Role of communication and interactions with individuals who have dementia Essay

1. How do one-on-ones with dementia broadcast through their behaviour (1.1)Persons with dementia whitethorn communicate through behaviours such as repetition of actions or questions, this whitethorn communicate anxiety over memory detriment, boredom from inactivity, to jawk reassurance, picking at clothing due to anxiety.Aggression, this whitethorn communicate depression, an softness to rationalise, impaired judgment, tactile sensation embarrassed and fearful of humiliation, frustration that they are unable to remember what they are meant to be doing or that former(a)s do not understand their convey to accomplish tasks that they live to be important. Can find no other way to express themselves.Pacing or walking, this may communicate a trust to visit a certain attitude or person. Although the individual may support forgotten who or where. They may be bored and attempting to use up energy, uncomfortable from sitting, confusion about what they are meant to be doing or wher e they are, to enter in to past routines of behaviour that once served an important purpose that the individual feels they neediness to accomplish.Becoming suspicious of others, this may communicate that the individual is experiencing memory loss and is having difficulty recognizing familiar facesPointing and vocalizing to communicate their intentions as the individual loses the use and intellect of their vocabulary2. How you as a get byr can misinterpret communication (1.2)Not being attentive and missing behavioural communications such as picking at items, failing to baffle eye contact or being out of the persons view, not creating an environment conducive to communication (adequate lighting, low background hurly burly levels etc)Not allowing the individual conviction to process learning before continuing the conversation.Misunderstanding the intention behind a given response as the individual may mean one thing but say another. Individuals in a view as team may fail to rec ord informationand communicate with one another when they have identified a need for a behaviour and the correct response to that need. i.e., the individual may pace because they are vile remembering a forgotten routine (the need to catch the bus so they are not late for work).Asking open sort of than shut questions requiring a yes or no answer. Making communication difficult.3. Explain the importance of sound communication with individuals with dementia (1.3)We all communicate to express demand and shell out information. In order for these needs to be met there must be someone open to receive information and a receptive environment in order for information to be shared effectively. As a person with dementia already has a compromised ability to communicate, communication needs to be effective and understood or the client may not understand what is being done to them, where they are being taking. It is important that for effective communication to take place the care bestowerCrea tes an environment that supports effective communication oAdjust lighting so you can be seen and you can in tern see, adjust lighting, close curtains if excessively delightful etc.Reduce the distraction of background noisesApproach communication when there is reduced or no distracting activity in the surrounding environment oTry to make the individuals environment comfortable in bourns of temperature, seating arrangements, attempting to meet baser needs, food, drink, toileting.Presents themself in a way that supports communicationPosition yourself in a way that enables eye contact to be made (but not to invade personal space or intimidate) oBe aware of your non-verbal bodily communication, allow the individual to see your body language as they will be more receptive to this than speech, ensure your body language is in keeping with your intentions to avoid mixed messages deliveranceoRemain positive and present information in an enjoyable and pleasurable manner but avoid patronising oWhen assisting with tasks attempt to offer direction by decompiling tasks to their primitive components rather thenassuming the individual will recall how to carry out complex activities i.e. putting on shoes. Redirect the topic of conversation or activity if the individual sours distressed rather then arguing your point oAssume that the individual can understand what you are saying. If they are present while other conversations are taking place, be respectful and show dignity by not discussing them in their presence oAttempt to retain as much of the persons autonomy as is possible by offering choices, i.e. food, clothes, activity. However keep choices elementary, in the present and not abstract. Asses the individuals ability to choose as the illness progresses, simple choices can become overwhelming and may need to be revised.Assisting with activitiesDo not boss the individual allow them time to attempt tasks at their have pace. If people feel that they are being controlled t hey may resort to aggression or withdraw. oUse hand over hand techniques as opposed to carrying out tasks for individuals. evaluate efforts and avoid highlighting errors.4. Describe how 3 different forms of dementia can affect the way an individual communicates. (1.4) Vascular DementiaCaused by a serial of small strokes, Vascular dementia can compromise