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PROJECT ECHO: Behaviors Associated with Dementia PROJECT ECHO: Behaviors Associated with Dementia

PROJECT ECHO: Behaviors Associated with Dementia - PowerPoint Presentation

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Uploaded On 2018-03-22

PROJECT ECHO: Behaviors Associated with Dementia - PPT Presentation

JABSOM Department of Geriatrics Mrs FI CC Combative behaviors during bathing care Mrs F is a 7 6 yo F with hx of Alzheimers dementia HTN who has been living at ID: 660367

person bathing care dementia bathing person dementia care bath bathe depression supervision staff date http alz www org alzheimers

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Slide1

PROJECT ECHO:Behaviors Associated with Dementia

JABSOM Department of GeriatricsSlide2

Mrs. F.I

CC: Combative behaviors during bathing care

Mrs

. F is a

7

6 yo

F with hx of

Alzheimer’s

dementia, HTN

,

who

has been

living at

a Nusing

Home

with her

husband

for the last

3 years.

She often refuses to take bath/shower and she also refused to have bed bath.

Despite behavior interventions by NH sta

ff, she continues to refuse to bathe.

Staff noticed she occasionally has odors due to lack of bathing.Slide3

Mrs. F.I

Meds: Zoloft,

Trazodone, Lisinopril, Metoprolol

Social

: No EtoH, no

smoking

, no illicit drug use

Her functional

status

Cognitively

interactive

.

Able

to stand, transfer and walk with

walker

,

needs supervision

.

Needs assistance for bathing, lower trunk dressing, needs supervision for grooming,

walking. Slide4

Physical Exam

BP 100/76, HR 86, RR 20, afebrile Weight:

120

lbs

, Height:

5’2

ENT

:

moist

oral mucosa, ill-fitting dentures

Chest, lungs:

unremarkable

CVS:

RRR, no Murmur

Abdomen:

Soft, no tnederness

Ext: Low muscle bulk, trace

edema

Skin:

Dry skin, no rash

Neurologic

: Nonfocal

.

Sensory intactSlide5

MMSE and Depression

MMSE: 14/30Geriatric Depression Scale (GDS)

4

/

15 (not depressed)Slide6

Bathing for elderly patients with Dementia

Before bathing careGathering bathing supplies.

Making

the room comfortable.

Placing

soap, shampoo and other supplies within reach.

Monitoring

water temperature.

http

://www.alz.org/care/alzheimers-dementia-bathing.asp#ixzz4doS2CDqsSlide7

BathingGive the person choices.

Fill the tub with 2 to 3 inches of water. Be sure the person has a role.Be aware that the person may perceive bathing to be threatening.Always protect the person's dignity and privacy

.

Have a familiar person of the same sex help, if that is more comfortable.

Read more:

http://www.alz.org/care/alzheimers-dementia-bathing.asp#ixzz4doSQ4zNwSlide8

BathingSet a regular time for bathing.

Be gentle.Simplify the bathing process.Coach the person through each step.Use other cues to remind the person what to do.

Use a tub bench or bath chair.

"Sponge bathe" as an alternative.

Individualized careSlide9

InterventionsNH staff set up “Date Night” with her husband complete with a “couple dinner table” and encouraged her to bathe prior to the date.

Her attending physician wrote a “You need to take a bath” prescription and RN shows it to her before her bath.Play her favorite music during bathtime.Slide10

COMMENTS?

QUESTIONS?

OTHER CASES?