It should not be assumed that nursing homes will necessarily have adequate behavioral management programs. In fact some homes specifically forbid behavior modification despite evidence that such programs can offer very effective and humane means of managing behavior problems. The absence of such programs generally indicates a lack of personnel trained in behavior modification principles, indeed, it is important that behavior modification programs be monitored by a licensed psychologist or other mental health professional specifically trained to administer them. Although some nursing homes are beginning to establish such programs and institute staff development needs, there remains a gap between what is being provided and what is needed. Many homes continue to depend on outside sources for assistance in providing specialized programs for their staff.
Practical and useful education programs are required for those staff members assigned to work with the Alzheimer patients. Coping with behavioral problems of Alzheimer patients requires skill, commitment, understanding, and patience. The staff must be willing to adjust to patient needs and change the programs and the environment to accommodate patient requirements rather than try to change the behavior patterns.
The lack of knowledge regarding the intellectual impairment caused by the disease and its various phases presents the staff with a great number of management problems. A basic fact that all staff should understand but often do not, is that Alzheimer’s disease does impair memory, reasoning, judgment, and orientation-and it is irreversible. The nursing home staff also needs to be trained in how to handle such symptoms as depression, confusion, bewilderment, and emotional instability.
Training of staff members should be an ongoing process. This can be accomplished by using the various phases of the disease as guideposts for planning and conducting training sessions and in-house workshops. The staff needs to know what takes place in the life of the patient in the prediagnosis period. This provides an opportunity to link the patient’s present behavior with previous patterns of behavior. For example, in one nursing home, the nurses were having a very difficult time getting one of their favorite patients to wear shoes. Much time and effort was expended getting Mr. R. to put on his shoes. When staff discussed this problem with his wife, it was learned that he never wore shoes at home throughout their forty years of marriage. Understanding previous behavior certainly facilitated their understanding of his present behavior.
Knowledge of the patients’ general decline will help staff members better understand the drastic changes that have already taken place in the lifestyle of the patients and their family members. The last two phases, severe memory loss and total collapse of self-management skills, are usually the point where nursing home staff enter into the life of the patient. Special training regarding these crucial periods is essential if the staff is to understand and improve its skills in working with the patients, their families, and the larger community.
Tags:alzheimer patients, behavior modification programs, behavior patterns, behavioral management, emotional instability, intellectual impairment, Medical Aspects, mental health professional, nursing homes, patient needs patient requirements
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