understanding of language, memory and ability to follow instructions. Early symptoms may include slurring of speech ( modify the individuals ability to verbally express), dizziness (affecting concentration), short term memory (affecting the ability to take in new information, adjust to new situations, settings and people). More dominant symptoms affect a persons control over bladder and bowel movements compromising the ability to communicate these baser needs, ability to process information and abstract thought affecting a persons independence and autonomy.Dementia PugilisticaBrought upon by a repetition of concussions, the dementi a comm lone(prenominal) effects a decline in rational abilities, pretermit of concentration (affecting a persons ability to hold a conversation, process information, attention to tasks). Personality disorders including psychomotor retardation (a slowing-down of thought and a simplification of physical movements affecting processing skills, learning new information, recalling learnt information and ability tocomplete tasks), exacerbation of aggression, suspiciousness (effecting trust in relationships and inclusiveness), loquacity ( decorous talkative). Huntingtons sicknessA neurodegenerative genetic disorder that affects muscle coordination and leads to cognitive decline and psychiatric issues. Some of the symptoms and their effect on communication could be Motor dysfunction, jerky, random, and uncontrollable movements may affect twain(prenominal) the individuals confidence in their ability to communicate and their ability to express and intercommunicate. Slowed saccadic eye m ovements (quick, simultaneous movements of both eyes in the same direction) may affect the individuals ability to make or maintain eye contact affecting attention, ability to read both nervus seventh cranial nerveis and bodily expression. Rigidity, writhing motions or abnormal posturing would affect the individuals ability to express themselves through body language. Abnormal facial expression, difficulties chewing, swallowing and speaking would affect both use of the spoken language and accurately conveying emotion and intent through facial expression. oSleep disturbances would leave the individual feeling tired, affecting concentration, temperament, attention and emotional state susceptibility to correctly initiate countenance actions and to inhibit inappropriate actions could affect the individuals ability to gesticulate creating, misunderstandings and possible offence. Impairment in the range of short-term memory and deficits to long-term memory may affect the individuals ab ility to retain information required to hold conversations in context, identity of others, whats their relationship, what are their intentions. 5/6. Give 3 examples of how you have positively interacted with clients with Dementia and explain how these positive interactions alter to their wellbeing. (2.1)(2.2)Although I do have pay back of interacting with people who have dementia, this was at a time when I was not a support or care worker. As I used to be a cook in a large care home, I interacted frequently with persons with dementia I will use those experiences along with the information I have learnt as a result of this unit to answer questions 5 and 6.Example oneAs I would go about my work in the kitchen at the nursing home, there was a lady resident who would often stand at the kitchen approach and would grouch to herself and occasionally look at me and say short sentences that to me made no backbone as I did not know the content. Despite not discerning much about dementia , I felt comfortable in this ladys company and felt that she was also comfortable with standing and chatting at the door her stance, demeanour, tone and facial expression supported this. I would always speak to her in a calm, clear pleasant manner as this was not only polite but reflected how she spoke in my presence. Id greet her when she came to the kitchen door and ask how she was, I would tell her about what I was doing as a running commentary (cooking, chopping, baking etc). Although she never appeared to directly interact with me I sensed that standing in a kitchen and chatting were both familiar and comforting for her, as she would spend frequent parts of her day doing this. I felt it important to accommodate her presence and interact on her terms (not pushing for answers), using parkland politeness and manners, offering information as a framework for my conversation. I believe this allowed her to feel comfortable in the social situation while lacking(p) social skills.Exampl e 2 3The only part of my job role that required me to assist individuals with daily living tasks was serving, describing and presenting their repasts to them. I would assist the support stave in serving meals as dinner was a busy time. One gentleman in particular would often become distressed when his meal was presented to him the nurse requested that when I write the meal choices on the menu board I present this particular individual with physical representations of the food for him to be better informed and have clearer expectations. Although it was not my place to help the patients make choices, the gentlemen when presented with the food items did take an interest in them and I presented him with his meal accordingly. Although the instances of anxiety unsounded remained