5 Tips to Reducing Challenging Situations in Dementia Care Organizations

By Debi Tyler Newsom, OTR/L, PAC Client Relations Director

Challenging situations happen constantly, and senior care is no exception. Team members could tell you stories about stepping into situations that have caught them completely by surprise.

How can you handle those horrifying moments in a way that protects the dignity of the resident and the composure of the staff person involved? How do you help equip staff for those moments?

See how Teepa handles the following challenging situation:

Here are 5 important points that will get your team through the most challenging situations.

1. Assess the severity of the situation

Is it annoying, risky, or dangerous? Sorting out those three possibilities will help determine a course of action.

Situations that put a staff member or resident at risk necessitate an immediate intervention to prevent injury. More typically, there is an element of surprise and something must be done, but there is no imminent danger.

2. Take a quick pause and gather your thoughts

What supplies or items do you need to help? Are those items within reach, or is it ok to leave the resident long enough to gather what you need? Will another person’s assistance be required, and do you have a way of getting their help immediately?

3. Consider the perspective of the resident, and use empathy to protect their self-respect

Seeing things from another’s point of view requires that you can understand what is happening for the other person. In caring for a person with dementia, this means knowing their skills and abilities, how they communicate, and what their preferences and habits are.

Communication may be with actions rather than words now, and an effective care partner will try to detect without making assumptions.

• What unmet needs were being conveyed or gratified? Could it be a need for sensory stimulation, curiosity without a sense of safety, loneliness? Could it have been an attempt to take care of something independently without the skill needed to complete the task? This is particularly true in situations that involve personal care, such as managing bowel movements.
• In dementia care, there is a tendency to believe that a person’s behavior is intentional, malicious, or spiteful when it is not. Have you ever felt sad and went to your spouse for comfort, or sat on the floor with your dog? What if you lived in residential care and believed that was your spouse in the next room, or that bed, when it was not?

4. Look in the mirror!

If you have a look of horror, disgust, or disapproval on your face, what does that convey to the resident? Does it match your words? Go for a judgment-free expression that says,?It’s ok, I’m here to help. Let’s work through this together.

5. What happens next?

If the first thing you do afterwards is dramatize the situation to a co-worker, how does that support the dignity of the resident? How do you empower that resident and respectfully support them if you can’t wait to share the story about what a mess they made or what you saw when you walked in the room?

How would this be different if this was your family member? Would you highlight their faults and mistakes, or smooth over their errors in a forgiving way, knowing that they are doing the best they can?

Think about how that would feel if you were the resident rather than the care partner.?Wow, this person really cares and is here to help me, not make me feel like an idiot that can’t do things anymore. Now there’s a different message when it comes to personal dignity!

Conclusion:

Equipping staff for the inevitable?Oh my!?situations involves assessing the situation accurately, preparation, and using empathy and understanding.

What challenging situations do your staff face, and how do you equip them to support the dignity of the residents they care for? Give your staff the training to?respond, not react?to those scenarios, and note how much the quality of care changes in your community!