Demetia Advice.

This subject would need a whole forum on its own but I thought others might find it useful to know a couple of things I've learned over the years that really helps when looking after a person who has dementia. I personally think dementia care is one of the hardest to do, though I also believe they can be the most rewarding also BUT it does take a certain time of carer and in ten years I've worked out it's usually one in ten carers so quite a low figure. It can be mentally draining listening to the same conversation day in day out and dealing with challenging behaviour so over they years I've developed a few tips which I hope others will be able to implement with their dementia clients.

One of the most valuable tips I can offer is validation, validation, validation!! Explain everything you'd like to do (for example "OK Rose, I am just going to brush your hair for you") and repeat it often during the procedure. Keep offering reassurance, speak in a calm voice and validate everything you do. This is a VERY laborious procedure and it takes time and LOTS of patience but it really does work rather well.

I have always found, without a single exception, that animals are a fantastic 'therapy' for dementia clients. Cats are perfect and the most preferable as they never object to being stroked but dogs work well too in a client's home. Another great therapy is a zoo or a working farm - people with dementia really do respond brilliantly to animals, I have known people with incredibly poor short term memory still be talking about meeting the horses and ducks weeks later!

Every dementia client I am assigned to, I always introduce a memory book - these are 'scrap' books of sorts and will contain photographs of family members past and present with a little bit written by each photograph - for example THIS IS ROSE, MY DAUGHTER - these little notes serve as a reminder and offer validation to the client. I also put in information about their working lives, the hobbies they enjoyed, etc. They work very well and you can also have some great fun putting them together! I usually make it a therapy with the client - get some pritt stick, some stickers, a marker pen, some pictures/photographs, a bit of glitter (I am a big fan of using different textures) or velvet and fill a scrap book or even a photo album. It will be a 'guide' that the client can look at and be used as a reminder for them. Sit down and talk with the client about what's in it - they love to reminisce.

GP's tend to not really know what to do with dementia patients and will often be put under pressure by family members and/or carers to medicate them for a quiet, easy life. A frighteningly common scenario is the prescribing of a drug called Quetiapine. In 2005 the BMJ issued a stark warning against using this drug in people with Alzheimer's - it was proven to worsen their condition yet it is still one of the first medications a GP will often prescribe. The usual dose is 25mg three times a day. It is now widely accepted amongst dementia specialists that this drug should NOT be used so if it is being, please please speak to the GP and get it changed to a more broad tranquiliser. Quetiapine is for use in Schizophrenia NOT Alzheimer's - it can result in incontinence, muscle weakness (prevents mobility), and increased confusion.

Make sure the client is under the care of, and regularly seeing the Community Psychiatric Nurse. A referral to see one will need to be made via the client's GP. CPN's are an excellent resource to have around and are always fully up to date with the latest therapies and drugs so please make sure ther's one on the scene!

If possible, try and get the client assessed by Social Services so they can attend a Dementia Day Centre - the social interaction is wonderful and incredibly therapeutic. These range in availability around the Country and obviously in larger towns and cities will be more accessible - in some instances they're open five days a week, in others one day or half a day a week. At some of them the client can be bathed or participate in various therapies such as art, massage etc. They are a wonderful facility and must be utilised wherever possible.

I am sure there's other things I can post and as they become available I'll add them to this thread! I hope they help!