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Positive Interaction and Communication

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Explain how different forms of dementia may affect the way an individual communicates Alzheimer’s disease is a combination of genetic and environmental factors which during the course of the disease a number of chemical and structural changes happen within the brain. Alzheimer’s disease develops very slowly several years its is not always detected at first but early signs are difficulty in forming new memories but some people may experience lauauage or spatial difficulties early signs of alzheimer’s are normally forgetting faces, names or recent events, putting items in odd places, forgetting where they have put them, or put in odd places, getting confusued about the time of day, when if differant environment getting confused about where they are, getting lost, forget words or what they are about to say, a change to their mood or behavior which is not normally them such as apathy, being irritated or lost of their confidence. Alzheimer’s will get worse over time but if differs from person to person. As a person’s Alzheimer’s gets worse their ability to remember to think, or make decisions worsens, their communication and language become more difficult. Some people become sad or depressed their behaviour may change.

Phobias or anxieties are common or experience hallucinations , see things that are not they or people who are not they, Their feel angry or become agitiated. They sleep pattern changes or problems with sleeping or restlessness at night. Become unsteady on thier feet or fall more often. Need more help with the daily living skills eg: making themselves something to eat forget how to use cooker, micowave or personal care eg: dressing, toileting or eating. Vascular Dementia This is caused by a problem with the blood supply to the brain. This is where the blood to the brain becomes blocked or damaged and the oxygenated blood will not beable to reach brain cells so they will eventually die. Symptoms will be pend on which part of the brain has been affected and how much of the brain has been damaged. Some people have both Alzheimer’s and Vascular dementia. Vascular Dementia is all so called Vascular Cognitive impairment.

The most common types are : Stroke – related dementia mulit infarct dementia (MID) this is whrere a series of small strokes happens this also includes dementia after a stroke had happened called post-stroke dementia. Subcortical vascular dementia- this is also called Binswanger’s disease which are small vessel’s related to dementia or lacunar state. This happens when small blood vessesls change in the brain. Vascular and Alzheimer’s have similar symptoms like mermory loss, disorientation and problems with communcation. Symptoms may differ depending on the area of the brain that has been affected Some of the symptoms are becoming slower to think, a changes in someones personality eg: becoming depress or apathy, not being interested in any thing, the person being more emtional, having diffculty or changes in walking. having bladder problems or wanting to urinate more. Vascular dementia becomes worse over time this can be over several years but this may differ from person to person. They could be a sudden or stepwise changes after a stroke or other events.

Dementia with Lewy Bodies- Lewy bodies dementia is a common cause of dementia the symptoms include memory loss, spatial awareness problems and a deline in problem solving skills. These symptoms are similar to Alzheimer’s and Parkinson’s. This is where people with this type of dementia have small, spherical structures are inside the cells of brain these are called Lewy bodies. By stopping important chemicals to the brain stops it from working these are called acetylcholine and dopamine when these are stopped from getting to the brain the brain cells died. Some of the symptoms are, a change in their alertness, a attention or confusion these are unpredictable and can change for hour to hour or day to day . Can have Parkinson’s disease type symptoms which could be slow movements, muscle stiffness or tremors. Having hallucinations seeing people or animals that are not there, to sleep walk or talk in there sleep, feeling unstaedy, falls or fainting. There symptoms gets worse over time but this can be over several years and different types of dementia can prodress at different speeds and this can vary from person to person.

Front-Temporal Dementia (Pick’s Disease) This dementia is a rare form of dementia this is ware a damage to the frontal or temoral part of the brain has been damaged. These control are language, emotions and behavior as well as reasoning, planning and decision making, reading and writing. This
normally affects people at the age of 30 to 60 years of age. Part of the frontal lobe regulates behaviour and the temporal lobe this supports understanding of language and factual knowledge but both frontal and temporal lobes can affect speech. This can vary from person to person and some symptoms can over lap between frontal and temporal forms. Some of the symptoms are personality cahanges , this could be how they express thier feeling to others or lack of understanding of feelings of others. Their may not show any interest or concern for others or become disinhitited or behave inappropriately. People may not be aware of their personal care or maintain their normal levels of hygiene or grooming.

Their may make inappropriate jokes or show lack of tack when in a socail environment, thier taste in food may change or their may over or under eat food or drink. Have behavioral changes, their cahange in their humour,sexual behaviour, mat become violent, change beliefs, have different interests or obsessions. some people become implusive or easily distracted. Find it difficulty with simple planning or decisions. Might is hard to get words out or understand words, their may repect themselves or use words or phases repeatedly or forget the mean of words, a deline in their language. Unable to recognize people, places or objects. In the early stages thier memory is able to remember day to day but may lack attention or concentration with could give the impression of memory problems. Frontotemporal dementia is a condition that is progressive and will get worse through time. The progression or speed of frontotemporal can vary, but often unfolds over years, some people live with the condition for unto 15 years before it detected. tHis the dementia progresses some people my show signs of problems with movement which will look similar to those see in Parkinson’s or Motor Neurone Disease.

