Long-Term Care Survey Alert
Reframe Cognitive Impairment To Help CNAs Provide Better Dementia Care
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These simple steps can improve quality of life for residents and staff. Perception is everything, and there are a couple of ways to quickly give frontline caregivers a new way to view residents with dementia and to care for them. To help caregivers understand that an elderly resident is cognitively functioning at the age of a young child, consultant Lynda Mathis, RN, with LTC Systems in Conway, AR, likes to use the Functional Assessment Staging (FAST) tool, which is designed for people with Alzheimer's disease to identify their functional capacity. The FAST scale includes 16 stages and sub-stages, ranging from a normal adult to one with severe Alzheimer's disease. (View the tool at http://ec-online.net/Knowledge/articles/alzstages.html.) You can also use the Reality Comprehension Clock Test for anyone with dementia to determine their functional age (for details, go to http://www.clocktestrcct.com). Tip: Mathis notes that most CNAs have experience with children. Thus, if they know that a resident has the cognitive reasoning power of a three- to-five-year old, they can apply that experience in knowing how to assist and protect the person. She also likes to teach people to use the "best friend" approach based on a book, The Best Friends Approach To Alzheimer's Care, by Virginia Bell and David Troxel. The book encourages caregivers to ask how they'd approach a person needing help if that person were their best friend, Mathis relays. And "what would you do if your best friend forgot how to tie her shoes or got lost? You'd say, my friend Sally is having a bad day. I'm going to help her." Sometimes it helps to "take off your clinical hat and forget the fancy diagnostic name for a person's condition," and instead talk about someone being a "best friend" or "lost child" who needs help, Mathis says. That approach taps into compassion and energies that almost everyone has, she adds. "We all want to help people or we wouldn't be in this business."
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