Healthcare Training Institute - Quality Education since 1979
Psychologist, Social Worker, Counselor, & MFT!!

Section 1
Track #1 - Introduction

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Welcome to the Home Study Course sponsored by the Healthcare Training Institute, homestudycredit.com.  This course deals with Treating the Aging Client with Dementia.

Our primary intent for this home study course is to provide quality education to foster your professional growth.  The Institute has provided quality education since 1979.
 
We appreciate that you have chosen us as a vehicle for you to earn your Continuing Education Credit.

The purpose of the course is to assist you in increasing your knowledge regarding how to treat patients, clients, etc. dealing with teenage addiction.  As each case study is given, if the concepts seem to be applicable to your situation, I encourage you to turn your CD player off and make a few notes regarding the application of the principle to your setting.  However, these notes are for your purposes only and are not to be sent to the Institute.  Also each track is very content dense.  So feel free to replay the track to review the content either for your own purposes, or if you feel appropriate play the track in an individual or group session for client education.  Also permission is granted to reproduce this CD.  We encourage you to duplicate give copies of this CD to colleagues, clients, etc. as you deem appropriate. We feel the information on our CD's is valuable.  Thus, we have an interest in distributing CD's in as many ways as possible, to benefit the greatest number of people, who have a need and are receptive to this practical information.

The questions in your Answer Booklet are sequential and deal with the section of content that preceded it.  For this reason, to facilitate the answering of each question, you might read the question from the Answer Booklet prior to listening to that CD track.  By knowing what the question is ahead of time, you will then know the content to listen for that contains the answer.  So just a hint, after you write down the answer to a question in your Answer Booklet, read on to the next question in order to give you a “heads up” to listen for the content that contains the answer to the next question.

Merely write the correct letter on the corresponding blank line in your answer booklet. Each answer is only used once. Keep in mind there is nothing trick or hard about these questions.  They are merely intended to verify the playing of this CD.

For the purpose of brevity, most generally, I will use the term “therapists” or “mental health professional.”  However, don’t let these terms deter you from applying the concepts to your situations.  When you hear the word “therapists,” if your job title is social worker, psychologist, marriage and family therapist, mental health counselor, professional counselor, resident director, program assistant, etc. merely substitute the appropriate term that is the most meaningful to you. In short, don’t let my use of the term “therapists” cognitively set you off track from hearing the content because your job title is school counselor, for example.  I will also use the term “client” for the purposes of brevity.  However, if you deal with patients, residents, students, consumers, etc., transpose “client” for the term that is the most meaningful to you in your work setting. 

On this CD set we will discuss such topics as: positive interaction techniques, managing difficult behaviors, catastrophic reactions, excess disability, care for the caregiver, non reality based communication, and cognitive retraining.

So  let’s get started.

On the rest of this track we will discuss positive interaction techniques which can be used by the caregiver of an elderly person with Alzheimer’s.  Included on this track are four basic rules for positive interactions.  The four basic rules for positive interactions discussed on this track are stay pleasant, calm, and reassuring, help maintain self-esteem, use simple sentences, and use nonverbal clues.

I have found that positive interaction techniques are productive in helping an elderly person with Alzheimer’s understand what is being communicated.  Would you agree that as a patient loses the ability to communicate with words, he or she may still understand nonverbal cues?

#1 Stay Pleasant, Calm, and Reassuring
An elderly person with Alzheimer’s may mirror the caregiver’s feelings.  To gain productive results, the caregiver may need to stay pleasant, calm, and reassuring.  Jeff’s father, Howard, age 83, had slowly lost most of his language skills with the progression of Alzheimer’s, however Howard’s expressive aphasia was not yet complete.  For example, Howard would try to tell Jeff something and be unable to say the word he wanted.  He then would then get frustrated, which resulted in having more trouble speaking.  Howard had the most trouble with nouns and adjectives.  Specific names and descriptive words eluded him.  When Jeff was helping him dress, Howard would try to tell Jeff that he wanted to put on his brown shirt, but he would lose the words.  Or, Howard would use the word ‘bath’ to fill in the blank for a word he could not say.  For example, Howard might state, “I want to put on my brown bath.”  Howard knew that he wasn’t communicating clearly, but he did not know why.  After gesturing at his torso, Howard had to wait for Jeff to understand.  Instead of showing his frustration or despair, Jeff would stay pleasant, calm, and reassuring.  Jeff stated, “It’s really hard to deal with my father sometimes.  But I just try to relax and treat him like I would want to be treated.  You know, that golden rule thing.”  Could the caregiver of the client you are treating benefit from receiving these reminders to stay pleasant, calm, and reassuring?  Perhaps you could play this track for him or her.

#2 Use Simple Sentences
Next, Jeff used simple sentences because they are easily understood.  However, you have probably experienced that oversimplification can lead to anger.  I find it best to speak to mildly impaired patients as normally as possible.  For example,  Jeff would guide Howard to the closet, pick a shirt, show it to Howard and state, “What about this one?”   At the other extreme, even the best communication techniques and use of simple sentences may not work with extremely impaired patients. Do you agree?

#3 Help Maintain Self-Esteem
In addition to staying pleasant, calm, and reassuring and using simple sentences, the third basic rule for positive interaction is to help maintain self-esteem.  Jeff knew he had to allow extra time for dressing and other tasks.  But when time was short, Jeff found that he could ease the process by helping maintain Howard’s self-esteem rather than getting impatient.  Jeff would simply get the appropriate clothes for Howard and state, “You always look great in this, Dad.”  Jeff would make sure Howard was looking right at him.  Howard saw the warm facial expression and smile.  Howard also heard Jeff’s calm voice.  By helping Howard maintain self-esteem, Jeff was engaging in a positive interaction instead of the more negative reaction which may feel more natural to the caregiver of a person with Alzheimer’s. 

#4 Use Nonverbal Clues
Jeff would also use other nonverbal clues.  Jeff would accompany his instructions to Howard with a hug or a gentle shoulder rub.  This usually worked because Howard interpreted Jeff’s actions as meaning he was not angry or impatient.  Howard felt that Jeff was simply making a suggestion.    Think of your Howard.  Could these techniques for positive interaction benefit your client?  Would it be helpful to play this track for the caregiver of your client?

On this track we discussed positive interaction techniques which can be used by the caregiver of an elderly person with Alzheimer’s.  Included on this track are four basic rules for positive interactions.  The four basic rules for positive interactions discussed on this track are stay pleasant, calm, and reassuring, help maintain self-esteem, use simple sentences, and use nonverbal clues.

On the next two tracks we will discuss managing difficult behaviors.  The next track will focus on analyzing behavior.  In order for the caregiver to continue with an ongoing assessment of the patient’s Alzheimer’s and associated behavior, I have found five steps which may be useful when analyzing behavior.  These five steps regarding analyzing behavior are deciding if the behavior is a problem, what the problem really is, with whom the problem occurs, where the problem occurs, and when the problem occurs.

QUESTION 1
What are four basic rules for positive interactions? To select and enter your answer go to Answer Booklet