Transcript Aging in Place - A Strategy for Caring for People with

Aging in Place A Strategy for Caring for People with
Intellectual Disability and Dementia
Partners in Care… Living in the Moment
March 6, 2007
Leslie Udell
Program Co-ordinator
Winnserv Inc.
Degree of Commitment to
Supporting Individuals
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Educating Board of Directors
Development of agency policies
Recruitment and education of new
board members
Accessible/Dementia Friendly
Housing
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Environmental considerations
Evaluating current housing
Considerations for people living in
apartments or on their own
Admission and
Discharge Criteria
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Dealing with individual’s actions and
reactions to the symptoms of Alzheimer’s
disease
The impact of significant health concerns
Supporting people who have the need to
wander
Supporting people who are living
independently
Considerations for a death at home
End of Life Care Policies
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Benefits and steps to planning ahead
Planned death at home
Advanced Care Directives, DNR orders
Funeral planning
Bereavement support
Assessment
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Documentation of decline
Gradual onset and continuing cognitive
decline
Atypical actions and reactions
Late onset seizure activity
Diagnosis and Misdiagnosis
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Detailed medical history
Thorough physical and neurological
exams
Psychiatric examination
Pharmacological review
Assessment Tools
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Videotaping
Vineland Adapative Behavior Scales
Inventory for Client and Agency
Planning (ICAP)
Scales of Independent Behavior
Adaptive Behavior Scale – Residential
and Community
Specialized Dementia Scales
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Dementia Scale for Down Syndrome
(DSDS) -Gedye
Dementia Questionnaire for Mentally
Retarded (DMR) – Evenhuis et al.
Assessment for Adults with
Developmental Disabilities (A.A.D.S.) –
McQuilliams, Kalsy, Oliver & Hall &
Generic Tools - Mini Mental
Change in Focus of
Supports Provided
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Maintaining skills
Stabilizing the environment
Minimizing choices
Giving reassurance
Personal care
Assessing and meetings medical needs
Meaningful activities
Supporting Families
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Provision of information
Planning and directing care plans
End of life decisions
After the death
Staff Levels and Training
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Appropriate levels of staffing
Dementia specific training
Maintaining and preserving skills vs.
learning new skill
Pain recognition and management
Addressing concerns about reactions and
actions related to the disease
End of life care, the dying process and
grieving for themselves and roommates
Provision of Personal Care
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Body mechanics
Use of equipment
Assistance for eating and drinking
Issues of incontinence
Support for Grieving
and End of Life Care
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Support teams for staff and roommates
Pastoral care for families, staff and
roommates
Staff discussions around their beliefs and
concerns
Families values and beliefs around death
and dying
Utilizing hospice and palliative care
Arrangements for final farewells
Disclosure of Diagnosis
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Do you tell the person that they have
dementia?
Consideration of policies on disclosure
Do you tell roommates about the
diagnosis?
Understanding the Disease
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How do you explain Alzheimer’s
disease to the individual and their
friends and roommates?
Fostering acceptance and addressing
concerns
Death, Dying and Grieving
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Rituals
Repeated grieving
The many faces of grief