2 Explain how physical and mental health factors may need to be considered when communicating with an individual who has dementia There are different forms of dementia and at different levels depending on what type of dementia and level of disability they have. If a person has fronto-temporal dementia it may be that their language skills are affected and these will vary from day to day or hour to hour. The early signs of someone’s language beening affected by dementia is they cannot find the right word. They may come a time when they cannot communicate correctly or successfully through communication. This maybe distressful to their family and friends but its part of their memory loss. Someone with dementia may be experiencing pain, discomfort, illlness, or side affects from their medication this may also affect their ability to communicate contact thre GP for or advice.

When communicating with someone who has Dementia before u speak keep yourself calm and relax, consider what you are going to ask that person is it something their who like to talk about, have that person full attention, make good eye contact, think about the environment you are in is it to nosily for that person to understand is the TV on to loud or is to many people talking , when your talking keep your voice clearly and calm, speak slower is it gives the person time to understand what you are saying, short sentences, do not speak sharply or raise your voice, do not talk about someone with dementia as if they are not their show then respect and patience, always include a person with dementia in conversion so they still feel part of what is going on and not isolated, do not talk to then as if their where a child. be postive, smile, try not to ask questions that need a complicated decision, given to many options just confused anf frustrates them, break down complicated questions so their understand and you get the correct information you need, listen to what their have to say and ensure that you respond so their know that you have understood them, because of their memory loss the may say that their have just eaten or someone has been to see them but this might not be the case so you have to use your judgment and act appropriately around what has been said, having good and postive body language around someone who has dementia helps them relax around you, ensure when you are talking you do not use sudden movements or tense facial expressions as this my upset of distress that person, alway match your body language and facial expressions to match what your are saying, let them have they own personal space and when useing physical contact use to show affection and care or to provide reassurance.

3 Describe how to support different communications abilities and needs of an individual with dementia who has sensory impairment . Ensure that the person with dementia had the correct precription for their glasses, that their hearing aids are working and if their have dentures that fit well and are comfortable or if in pain because of bad tooth care to make an appointment to call at the person house to to take to the dentist. involve the family with descion making. Speak slightly slower but try to keep natural rhythm of your speech, do not distort your your speech by shouting or over exaggerating it, do not cover your month while talking if the person is able to lip read, get in to a position where the person can see your face, look straight at them, come closer to them, make sure the area is quite and well lit (TV or radio off), not to many people talking at the same time with could confuse that person as to who is talking and about what, if that person is unable to understand you write it down if the person is able to read or use picture or objects to help the person understand.

4 Describe the impact the behaviours if carers and others may have on a individual with dementia It is important that with support that family, friends and carers come to terms about the person who has dementia. Informal carers are better know as family members or friends, they play an important role with some with dementia, they help through care to help the person with dementia and help to keep that person at home. Its important that the relationship with family and friends remains in tact, but by giving that person with dementia support can be demanding and stressful and this is where support, understanding and knowledge helps. People’s relationships changes because of the dementia its important that families and friends are support to help that person. Because of dementia family and friends do not understand what has happened to that person because their cannot remember what has happened yesterday but can remember from years ago this can be frustrating and confusing for families and with support and given the correct information can help them to come to terms as what is happening to their love ones .

They may feel like they have lost that person because their no longer recognise them. Family members may feel anxiety,anger,despair,guilt,embarrassment, sadness, isolated or lonely and with support to come to terms with the changes with they loves one . Family and friends will need most support as their dementia gets worse. Family, friends and carers have the right to have an assessment to support them with their own needs. Cares ( Recognition and Services) Act 1996. The family member of friend may feel that they are going everything themselves and that other family members are not pulling they weight or its just left down to them or that decisions about what care that person requires and this can cause conflict within the family. Some family members and friends find it difficult to understand the type of dementia the person has and their may find it difficult or challenging to offer support. Some carers feel isolated as their feel that they are the only ones supporting their loved ones.

Be able to communicate with an individual with dementia using a range of verbal and non verbal techniques., taking into account of the abilities and needs of the individauls, carers and others 3 Analyse ways of responding to the behaviour of an individual with dementia, taking account of the abilites and needs of the individual, carers and others. When you are caring for someone with dementia it is important that help them remain fit, well and healthy as possible both physically and mentally. This helps them feel better in them selves, enjoy life better and more pleasurable for all involved. By remembering that the person your are looking after is not being deliberately difficult and but thier sence of reality is very different from your but is very real to them. Some one with dementia can be affect a person’s ability to reason and logic so things that look obvious to you may be different with people with dementia.

