Dementia care


Laying the foundation To enable a resident living with dementia to be able to move around a facility like an able-bodied person they need to be cared for in a well-designed facility,17 where it feels like a real home with room for personal items that bring back fond memories. The facility needs to have sufficient space for an ergonomic working environment, supporting the resident’s quality of life, carer safety, operational workflow and financial efficiencies.18 A functional assessment tool,19


can


be used to assist facilities and carers to identify the needs of residents for whom they provide care. This tool can support decisions related to activities of daily living throughout the day,20,21


a combination of environment, equipment and care skills.


Calming sensory experience As people with dementia experience a progressive loss of cognition, the majority develop distressing behavioural and psychological symptoms of dementia (BPSD).22,23


It is recognised that the use


of non-pharmacological interventions such as cognitive therapy, aromatherapy and multisensory therapies can have a positive effects on BPSD, activities of daily living and quality of life.24 One such intervention, is the use of a multisensory rocking chair.25


A recent


international survey was conducted to understand how the Wellness Nordic Relax Chair was being used and its impact on care home residents.26


The study


found how the rocking motion and the use of music could support one to one interaction, reduce moments of friction and provide seamless care, which could support activities of daily living. 27, 28, 29


Empowering mobility A person living with advanced dementia is


space.34 The purpose of proprioception


is to control force by grading muscle contractions, allow limbs to move in sequence such as walking and maintain upright posture.35 For dependent residents, a combination


of bed articulation, mattress immersion and envelopment, a modular positioning system which provides proprioceptive stimuli, may help to reduce paratonia, contractures and pressure ulcer formation.36


The same approach could


be considered when supporting different activities of daily living throughout the day.


considering


at risk of developing high muscle tone and paratonia.30 This is a form of hypertonia often associated with difficulties in positioning and daily care that can have a profound impact on physical health and care needs.31, 32 Due to the deterioration of the


neurophysiological subsystems associated with motor, sensory, autonomic, cognitive, or behavioral pathways, there is a link between reduced mobility, pressure ulcer incidences and dementia progression.33


Proprioception


refers to an individual’s awareness of joint and body movement and their position in


Pressure ulcer prevention Pressure ulcer prevention requires an organisational and multi-disciplinary approach. Guidelines recommend early risk assessment and consideration of sub-epidermal moisture measurement as an adjunct to routine clinical assessment.37 Early interventions such as an


appropriate support surface, microclimate management, wound care and the implementation of safe handling techniques would support an integrated approach.38


Reduced mobility


is a significant risk factor for pressure ulcer development, international guidelines emphasise the need for regular repositioning, which can help prevent skin damage. 39 The use of appropriate equipment,


postural changes and best practice care skills can result in a reduction in work related injuries40,41


decrease in shear and friction42


and a potential on


March 2021 • www.thecarehomeenvironment.com


41

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