Neurocognitive Disorders and Delirium Interventions

Delirium Interventions

reorientation

cognitive anchor

routines

polysensory stimulation

positioning

cognitive stimulation

care partner training

correction of sensory deficits

Reorientation

orientating client to time, date, location, etc.

ex: install clocks wand calendars in rooms

Cognitive Anchor

things that help our brains connect with out communities and feel secure

F: friends, family, favorite things, familiar things

Routines

sleep/wake cycle

physical activity

meals and hydration

BADLs

Polysesnory Stimulation

intense external stimulation with an objective of increasing the patient’s level of alertness

only used with hypoactive symptoms

Positioning

use of devices and adaptations to precent edema and bedsores on vulnerable body parts

Cognitive Stimulation

cognitive exercises

sequencing cards and games

Care Partner Training

trading family members

Correction of Sensory Deficits

encouraging patients to use glasses or hearing aids

Cognitive Oriented and Psychosocial Approaches

behavioral therapy

cognitive therapy

CBT

behavior modification and activation

memory training

visual imagery

story telling

memory aids (internal and external)

journaling

MCI Interventions

exercise and physical activity

diet

music

dance

social activités and connections

medication management

External Aids

carry small notebook (reminders, notes, directions, etc)

leave messages on your answering machine

use a calendar to track your scheduled appointments

write reminders with a dry erase marker on bathroom mirror

Internal Aids

pay attention and really focus on material you want to remember

rehearse information and test yourself

use relaxation techniques before trying to remember things

crease a visible image or personally meaningful association when trying to remember names and faces

put easily misplaced items in a visible “memory spot” every time

organize lists you want to remember

break lists into smaller chunks or groupings

Early Stages of Dementia Interventions

educating client, family and caregiver on disease

impact on occupation

planning for future needs

look at available resources

establishing a consistent and predictable routine is critical

used of a compensatory approach

Middle Stages of Dementia Interventions

continued problem solving on how to maintain independence

over learning task to preserve habits and routines (except for driving)

identifying at risk drivers and helping caregivers develop and reinforce a plan for driving cessation

sleep and rest

minimizing fall risk and implement safety measure

managing behavioral expression and responsive symptoms

caregiver education

leisure and social opportunities

Late Stages of Dementia Interventions

maintaining quality of life, dignity, choice and self determination

preserving routine and valued occupations

strutting the environment to allow appropriate sensory stimulation as well as tp promote safety and independence

family and caregiver education

gentle stretching and ROM exercises to prevent secondary impairments

effective strategies to manage challenging behaviors

support services for caregivers

Specific Approaches

if you want to seek out speciality training or adopt a protocol at your workplace

Strategies

tips and strategies to try to address concerns or challenges that come when working with persons who have major NCD

4 Categories of Activities

productive activity

leisure activity

self care activity

rest and restoration activity

Productive Activity

paid or unpaid

feeling you make a difference

Leisure Activity

passive or active

activities that are pleasurable

Self Care Activity

big or little

taking care of body, brain, world, etc

Rest and Restoration Activity

recharging your battery and regaining energy

Positive Approach to Care (PAC) or Snow Approach

positive physical approach (PPA)

hand under hand (HUH)

Positive Personal Connections (PPC)

Positive Action Starters (PAS)

Positive Physical Approach (PPA)

6-9 step method used to approach and connect with a person living with dementia

Hand Under Hand (HUH)

utilizes the remaining muscle memory of a person living with dementia to offer comfort and initiate activity

Positive Personal Connections (PPC)

5 phrases that help care partners connect with the person living with dementia before jumping into the task

greet (introduce yourself and use their preferred name)

compliment (indicate something about them of value)

share (first about you, then leave a blank)

notice (point out something in the environment)

seek (explore a possible unmet like, want or need)

Positive Action Starters (PAS)

5 phrases that help care partners receive less resistance and refusals when getting started with a care task

help (be sure to compliment their skill in this area, then ask for help with something)

try (hold up or point to the item you would like to use, possibly sharing in the dislike of the item or task)

choice (try using visual cues to offer 2 possible or 1 choice with something else as the other option)

short and simple (give only the first piece of information, maybe offer a time frame of 1-5 minutes)

step by step (only give a small part of the task at first)