CNA Guide: How To Deal With Clients with Alzheimer’s Disease?

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According to the Mayo Foundation for Medical Education and Research, dementia reportedly affects 3% to 11% of community-residing adults older than 65 years of age and about half of community-residing adults older than 85 years of age. Many of those suffering from dementia who are older than 85 reside in institutional settings. Almost 60% of adults 100 years of age and older demonstrate dementia. With this high incidence, the need for nurses to take care of these demented clients also increases. As such, becoming a certified nursing assistant or a CNA opens you to several job opportunities. The Western countries would never lose the need for CNAs as the baby boomers are expected to hit the retiring age soon. Thus, there’s a great possibility that as a CNA, you’ll be working with clients with Alzheimer’s disease. So here’s a quick CNA guide to dealing with clients with Alzheimer’s disease:

Definition:

  • Alzheimer’s disease is a progressive, irreversible, degenerative neurologic disease that begins insidiously and is characterized by gradual losses of cognitive function and disturbances in behavior and affect. Although Alzheimer’s can occur in people as young as 40, it is uncommon before age 65. The prevalence of this disease increases dramatically with increasing age, affecting 30% of those 85 and older.

Symptoms:

  • loss of speech
  • loss of motor function
  • profound personality and behavioral changes such as paranoia, delusions, hallucinations, inattention to hygiene, and belligerence

Nursing Management:

  • Supporting Cognitive Function
    • Provide a calm, predictable environment to help the client interpret his surroundings and activities.
    • Limit environmental stimuli and established a regular routine.
    • Speak in a quiet, pleasant manner. Offer clear and simple explanations. Use of memory aids and cues help minimize confusion and disorientation, as well as provide a sense of security to these clients.
    • Display clocks and calendars prominently to enhance client’s orientation to time.
    • Encourage client to have active participation to help maintain cognitive, functional, and social skills for a longer period of time.
  • Promoting Physical Safety
    • Remove all obvious hazards and install hand rails to facilitate the client’s maximum independence and sense of autonomy.
    • Adequate lighting must be ensured, especially in halls, stairs, and bathrooms. Nightlights are helpful especially for clients who have the tendency to be confused during nighttime.
    • Persuasion or distraction may help in reducing client’s wandering behavior.
    • Restraints should be avoided, as this will further agitate the client.
  • Promoting Independence in Self-Care Activities
    • Clients should be assisted in to remain functionally independent for as long as possible. Simplify daily activities into short, achievable steps so that the client will feel a sense of accomplishment. Clients should be encouraged to make choices when appropriate and to participate in self-care activities as much as possible.
  • Reducing Anxiety and Agitation
    • Move client to a familiar environment.
    • Listening to music, stroking, rocking may help.
    • Distraction may quiet the client.
  • Providing for Socialization and Intimacy Needs
    • Encourage visits, letters and phone calls from friends. Visits should be brief and non-stressful. Also, limit the visitors to one or two at a time to help reduce overstimulation.
    • Encourage client to enjoy simple activities as a form of recreation. This may include walking, exercising, socialization, caring for a plant or a pet.
  • Promoting Adequate Nutrition
    • Serve familiar foods that look appetizing and taste good. Food must be bite-sized to prevent choking. Hot food and beverages must be served warm to avoid burns.
    • Offer one dish at a time for clients to avoid playing with food.
    • Provide aprons or smocks, rather than a bib to protect the client’s clothes.
  • Promoting Balanced Activity and Rest
    • During daytime, encourage clients to participate in exercise regimens. Discourage long periods of daytime sleeping.
    • During nighttime, if client has trouble sleeping, offer warm milk, back rub or play music to help the client relax.

Comments

  1. Jo Clark says:

    I happen to have worked as a CNA for years while in school plus have a father with advanced Alzheimer’s now. Whoever made this list above did an excellent job!

    By the time we CNAs see someone with Alzheimer’s, they are likely already in a skilled care setting. I just wanted to share a couple of things I found out from experience, and even though these folks are already in a nursing home, etc., it’s not too late in some cases to alert family members to a few things.

    My father is blind as a bat without his glasses, and early on, he broke his glasses several times. It’s very helpful if the family can determine where he got his last set of glasses to get another set made, if possible. Also be aware, there are eye doctors out there that can diagnose and prescribe eyeglass prescriptions without the cooperation of the client/patient, by using specific equipment. I went to every eye doctor in town before the last one alerted me to this.

    The other thing is dental care. Try to get any necessary dental care done before the disease progresses so far that the patient is unable to tolerate it or cooperate with it. My father has had massive aggression problems with his disease process, and at this point, he won’t allow anyone near his mouth, for any reason. These dental appointments can be done even while they reside in a nursing home, if they’re done early enough.

    Just wanted to share my experiences. It’s Christmas eve, so Merry Christmas and Happy Holidays to everyone!