confusion. You also need to remember that things that used to be done almost automatically now may take more time. With this in mind you should allow more time to complete even the most simple tasks so there is no need to rush your loved one. Additionally, when providing instruction to the person with Alzheimer’s Disease provide them one at a time.
• Limiting choices – Providing fewer options for your loved one makes decision making easier. Instead of choosing an outfit from a closet filled with clothes, provide two outfits to choose from. During meals and conversations try to reduce distractions as it will be easier to focus on one thing at a time.
• Allow him or her to do things independently – Encourage your loved one to do as much as possible for him or herself. Your husband may be able to shave himself independently if you turn on the electric razor and place it in his hand. Your mother may be able to dress herself if you lay out her clothes in the order they go on. Doing things independently will increase your loved ones self-esteem.

Judgement and problem-solving skills also become impaired as the disease progresses increasing the risk for injury therefore it is important to create a safe environment. Some easy ways to safeguard the home environment include:

• Remove throw rugs, extension cords and clutter that can cause your loved one to trip or fall. Install hand rails on both sides of stairways and install grab bars in the tub and by the toilet.
• Install locks on cabinets that contain anything dangerous such as medication, cleaning supplies, alcohol, guns and any dangerous utensils and tools.
• Ensure that there is a fire extinguisher readily available and that your smoke and carbon monoxide detectors are in working order. If your loved one smokes do not allow him or her to smoke when alone. Control access to matches and lighters.
• Remove electrical appliances from the bathroom to prevent electric shock. Set the water heater temperature to 120 degrees to prevent scalding and burns.

When educating families about Alzheimer’s Disease and other forms of dementia our care managers advise them that the Client’s ability to function and cope will continue to decline as part of the disease process. Their abilities may vary from day to day or even hour to hour. It is key to stay flexible and adapt your routine when needed.

Suddenly a favorite food may become unappealing. If this is the case, try variations and provide finger foods if your loved one wanders so he or she may “eat on the run”. If your loved one insists on wearing the same clothes (which is a common occurrence) we advise that you purchase a few identical outfits and when your loved one is bathing switch the outfit that has been worn with a clean one.

At Distinctive Care, independence for the older adult is a driving force behind what we provide for our Clients. We alway let our family members know that they should allow and encourage the Client to do as much as possible for him or herself. You may need to relax your standards and not always strive for perfection. It may not be necessary to bathe every day (remember folks from this generation did not bathe daily, the norm was once a week) if they find bathing upsetting. You can always encourage sponge baths between tub baths or showers.

I have provided you with several intervention that may be implemented by those providing care for a loved one with Alzheimer’s Disease or dementia. Remember not every intervention will work in your particular situation. Instead you should tailor them to meet your individual needs.

If you have any questions about anything you’ve read here, please do not hesitate to contact one of our care managers at Distinctive Care Geriatric Care Management. You can reach us at 201-857-5283. We will be happy to assist you.