Reflection: Communication with Dementia Patient

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REFLECTION: Communication with Dementia Patient

During my rotation in Care of Elderly on Sarratt Ward, WGH, we once had a patient with severe dementia. She came in with a chest infection and had been unwell for two weeks and therefore not mobilized during that period of time. Previously she was walking with supervision of one. She was living in a residential home and for her to be able to go back there she was expected to be able to walk again with minimum assistance of one.

The nursing staff reported that her chest infection had resolved and she was now more alert. They did get her out of bed but with lot of difficulty, as she would not follow any instructions or commands.
The first time I saw her I had the rehab assistant with me. We were going to assess her ability to walk. I together with the rehab assistant tried to get her to walk, but we were not able to convince her to even stand from sitting in the chair. I explained to her that if she wanted to go back to the residential home she will have to practice walking with us, but she just looked at me and didn’t seem to respond to that. Both the rehab assistant and I tried to convince her by explaining in different ways but she just wouldn’t get up. After 20 minutes of trying we gave up.

Later that day I discussed the dementia patient with my supervisor. I told her about my failed attempt. My supervisor suggested that I use one or two word commands such as “stand up”, “lets walk”, “stop”, “turn” etc, instead of long sentences or explanations. She also advised me to use physical prompts together with the verbal commands to guide the patient to do what I wanted her to do.

Next day when I saw her together with the rehab assistant we went up to her and we introduced ourselves to her again, but instead of explaining to her of what we wanted her to do I just said “stand up” and gave her a physical prompt

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