Dementia Behaviour Management Advisory Services

1. Dementia Behaviour Management Advisory Services Supporting workers • Advice • Information • Referral Helping Australians with dementia, and their carers

2. Partner logo here Helping Australians with dementia, and their carers

3. Partner logo here How we Perceive the Environment as we Age This happens to us all! Vision: • Begins to reduce in your 40’s • Lens yellows • Impact of disorders such as cataracts and glaucoma Impact on Function: • Mobility • Colour perception and glare • Night vision Helping Australians with dementia, and their carers

4. Partner logo here How we Perceive the Environment as we Age Hearing: • Generally a gradual decrease which can start in your 20’s • High frequency sounds go first Impact on Function: • Irritable isolation • Misperception • Socially vulnerable Helping Australians with dementia, and their carers

5. Partner logo here How we Perceive the Environment as we Age Taste and Smell: • Number functioning taste buds decline from about 50 • Number of smell cells decrease from about 60 Functional Impact: • Nutritional risk from loss of interest in food • Safety risk from not detecting odours such as gas leaks etc Helping Australians with dementia, and their carers

6. Partner logo here How we Perceive the Environment as we Age Cutaneous Senses: • Pain threshold rises with age • Greater sensitivity to cold • Sweat less and decreased sense of thirst Impact on Function: • May not complain of pain until condition advanced • Predisposed to hypothermia • Vulnerable to dehydration Helping Australians with dementia, and their carers

7. Partner logo here The Shrinking Environment of the Person with Dementia • With the progress of dementia, the persons awareness of the world shrinks from A to D Helping Australians with dementia, and their carers

8. Partner logo here The Shrinking World At A: • The person loses “connection” with the wider world, including distant friends or relatives not seen frequently. Projects or activities that are not particularly meaningful are not pursued • Relationships with family and friends are maintained Helping Australians with dementia, and their carers

9. Partner logo here The Shrinking World At B: • The person fails to recognize the layout of close family members house or recognize new grand children. A project in the shed seems to be ignored. • Relationships focus on those with close family and friends Helping Australians with dementia, and their carers

10. Partner logo here The Shrinking World At C: • The person fails to recognize the layout of their own home or close friends. Skills for daily habits such as doing the newspaper crossword, fail • Relationships focus on a deeper dependence on close family Helping Australians with dementia, and their carers

11. Partner logo here The Shrinking World At D: • The person is unable to recognize their closest family. The world that is perceived and acted upon is only that that is within reach • Relationships demonstrate a dependence on the caregiver and the environment must now in many ways be brought to them Helping Australians with dementia, and their carers

12. Partner logo here A “Person in TheirEnvironment” Model • The Environment • Social: • Human contact • Meaningful activity • Safety and supervision • Individual approach and flexibility • Optimal stimulation • Physical: • Homelike • Appropriate cues • Options eg. privacy vs interaction • Safety • Optimal stimulation • The Person • Is made up of: • Input from the • senses • Basic human needs • Individual needs • Their “story” Helping Australians with dementia, and their carers

13. Partner logo here Impact of Imbalance • If there is an imbalance between the person and the environment in which they live, then their ability to function in that environment is decreased. • The greater the imbalance the greater the potential for dysfunction. This will show up as: • Decreased Well Being both residents and staff • Increased behaviours of concern • Difficulty with completing meaningful activity • Reduced independence Helping Australians with dementia, and their carers

14. Partner logo here Environmental Changes that Decrease a Persons Function Social Environment: • Lack of meaningful human contact • Lack of an individual approach • Inflexible rules • Lack of structure • Over or under concern with personal safety • Reduced access to meaningful activities Physical Environment: • Poor lighting • Too much noise/echo • Poor seating • Poor architectural design • Limited sensory experiences • Sensory overload • Change to unfamiliar environment Be mindful of the interconnected nature of things Helping Australians with dementia, and their carers