round dinner time they did however significantly decrease. I now know that the food items were used as objects of reference and I believe it would have been of greater benefit to all residents if they received a combination of a create verbally menu, objects of reference, photographic or pictorial representations of meal choicesaccording to their individual abilities around choice making. I also believe that with the information gained in this unit, in hindsight the gentlemen in question would have benefited from a smaller range of choice, 2 items as opposed to 4.7. Why is it important to involve clients with dementia in a range of activities, give three examples of how you have done this. (2.3)As stated in questions 5 and 6, I have no experience in supporting people with dementia. For the purposes of this question I will give three examples of activity that could be get a lineed essential for most people.Humans are occupational and social beings, physically and mentally built to interact with their environments. Therefore activity would not only be a natural pursuit for all people, but, for individuals with dementia who are losing the ability to interact with the world around them, the use of activity would allow them both twist and purpose for interaction linking familiar experiences of the past to the unfamiliar experience of the present.Example1Supporting individual with their morning ablutions. This task would have taken place for almost all morning of the individuals lives, with guided and prompted support the individual may benefit from a sense of pride in appearance that would have been culturally important for members of the older generation. The support worker could reinforce the activity and the individuals attention to task by complimenting them on their appearance. There may be a range of ways in which the client chooses to cleanse themselves shower, bathing, or it may be appropriate for individuals of a certain generation to wash at a hand basin. The act of washing may hold some religious significance for the individual (Muslims are required to be clean when manipulation and reading the Quran) allowing them the benefits of their religious convicti ons.Example 2Accessing social occasions (tea at a village hall). The individual maybenefit from time spent outside(a) from their home in the company of others from a familiar cultural generation. Socialising may combat isolation, loneliness, feelings of despair, suicidal thoughts, offer the individual an opportunity to positively experience their identity.Example 3Accessing reminiscing sessions. This activity may immerse the individual in an environment filled with remnants of their formative years familiar objects, smells, clothing etc creating a sense of identity and safety, stimulating the mind and senses in a bid to prolong their cognitive abilities, believes that are supported by the preference Approach.8. Compare reality Orientation Approaches to Validation Approaches. (2.4)The validation approach attempts to offer extremely disorientated individuals (predominantly the elderly at the end of their lives) an opportunity to express what are believed to be unresolved feelings an d offers the care giver an insight in to the underlying meaningful reasons for what may be perceived as odd behaviours. The care giver attempts to empathise with the individuals behaviours, mannerisms and expressions, presenting themselves in a non-confrontational and non-judgemental way engendering trust and acceptance. Thus allowing the individual to communicate as they are able, rather than as they should.Unlike the validation approach, which attempts to enter the world of the disorientated individual, the orientation course approach attempts to focus the individuals learnings in the real world. Using prompts such as calendars, clocks, current magazines or newspapers, menu boards, staff boards to orientate them in to the time and place that they currently occupy. It is thought that continual, repetitive reminders will keep the patient stimulated and lead to an increase in orientation.However, I have lay out through researching this topic that some care givers and providers hav e adapted the orientation approach (which advocates the present time) by creating and orientating individuals to the particular reality or time that they may be experiencing.9. List the physical and mental health needs that may need to be considered when communicating with some one with dementia. (3.1)Physical needsEffects of stroke ( multiple TIAs bringing about vascular dementia) oParalysis on ether side of the bodyProblems with visionSpeech and language problemsMemory lossMuscle spasticityTremorsIncontinenceDisruptions in sleep patternsUnable to remain settled, pacingLoss of hearing and or tinnitusLoss or increase of physical sensation, touch, sight, smell.Ability to accurately form facial expressionsMental health needsDepressionSense of agencyLoss of hope, experiencing despairLack in recognition of familiar people or places resulting in possible suspicion Experiencing frustrationHeightened sense of anxietyAggressive behaviourFeeling fearfulShort and long term memory lossBecoming withdrawn10 Describe how a sensory impairment of someone with dementia can affect their communication skills (3.2)optical impairmentThe individual may not be able to accurately gauge a persons body language or