WHEN ROUTINE IS NOT BORING

Posted on

Feb 02, 2016

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Jane Silverstain is enjoying the caressing rays of the morning sun. Her husband, Benjamin is seated next to her helping to hold her favorite coffee cup and steady her tremulous hands. Jane has Parkinsons disease as well as dementia. Benjamin, also in his late 80s had a recent heart attack and his chronic diabetes has decreased the sensation in his feet.

A knock at the door by Mary, their caregiver, is a welcome interruption to their morning quiet time. It is time for their medications, assisting Jane with bathing and dressing the wounds from the ulcers on Benjamins feet.

Oh Mary, good to see you! Mrs. Silverstain responds, acknowledging her with a big smile and recognizing Mary who has been her care giver for the last year. Jane will now accept assistance with activities of daily living and is cooperative. Benjamin can go grocery shopping after Mary dresses his wounds.

Dementia is a subject that most people try to avoid but as the fastest growing disease worldwide each of us will be confronted by it directly or indirectly. In the United States there are already an estimated five million suffering from Alzheimers, the seventh leading cause of death.

Home Health Agencies in their efforts to provide comprehensive skilled nursing care must also be well versed in addressing dementia cases. The fundamental principle is to set daily routines. In the case of Jane small details such as a favorite cup, while it may not matter to the caregiver, may be crucial for the assisted person.

Routines provide maximum independence with minimal assistance while maintaining the dignity of the individual by:

Maintaining functionality though daily exercise (mental and physical)
Reducing anxiety for the caregiver and the person with dementia
Giving the person with dementia the comfort needed to accomplish their daily tasks
Organizing the delivery of care by the caregiver
Decreasing the chance of challenging behaviors
Fostering independence
Increasing self-esteem and confidence
Adjusting routines as dementia progresses by simplifying complex



As dementia cases are expected to increase, competency in caring for the individual with dementia is a big challenge. Family members and Home Health Agencies need to place emphasis on understanding the complex nature of dementia. It is easy to dress a wound or administer medications, but behind these needs is a person whose dignity and independence should be valued and upheld.



By Moses Wananu, MD, Medical Director Golden Age Home Health LLC.

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