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We will help you navigate
the aged care placement maze.
For many years, the design of aged care
facilities has seemed to be dictated by staff and administration considerations
rather than the needs of the residents. Consequently, many of the older facilities
have a sterile and institutional feel.
|Home Like|| |
the food, language, culture and ambience reflect the residents previous home
the colour scheme, fittings and furnishings in accord with the residents previous
too bright (glare and shadows) or too dark|
reverberating sounds, possibly best to avoid large (intrusive) public address
specific units are usually between 6 to 15 residents|
doors, electronic tags (if needed)|
to view most important areas (bedroom, dining room, toilet) from community areas.
Avoid long corridors, many corners to navigate|
no distracting patterns, no steps|
signage, wheelchair access, grab bars|
than one needed, different sized and comfortable chairs, TV, radio, video|
for both community and individual meals|
paths, seats, security, shade, garden features (japanese garden, fountains)|
social and activity program, community (school groups, church) and carer involvement|
about continuing training for staff, note involvement of staff with residents
and staff attitudes|
Nursing homes should be designed to reinforce orientation and to be cheerful; they should provide regular low-stress activities and minimal new stimulation. Such measures can help by giving patients a sense of some control and personal dignity.
Large calendars and clocks and a routine for daily activities help reinforce orientation; medical staff members can wear large name tags and repeatedly introduce themselves.
Changes in surroundings, routines, or people should be explained to patients precisely and simply; nonessential procedures should be eliminated. Patients should be given time to adjust and become familiar with the changes. Telling patients about what is going to happen (eg, about a bath or feeding) may avert resistance or violent reactions.
Frequent visits by staff members and familiar people encourage patients to remain social. The room should be reasonably bright and contain sensory stimuli (eg, radio, television, night-light) to help patients remain oriented and focus their attention. Quiet, dark private rooms should be avoided.
Patients with dementia are susceptible to muscle disuse atrophy, which can be delayed by adequate physical exercise and nutrition. A regular, supervised exercise program (eg, 15 to 20 min/day of walking) is recommended. Exercise can reduce restlessness, improve balance, maintain cardiovascular tone, help improve sleep, and reduce frequency and severity of behavior disorders.
Mental activities, usually focused on the patient's interests before the onset of dementia (eg, current events, reading, art), should be encouraged. These activities should be enjoyable and provide some stimulation, but they should not involve too many choices or challenges nor be used as tests of mental function.
Occupational therapy helps maintain fine motor control; music therapy provides nonverbal stimulation. Special effort may be required to ensure continuing interaction, with the same people if possible (eg, with family members or friends when available, with people in support groups, or otherwise with adult day care or companion services workers).
Group therapy (eg, reminiscence therapy, socialization activities) may help maintain conversational and interpersonal skills. Behavior disorders are best treated with individualized behavioral interventions, rather than with drugs. However, frank psychotic symptoms (eg, paranoia, delusions, hallucinations) should be treated with antipsychotic drugs, started at a low dose.
Patients must be carefully monitored for adverse effects. Because dementia is a strong risk factor for other problems (eg, falls, urinary incontinence), prevention and treatment strategies for these problems should be implemented.
Aged Care Connect pty ltd
1300 884 850
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