Reassure the person that very thing is going to be fine if upset or agitated this could be a activity that their do not want to do at that time eg: getting dressed or having a bath try to keep the situation calm, think about how you would feel it you where told to do something you do not want to do, does that activity have to be done then or that day, allow that person to calm down. See if you can establish what has happen to upset that person so the problem can be resolve more quickly via communcation. By playing their favorite music, talking, looking at pictures their like may calm the sitution down. Have breaks or support for your self especially if you are feeling stressed or irritated because of the repetitive behaviour. Ask for more advice from other professionals if behavior becomes to much or before behavior becomes to stressful.

They may be medication that can comtrol these out bursts but has to be monitored and reviewed very carefully. Always ask about side affects incase it makes the dementia look worse. If any affects Gp to be contacted straight away. It could be that your lack of understanding or communication of what that person it trying to say could be the cause of their behavior. That person may be feeling frustrated or angry that you do not understand what is being said or trying to communicate to you what there are saying. Look at their body language and try to assess the situation. Give the person time and space to clam down and offer them ressurance that every thing is going to be alright.

Outcome 3 Be able to communicate positively with an individaul who has dementia by valuing thier individuality

1 Show how the communication style, abilities and needs of an individual with dementia can be used to develop thier care plan Get to know the person with dementia , talk to their family and friend to get some back ground information where they lived, any pasts interest’s, jobs, family, children or hobbies. Use mermory books, pictures or any information that makes the person remember their past, it could be that they was something very interesting happened tot he person or their family and their are very proud of and their remember it very vividly so it should be that their are encouragr to talk about so the mermory is kept alive. Communicate with the person in a way that their understand what you are saying, by useing verbal reminders eg gestures, written messages or what ever ir takes to get the correct information about that person. Be complimentary about what you are being told, if their having trouble finding help them by filling in the blanks. When doing their care plan communicate about thier life style, their beliefs and religion as this could be a big part of the person’s life.

Beable to use positive interaction approaches with individuals with dementia 1 Explian the differance between a reality orientation approach to interactions and a valadation approach Reality orientation – Its about given information about time, place or a person this is to help a person understand their surroundings and situation. This information has to repeated regular so the person understands. This could be everyday clues like calenders or clocks to help orientate this person by saying is 12 oclock its time for lunch this would give that person that its time to eat. Reality orientation is for people who are living with memory loss but if someone is fixed on or believes their in a certain place, situation or settled in the their belief then useing . reality orientation could cause distress. Validation approach – This is method of communicating with and helping disoriented older people. This is a practical approach that helps people reduce stree, increase happiness and dignity.

Validation is built on an empathetic attitude and holistic view of individuals. By seeing the world through someone else eyes can let the carers step into their world and have a better understanding of their sometimes bizarre behavior. Validation is a theory that understands that people are at their final stage of their life and tyring to resolve any unfinished business before their die. Validation techniques allows that person to have the opportunity to express what their want to express weather verbally or non verbally. All professional are taught to be caring, non judgmental, allow that person to express their feelings, believe when a perosn can express the things that have been often suppressed for many years, thr intensity of the feeling lesson, they will opeup or communicate more and are less likely to with draw into futher stages of disorientation. 4 Demonstrate how to use aspects of the social environment to enable positive interactions with individuals with dementia. The needs and abilities of a person with dementia should be taken into consideration within their social and physical environment. A dementia friendly environment helps a person with dementia reach their full potential and gives a good quality of life fo those with dementia and their familes.

To give personal centered care to someone with dementia there are five needs for people with demnetia. These are Comfort People – People with dementia may have a sence of loss this causes anxiety and insercurity so a environment which feels comfortable and empowered with help. Attachment -When someone who has dementia by feel like their are in someone else’s environment and their need support and encouragement to feel like their belong or attachment themselves to someone as their feel insecure about the environment their are in. Inclusion – Where someone who had demnetia finds it hard to include themselves as their feel that their do not have the same impairment as others. Individualised – That a person has care and physical settings so their feel like their belong. Occupation – When someone feels their involved with everyday life. Carers and others need to create conditions to support an social environment which draws on peoples experiences, strengths and abilitres. Treat people as in individual. To built all intercations around that persons life story’s in the care setting.

5 Demonstrate how reminiscence techniques can be used to faclitate a postive interaction with the individaul with dementia. The is a discussion about someones past events, activities ot experiences, with could be with a group of people or individual to that person. With aid of prompts such a household itens, photographs, or ither items from their past like music. Because of reminiscing it encourages people to talk, if within a group this may start a conversation where by a few of them may have things in common, only this happens about once a waeek but it could a more if it helps people to start and talk. When talk to someone about a life review you could use a memory book which has been put together over time with that people or by family, is normally done on a one to one this is where someone is guided through life experience, because it is personal to that person can sometimes be an emotional time and by having one to one allows the carer time to help that person get through it. Someone with cognitive impairment sometimes reminiscence through dance and this could stimulate their memory. Organizing tea dances helps people participated as these are good memery’s for people due to the music and structure that is used.

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