1. The human proper of all folks dwelling with Alzheimer’s illness and different types of dementia is to be with individuals who know their life story together with cultural habits and non secular religion (Bell & Troxel, 2003).
2. Growing friendships, relationships, and belief with folks with dementia is the inspiration of person-directed care (Bell & Troxel, 2003; Zgola, 1999). Understanding, understanding, and thoughtfully utilizing the life historical past of the particular person with dementia are the keys to creating and sustaining this basis.
three. The one solution to really perceive a person in later life in a holistic method is to see him or her in a life-course perspective.
Four. Though an increasing number of cueing is required because the illness progresses, the long-term reminiscence stays comparatively intact till the later levels of Alzheimer’s Illness. Due to this fact, there’s a have to “capitalize on what will be remembered from the distant previous to assist counter the menace to personhood” (Chaudhury, 2002).
5. “Neurodevelopmental Sequencing Strategy” in Dementia. Conduct, motion, and purposeful losses in folks with dementia happen in roughly the reverse order of their authentic growth (Buettner, & Kolanowski, 2003). Purposeful skills, expertise, and actions an individual acquired, realized, and loved in infancy, childhood, and early grownup life could also be comparatively preserved into the later levels of dementia. This key precept will be described within the phrase “What Goes In First, Goes Out Final.”
6. To have the ability to have a significant interplay, connection, and communication with the particular person with dementia (e.g., dialog prompter) and to have the ability to attribute that means to seemingly incoherent speech (Chaudhury, 2002).
7. To have the ability to establish, focus, and capitalize on the particular person’s remaining skills (Sure, we have to perceive and proactively compensate for the decreased or misplaced skills however we additionally have to keep away from focusing excessively on these). As a result of progressive nature of Alzheimer’s illness, this can be a “shifting goal” that requires common evaluation and adjustment.
eight. To have the ability to plan, encourage, and have interaction the particular person in enriching, applicable, and personally significant actions based mostly on her or his life-long pursuits, present skills, disabilities, and preferences. This, whereas remaining open to the likelihood that life-long pursuits might change amongst sure people.
9. To know the that means of behavioral expressions for the particular person dwelling with dementia (Rasin & Kautz, 2007). For instance, to have the ability to establish and tackle distant triggers from the distant previous of distressing behavioral expressions (Landerville et al. 2005). Analysis and observe have demonstrated a relationship between numerous early-life annoying occasions (e.g., life-threatening experiences and traumas) and present distressing behavioral expressions (Cohen-Mansfield & Marx, 1989; Feil, 2002).
10. To have the ability to design a bodily setting in a method that’s personalised, acquainted to the person, comprehensible, and constant together with her or his lifelong optimistic experiences comparable to of their houses. This, from basic design of bodily areas to cultural, ethnic, and acquainted symbols, favourite and personally significant objects, and furnishings. This, whereas constantly adapting the bodily setting to the particular person’s cognitive disabilities and remaining skills.
11. To know what within the particular person’s life provides him or her hope (Kivnick, 1993) and to make use of this information to nurture this sense within the current.
12. To know what it’s within the particular person’s life (from her/his perspective) that’s most price dwelling for or that makes her/him really feel most alive (Kivnick, 1993).
13. To know whom or what the particular person particularly cares about (Kivnick, 1993) and to make use of this information to plan conversations, emotional assist, significant engagement, and private care.
14. To know the issues which have at all times given the particular person confidence and made him or her proud (Kivnick & Murray, 2001) and to make use of this information frequently to advertise these emotions and experiences within the particular person.
15. To know the particular person’s fears and to make each effort to keep away from conditions, conversations, actions, and care duties that will set off these fears.
16. To have the ability to anticipate and proactively tackle the particular person’s bodily, emotional, psychological, social, occupational, cultural, and non secular wants. Numerous unmet wants associated to the particular person’s psychosocial historical past typically contribute to distressing and dangerous behavioral expressions (Whall & Kolanowski, 2004).
17. Many relations need to stay concerned within the care of their relative when the particular person lives in a long-term care dwelling (comparable to a nursing dwelling or an assisted dwelling residence). Studying concerning the distinctive and wealthy life-history of the particular person is a good way to contain relations in her or his assist and care (Chaudhury, 2002). This, in flip, might inform and result in extra individualized and efficient care and highest sensible bodily perform, emotional / psychological well-being, and security.
18. To have the ability to develop an individualized care plan that respects the particular person’s values, beliefs, religion, persona, way of life, day by day routine, habits, coping model, areas of sensitivity, fears, traumas, accomplishments, expectations, pursuits, particular expertise, likes, dislikes, hobbies, and preferences.
19. To narrate to the particular person with empathetic identification and make her/him really feel that she/he’s understood as an actual particular person (Chaudhury, 2002).
20. To have the ability to see the particular person behind the dementia and/or her/his behavioral expressions and to protect her or his personhood, id, sense of self, and dignity so long as doable (Kitwood, 1997).
“Individuals with dementia might have one thing essential to show the remainder of humankind. If we make the enterprise considered one of real and open engagement, we are going to be taught an awesome deal about ourselves“
– Professor Tom Kitwood, writer of the groundbreaking guide: Dementia Reconsidered: The Particular person Comes First (1997).
Bell, V., & Troxel, D. (2003). The very best buddies strategy to Alzheimer’s care. Baltimore: Well being Professions Press. Buettner, L. & Kolanowski, A. (2003). Observe pointers for Recreation Remedy within the care of individuals with dementia. Geriatric Nursing, 24(1), 18-25.
Chaudhury, H. (2002). Place-biosketch as a instrument in caring for residents with dementia. Alzheimer’s Care Quarterly, three(1), 42-45.
Cohen-Mansfield, J & Marx, M.S. (1989). Do previous experiences predict agitation in nursing dwelling residents? Worldwide Journal of Growing old and Human Improvement, 28(Four), 285-294.
Feil, N. (2002). The validation breakthrough: Easy strategies for speaking with folks with Alzheimer’s-type dementia. (2nd version). Baltimore: Well being Professions Press.
Kitwood, T. (1997). Dementia Reconsidered: The Particular person Comes First. Berkshire, UK: Open College.
Kivnick, H.Q., & Murray, S.V. (2001). Life strengths interview information: Assessing elder shoppers strengths. Journal of Gerontological Social Work, 34(Four), 7-32.
Kivnick, H.Q. (1993). On a regular basis psychological well being: a information to assessing life strengths. Generations, 17(1), 13-20.
Landerville, P., Dicaire, L., Verreault, R., & Levesque, L. (2005). A coaching program for managing agitation of residents in long-term care services: Description and preliminary findings. Journal of Gerontological Nursing, 31(three), 34-Four.
Rasin, J., & Kautz, D.D. (2007). Understanding the resident with dementia: Views of assisted dwelling facility caregivers. Journal of Gerontological Nursing, 33(9), 30-36.
Whall, A.L. & Kolanowski, A.M. (2004). The necessity-driven dementia-compromised habits mannequin – a framework for understanding the behavioral signs of dementia. Growing old & Psychological Well being, eight(2), 106-108.
Zgola, J.M. (1999). Care that works: A relationship strategy to individuals with dementia. Baltimore: The Johns Hopkins College Press.