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PERSONAL HYGIENE IN PWS

PERSONAL HYGIENE IN PWS. September 2017 Susanne Blichfeldt MD. Denmark. TO HELP. From S ø ren Kirkegaard . DK ( 1813) In short : To help another person you need to understand more than he does, but first of all you need to understand what he understands. Otherwise you cannot help.

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PERSONAL HYGIENE IN PWS

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  1. PERSONAL HYGIENE IN PWS September 2017 Susanne Blichfeldt MD. Denmark

  2. TO HELP • From SørenKirkegaard. DK ( 1813) In short: • To help another person you need to understand more than he does, but first of all you need to understand what he understands. Otherwise you cannot help. • Do you really want to help ? Or is your wish to be admired for your knowledge ? • All help starts with humiliation ! • To help is not to rule but to serve • Patience is needed • And, You have to accept that perhaps you are wrong

  3. GOOD HYGIENE IS IMPORTANT • To avoid infections • To prevent and avoid diseases. • This is known for more than 200 years • To look nicely • To smell nicely • Important for yourself, your health, • For your personal contacts

  4. PWS and HYGIENE • IMPORTANT : To look nice and avoid diseases • DIFFICULT in PWS: when you: • do not understand the problem ( understanding) • do not sense or feel when to act (sensation) • do not know how /what to do ( plan and act) • do not know how / when to stop when started • create own rules and ideas, difficult to change

  5. PWS: Understand the importance • Many do not understand, but perhaps know, are taught, the consequence of poor hygiene • To really understand the question it demands the ability of abstract thinking: • About infections and diseases • To imagine the reactions of others • So: having PWS you need practical guidance

  6. Sensation difficulties in PWS • When is my body warm and cold ? • Which type of clothes to choose ? • Where is my body… and where are you? • Where do I place myself in front of you ? • How tall, how broad, am I ? • The length of arms and legs etc.

  7. What is difficult to do • Abstract thinking and to plan what you are toldto do, can be impossible. (PWS) • Ex .” Oh you have some dirt on your elbow, please go to the bathroom and wash it, and: • Take care that you do not wet your clothes. Come back in two minutes, we are leaving in 5 minutes” • This message has 6 oral messages • …. and no pictures, so for some: impossible

  8. Understand instructions • What is only told is often difficult to understand • Pictures and drawings can help • Timers can help to structure and limit time • We have to be there until it is learnt • Example: • “ I really did tell him what to do. and he did the opposite…..and he had said he understood “… why…. ?? • He did not want to hurt you, he hoped to be praised, • but the result was the opposite. Who is responsible?

  9. Own rules • People with PWS need structure and limits • When we do not give structure, many try to create it themselves. • When we then try to change their own rules, without doing it clearly enough, crises arise • Routines are difficult to change, if not understood, he/she feels uncomfortable and afraid.: Security and control is taken away

  10. What to do • To help… need to understand and put yourself in the place of the person with PWS • When we know and understand it is easier to help. Because it is difficult to understand and learn: start early and create routines that can be used always, and prepare changes ahead of time

  11. DAILY ROUTINES • Brushing teeth • upper jaw > left to right. 1 min. • lower jaw same • Washing hands • amount of soap and water? • Drying etc. How much time ?

  12. The shower • Hair and Body • How to start, the amount of soap • Amount of water. Temperature of water • When to stop • How to dry? • Use pictures and timers • Evt. a photo of the person himself doing it

  13. Clothes • Underwear change every morning • Prepare in the evening for next day (clothes) • Usepictures ( if it is difficult) • Use standards for: rain • snow • sun • someneedrules for +/- a jacket. • Whichtemperatureif, they do not feel warm

  14. Cleaning and tiding • Show and be there the first times • All things have a fixed place in the room • Tiding and cleaning is done systematically • Same procedure each time if needed

  15. Conclusion • Personal hygiene can be difficult for adults: • Poor understanding of the reason • Poor body imagination • It is difficult to plan and finish a procedure • Expectations are often (too) high, • Often too little help and understanding is given • They try their best, but cannot • Worst cases: blaming and conflicts

  16. Final conclusion • Routines • Guidelines • Individual support • Stop the conflicts • Help the one with PWS to become successful • It is possible with the right help and support

  17. Start early

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