15. Partner logo here SomeBehavioural Impacts of a Poor PhysicalEnvironment • Poor Orientation • “Wandering” and “Intrusiveness” • Resistiveness to care • Lack of social engagement • Agitation and Aggression • Reduced sleep Helping Australians with dementia, and their carers

16. Partner logo here Orientation, Wandering and Intrusiveness Impacted By: • Poor Signage • Positioning of Signage • Poor lighting • Lack of cues to outside world • Unclear about use of a room/space • Lack of options for places to stop • Poor Seating Helping Australians with dementia, and their carers

17. Lighting & Glare Issues Helping Australians with dementia, and their carers

18. Lack of Signage Helping Australians with dementia, and their carers

19. Partner logo here Orientation, Wandering and Intrusiveness Can be assisted by: • Well thought out seatingplacements and options • Clear well placed Signage • Culturally specific signage as needed • Appropriate clocks and Calenders • Clear day by day information • Clear boundaries Helping Australians with dementia, and their carers

20. Good Signage Helping Australians with dementia, and their carers

21. SimpleCalenders Helping Australians with dementia, and their carers

22. Culturally Specific Signage Gabinetto Helping Australians with dementia, and their carers

23. Clear Boundaries Helping Australians with dementia, and their carers

24. Partner logo here Resistiveness to Care Impacted By: • Poor contrast in Bathroom • Unclear about use of the room • Temperature • Poor Cueing • Lack of Comfort Helping Australians with dementia, and their carers

25. Poor contrast in Bathroom Helping Australians with dementia, and their carers

26. Partner logo here Resistiveness to Care Can be assisted By: • Coloured toilet seats • Contrasting shower curtains , towels and bath mats • Recognizable taps, fittings • Ensuring space to move • No echoes • Warmth • Sense of Luxury Helping Australians with dementia, and their carers

27. Good Contrast & Cueing Helping Australians with dementia, and their carers

28. Improved Comfort Helping Australians with dementia, and their carers

29. Partner logo here Lack of Social Engagement Impacted By: • Poor Signage • Positioning of Signage • Lack of cues to outside world • Unclear about use of a room/space • Poor seating and seating arrangements • Poor access to activity • Too much clutter Helping Australians with dementia, and their carers

30. Partner logo here Lack of Social Engagement Assisted by: • Imaginative use of mobile décor such as cushions & rugs • Well placed and variety of seating options • Safe access to outside with attractive view to draw out • Selection of accessible “activities” • Site line to draw you to the “place to be” Helping Australians with dementia, and their carers

31. Access to Activity Helping Australians with dementia, and their carers

32. Partner logo here Agitation and Aggression Impacted By: • Poor Signage • Positioning of Signage • Lack of cues to outside world • Unclear about use of a room/space • Difficult to interpret clutter Helping Australians with dementia, and their carers

33. Partner logo here Agitation and Aggression Assisted By: • Understandable environment • Meaningful activity • The use of sanctuary • Soothing sound Helping Australians with dementia, and their carers

34. Partner logo here Calm Helping Australians with dementia, and their carers

35. Partner logo here Reduced Sleep Impacted By: • Room Layout • Lighting • Noise • Lack of Familiarity • Temperature Helping Australians with dementia, and their carers

36. Partner logo here Reduced Sleep Assisted By: • Cosy Room • Sight lines • Familiarity • Music/sound • Controllable lighting Helping Australians with dementia, and their carers

37. Partner logo here GoodSleep Helping Australians with dementia, and their carers

38. Partner logo here Requirements for Change • Ability to be pleased with small victories • Persistence • Sense of humour • Creative problem solving • Bring someone along with you to keep you sane Helping Australians with dementia, and their carers

39. Partner logo here AND FINALLY…………..A few things you can do without hiring an ARCHITECT • Have residents make their own door name plates • Make cushions and throw rugs in craft groups • Get the blokes to sand and stain an old bookcase to put activity boxes on • Regroup the furniture Etc Etc Etc…………. Helping Australians with dementia, and their carers