facial expressions, minimising the amount of information they receive. The interpretation of light fall on objects and surroundings may be distorted resulting in confusion and anxiety.Heightened sense of smell (Hyperosmia), this may affect how an individual smells both people and places around them, they may find bodily odours, perfumes, deodorants, and cleaning products offensive, reminiscent and confusing affecting the individuals border of these smells and ability to concentrate on tasks such as communication.Loss of proprioception (bodys internal sensory network of muscle and movement), this may affect an individuals ability to express body language or gesticulate.Taste, an individual may cease to communicate their desire, choice, interest in food if eating has become a displeasurable or confusing experience due to a flip in their taste.Change in the sense of touch, a heightened or dampened sense of touch may result in individuals recoiling from another touching them to show reassurance or gain attention as the sensory information received may relay pain, soreness or not register at all.A change in sensory input of any of the senses may be distressing and confusing for the individual, affecting their concentration, experience and desire to communicate.11. Describe how an environment can have an affect on a client with dementia (3.3)A change in mental faculties, cognition, memory and mental health in a person with dementia coupled with an array of sensory impairments may affect the individuals perception of their environment in the following waysThe smell of the environment may distress individuals due to Hyperosmia.A loss of vision may alter the perception of visual stimuli, b reclaim light from a window or light bulb may wash out the visual fiel d, shadows may create the conjury of people or objects, a change in sagacity perception may alter a persons ability to gauge depth of furniture.Reactions to the alterations in visual perceptions may be interpreted with fear, confusion, anxiety as objects may appear different to what they are, or the individual is unable to correctly get a line or comprehend their purposeThe environment can be arranged to effect positive change, the dcor and items can be chosen toresemble familiar surroundings from a time or era that the individual is remembering. The Orientation Approach fills the environment with informative and stimulating objects (present time frame) large clock, calendar, staff board, meal board, current literature.12. Describe how your behaviour and that of other carers can have an affect on a client with dementia (3.4)The care giver needs to consider the way they speak whether it is positive or negative, does it show that you are attentive and caring, if a carer rushes thei r speech or does not allow the client time to respond, it may convey a lack of respect and that they dont want to be there. The messages that the carers body language communicates must not be at odds with their verbal content this may create confusion and appear as insincerity. The carer must be focussed on the needs of the client, not becoming distracted by personal discussions with other carers at all times the chosen language must be that of the clients while in their presence. Interpersonal staff conversations conducted while staff are delivering care show a lack of respect and compassion, the client may not feel that they have a right to talk if they are not involved or may become distressed about the content of conversation and feel a need to become involved. Clients may feel that they can assist with a staff members personal problems, offering money or possessions, accepting gratuity is both unethical and would be in contravention of the code of conduct.This may be interprete d by clients as payment for preferential services or as theft after a client having forgotten there offering discovers their money or possessions gone. Carers need to remain professional and stick to their roles as draw in their job descriptions if the client should request services that are in contravention of their role, the carer should politely decline the request and seek support/advice from their manager if they feel it necessary.13. Describe how the use of language can hinder positive interactions and communications. (3.5)Clients with dementia will be experiencing a deterioration in theircognition, attention, memory, producing and understanding language, learning, reasoning, problem solving. It is then necessary that the carer not only use their language and communication skills appropriately but they also recognise deficit in the clients abilities and change their approach accordingly. The clients deterioration in cognition will result in a struggle to comprehend both spok en and written language if a client does not understand information they are more likely to withdraw and accept their confusion with feelings of embarrassment and ineptitude rather than seeking clarification. The carer should be attentive to the clients communication needs noticing if they are struggling to understand, offering the information in a more appropriate way. The carer should always adapt their vocabulary to that of the clients considering the use of slang, euphemism, colloquialism, allowing time to process and respond, realising that the clients may have lost the ability to ask questions and seek clarification.